Children's Cholesterol Dropping

The number of US children with elevated cholesterol appears to be steadily declining over the past 20 years, a large study has found. Elevated cholesterol in children is not good, and can lead to a risk of coronary artery disease.

Results of the study were surprising since childhood obesity remains unchanged. Individuals who are obese are at greater risk of developing high cholesterol.

Regular exercise keeps cholesterol at healthy levels.

Brian K. Kit, MD, MPH, a lead author from the U.S. Centers for Disease Control and Prevention, said the study confirmed a favorable trend of declining cholesterol among US children and adolescents. Between 2007 and 2010 about 8 percent of youths had elevated total cholesterol, down from 11 percent between 1988 and 1994.

During the study, researchers reviewed data regarding 16,116 youths between the ages of 6 and 19 who participated in the National Health and Nutrition Examination Survey (NHANES) during three time periods including, 1988-1994,1999-2002 and 2007-2010.

Investigators tested participants for total cholesterol, total cholesterol without "good" high-density lipoprotein (HDL) cholesterol and HDL levels. In teens between the ages of 12 and 19, levels of "bad" low-density lipoprotein (LDL) cholesterol and triglycerides also were measured.

Researchers found that average total cholesterol among children and teens decreased from 165 mg/dL between 1988-1994 to an average of 160 mg/dL between 2007 and 2010. HDL cholesterol increased slightly on average during that same period from 50.5 mg/dL to 52.2 mg/dL.

In addition, 22 percent of youths had either low HDL cholesterol or high total cholesterol without HDL in 2007-2010, a decrease from 27.2 percent in 1988-1994.

Total cholesterol was lowered an average of 4.3 mg/dL for boys and 6.5 mg/dL for girls over the study period. Girls and boys who were black or Hispanic, or girls who were white also were found to have lower total cholesterol at the conclusion of the study.

In an accompanying editorial, Sarah D. de Ferranti, MD, MPH, from the Harvard Medical School and Boston Children's Hospital, encouraged interventions such as an increased tax on soda, improved access to water in schools and a push for more physical exercise.

"Better understanding is needed about dietary trends and physical activity during childhood, areas that were not explored in the study by Kit et al but could be assessed using NHANES data," she wrote. "However it seems clear that population-wide efforts to alter cardiovascular disease risk have potential to influence health risks."

Dr. Ferranti received grants from the National Institutes of Health/National Heart, Lung, and Blood Institute, and received royalties or payments from agencies including the Pediatric Endocrine Society, the Pediatric Rheumatology Society, UpToDate and Covidien.

The study, funded by the National Heart, Lung, and Blood Institute and the National Institutes of Health, was recently published in the Journal of the American Medical Association.