Since then, Miller, now 17, has been put on four cholesterol-lowering medications. His cholesterol levels have gone down significantly, but not enough, his mother says. He needs another procedure to further lower his cholesterol levels, his doctor said.
"I figured that people lived long lives with high cholesterol," said Debbie Miller, 53, Keith's mother and a criminal investigator for the federal government. "I didn't know it was life-threatening."
Familial hypercholesterolemia can be diagnosed before birth, but most cases are undiscovered until later in life, when symptoms develop.
"Keith's story illustrates the critical need to screen for cholesterol in children," said Dr. Peter Kwiterovich, a blood cholesterol researcher at The Johns Hopkins Children's Center and one of Miller's specialists.
"He would've been a candidate for selective screening, and it's possible if we saw him at 4 to 5 years of age, we could have prevented his bypass surgery completely," Kwiterovich said.
Cholesterol isn't necessarily all bad. It's used to form cell membranes and needed for a healthy body. But too much of the soft, waxy substance can clog arteries and lead to a heart attack.
Doctors can check cholesterol levels through a simple blood test. Children with elevated cholesterol readings should focus on changing their diet, increased physical activity and weight reduction.
The report suggests the use of low-fat dairy products, such as 2 percent milk, for children as young as one year of age if weight is a concern. The statement also recommends a healthful diet for all children older than 2. This means decreasing sugar and carbohydrate intake and avoiding saturated and trans fats, which are found in many animal products, fast foods and commercially baked goods.
Instead, children should eat foods high in fiber, such as whole grains, and lots of fruits and leafy green vegetables. White pasta and rice should be eaten in moderation, doctors say.
"What is lost these days is the family meal," Levy said. "Families who shop, cook and prepare meals together are generally healthier, have a better outlook on nutrition and have lower cholesterol levels."
Levy said the report incorporates new studies and ties together findings from the past 16 years, providing more complete information for parents and pediatricians.
"We hope to screen kids more thoughtfully now," Levy said. "And health problems in the future may be avoided by taking careful family histories."
Levy finds the new guidelines being issued today clearer for pediatricians than the previous ones published 10 years ago. But Hopkins' Kwiterovitch said he also wanted to see more discussion on the risk factors of heart disease and the possibility of universal screening in the academy's statement.
"It's a step in the right direction," Kwiterovitch said. "But we need more comprehensive reports, which give more specific directions for doctors to follow."
euna.lhee@baltsun.com
