Does Your Kid Need A Cholesterol Screening?
Getting your cholesterol tested used to be an over-40 phenomenon. Not anymore. A recent panel released recommendations which advocated the routine testing of children between the ages of 9 and 12 for elevated blood cholesterol levels. The National Institutes of Health (NIH) panel also recommended screening of high risk children between the ages of 2 and 6 years old.
Rising rates of childhood obesity, increased consumption of overly processed fast foods and sedentary lifestyles has created a trend towards early stage heart disease, and metabolic syndrome in children, diseases which rarely if ever were seen in children fifty years ago. In autopsies done on casualties of the Korean and Vietnam wars, atherosclerosis (hardening of the arteries) was seen in young men their late teens and early twenties. It became apparent that heart disease was no longer a disease of old men, and researchers starting looking at the effect of elevated cholesterol in younger adults on the subsequent development of heart disease.
It is now understood that atherosclerosis begins in childhood. This is the underpinning of coronary vascular disease (CVD) which appears in adulthood. Elevated levels of blood cholesterol seems to fuel both the atherosclerotic process and the development of heart disease. With this in mind, medical researchers have been tossing around the idea of testing children for cholesterol levels for the last twenty years.
In a soon to be published article in the August issue of Pediatrics the NIH panel's findings come under fire. According to Thomas Newman, MD and colleagues based at the University of California San Francisco, the panel's recommendations are overly aggressive, and driven by the conflicts of interest declared by some of the panel members. According to Dr. Newman, the panel chairperson and members disclosed an "extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments." Some of the companies which the panel members had associations with included Astra Zeneca, Pfizer and Roche, all of whom manufacture cholesterol-lowering drugs. Dr. Newman adds that "a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles.”
While the panel recommended the routine screening of children for cholesterol levels, it made no attempt to estimate the costs of such interventions. Such costs could rise into the billions of dollars. The benefit of starting such screening programs relative to the costs involved are unknown. Currently, approximately 10% of American children are thought to have unhealthy cholesterol levels.
Image courtesy of Laura Smith