title: Influence of cholesterol screening and nutritional counseling in reducing cholesterol levels in children. The American Heart Association.
abstract: The purpose of this study was to determine whether cholesterol screening and nutritional counseling can reduce cholesterol concentrations in populations of otherwise unrecognized hypercholesterolemic children. A large pediatric practice in Parma Heights, Ohio, has conducted cholesterol surveillance of children over 2 years of age since 1986. The importance of cholesterol and other recognized risk factors for the progression of atherosclerosis is discussed with all families, and the American Heart Association's Step-One diet is recommended. The present study examines data from a cohort of 894 children (473 boys, 421 girls) who had cholesterol concentrations above 185 mg/dL (4.79 mmol/L) (the 90th percentile) at baseline and, after counseling, had a repeat measurement an average of 2.2 years later. Their mean ages were 7 years at the first testing and 9.2 years at the second. Children who had cholesterol concentrations above 200 mg/dL (5.18 mmol/L) (the 95th percentile) had lipoprotein profiles done, and if their LDL cholesterol exceeded 130 mg/dL (3.37 mmol/L) (the 95th percentile), they were referred to a nutritionist, and family members were advised to have their blood lipids analyzed. Mean cholesterol concentration for all 894 children over this time period decreased by 9.4% (19.5 mg/dL [0.51 mmol/L]; 95% CI = 17.5 mg/dL [0.45 mmol/L] to 21.5 mg/dL [0.56 mmol/L]; P < 0.001). A similar decrease of 8.6% (16.6 mg/dL [0.43 mmol/L); 95% CI = 14.0 mg/dL [0.36 mmol/L] to 19.3 mg/dL [0.50 mmol/L); P < 0.001) was observed for the 463 children who had initial cholesterol concentrations between 185 and 200 mg/dL (4.79 and 5.18 mmol/L) and who therefore received a less intense intervention. Cholesterol concentrations in groups of otherwise unidentified hypercholesterolemic children can be significantly reduced as a result of cholesterol screening and nutritional counseling in a pediatric practice setting.
authors.affiliation: Division and Pediatrics, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: J
authors.initials: J
authors.lastname: Fitch
authors.forename: R E
authors.initials: RE
authors.lastname: Garcia
authors.forename: D S
authors.initials: DS
authors.lastname: Moodie
authors.forename: M
authors.initials: M
authors.lastname: Secic
mesh_terms: D000367:Age Factors; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003376:Counseling; D018752:Diet, Fat-Restricted; D005260:Female; D005544:Forecasting; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D007223:Infant; D008297:Male; D008403:Mass Screening; D014481:United States
chemical_list: D002784:Cholesterol