Q: Can a teen have an elevated cholesterol level?
A: Although most discussions about cholesterol and itrelationship to coronary artery disease imply that this is a matter of concern to adults only, we know that the beginnings of this form of heart disease may be traced to childhood.
Whether a cholesterol level is elevated is determined by measuring the cholesterol levels of large numbers of people of varying ages. A range of normal values is then developed, and people whose cholesterol levels exceed the 75th percentile for a given age and sex are said to have an elevated blood cholesterol. These people are felt to be at increased risk for coronary artery disease.
The American Academy of Pediatrics recommends cholesterol screening only for children from families where one or more relatives have some evidence of coronary artery disease prior to age 60. Physicians usually recommend nothing more than dietary management for adolescents with high cholesterol levels unless the level exceeds the 90th percentile. Even in this case, diet modification is the first step.
If your son or daughter has a high cholesterol level, he or she should get no more than 30 percent of calories from fat. This kind of diet is recommended for all Americans beyond childhood regardless of cholesterol level. Cessation of smoking, maintainance of an ideal body weight and regular exercise for at least 30 minutes three times per week also will favorably affect the cholesterol level.
Dr. Joffe is director of adolescent medicine at the Johns Hopkins Children's Center.