Who knew you’d get two, count em TWO, blogs in one day! After I finished my earlier entry, I was reading the papers online and discovered that the AAP is recommending that all children over the age of 10 and children between the ages of 2 and 10 with risk factors for high cholesterol get fasting lipid screening tests done to assess total cholesterol, LDL (the bad cholesterol), HDL (the good cholesterol) and triglycerides. Risk factors for early screening are being overweight (>85th %ile for BMI), having diabetes or high blood pressure, having a family history of high cholesterol, having a male relative with a heart attack before age 55 or a female relative with a heart attack before age 65.
To determine your child’s BMI you can use this handy calculator and then use the graph to find your child’s percentile. http://www.cdh.org/ClinicalServices.aspx?id=9523 In my EMR, BMI and percentiles are automatically calculated so you will know at your child’s check up if this is an issue.
What this means for your child is that my nurse will be drawing (through a vein rather than a finger poke) a sample of blood at the check up if your child has been fasting overnight and I will send it off to the lab. If your child has an appointment too late in the day to do a fasting sample at the check up, you can either take a request to the lab and have them draw the sample any morning, or return to my office for a lab draw early in the morning. After sending the blood off, I get results in a day or so and will notify you by email of the results. If the labs are abnormal, I will also send the dietary and exercise changes that are recommended and I will encourage you to implement them for a six month period after which we will do the lipid panel again. If things haven’t improved significantly, then we will discuss the pros and cons of lipid lowering medications for your child. If your child’s labs are normal, we will repeat the levels in 3-5 years.
Its a lot to chew on but it emphasizes the importance of doing what we can to keep our kids at the lowest risk. 70% of children have some degree of atherosclerosis by age 20 and although the serious complications of high cholesterol may take decades to present themselves, the eating and activity habits we encourage in our children often last a lifetime. The dietary recommendations to treat high cholesterol include eating more fruits and veggies, whole grains and lean meats while still consuming skim milk and low fat cheese/yogurt for calcium and protein and keeping saturated fats at less than 7%. Not a bad plan for any of us! Also regular activities as simple as a 30 minute bike ride or brisk walk 4 days a week will lower cholesterol too. Prevention is always better than intervention and certainly more desirable than medications so load up your plate with the fruits and veggies of the season before you walk to the park in the evening to play!
Eat, love and play and each day will be your best!
Molly O’Shea, MD Birmingham Pediatrics + Wellness Center