Keith Miller leads what doctors call a healthy, active lifestyle. The suburban Baltimore teenager has always loved sports and plays soccer competitively. He avoids eating pizza and junk food.
But despite all that, Miller had cholesterol levels nearly five times his average peer and underwent a double bypass surgery to repair his heart two years ago when he was 15.
Though open-heart surgery remains unusual in young patients, medical experts fear that cholesterol levels are rising at an alarming rate. Often, as in the case of Miller, the culprit is genetics. But for others, it is linked to what some say is an "epidemic" of obesity among American youngsters.
As a result, the American Academy of Pediatrics is scheduled to release today a new policy statement on cholesterol screening and treatment options for children - including those as young as 2. The academy advises cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. The recommendation also includes patients whose family history is unknown or who have risk factors for heart disease, including obesity, high blood pressure, cigarette smoking or diabetes.
"This policy seems to say 'screen everyone,' but it actually stops short of universal screening," said Dr. Frank Greer, chairman of the academy's Committee on Nutrition and one of two authors of the report. "It exempts those patients with no risk of cardiovascular disease, either in themselves or their families. But most everyone will qualify for screening."
Screening should start as early as 2, but no later than age 10. If results are normal, patients should be retested in three to five years. The new policy calls for more aggressive treatment, including with medication, among youngsters found to have high cholesterol levels.
The previous policy, issued in 1998, also recommended screening for children with family histories or risk factors. But the new guidelines put a greater emphasis on the need for such screening and for subsequent treatment, given the expanding waistlines, poor eating habits and sedentary lifestyles of American youth.
Doctors wrote that the report, Lipid Screening and Cardiovascular Health in Childhood, has taken on "a new urgency, given the current epidemic of childhood obesity."
