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Daily Dose

Importance of Cholesterol Screening

Once again there is a lot of news about the appropriate time to screen children for lipid abnormalities.While we have been on the topic of screening, let's look at another area, cholesterol and triglycerides. Once again there is a lot of news about the appropriate time to screen children for lipid abnormalities. The medical community always likes a lively discussion with good scientific evidence, but the AAP, the American Heart Association, and the U.S. Preventative Services Task Force do not have a clear consensus on screening in children.

I think that the most important issue is knowing your patient's family history. We pediatricians should all be aware of the increase in cardiovascular disease in this country, and should continue to ask parents their cholesterol and lipid levels, if they take medication and their parent's history. In other words, we need to ask about grandparents too. I think this is fairly routine, but as a child gets older, they need to know their own family history so that they are informed (I learned this lesson from our eldest son when he told his "adult doctor" that he did not think he had any disease etc in his family, what did he think that cholesterol pill was that his Dad took everyday?) If there is a history of high lipids in the family it is probably worth screening your children somewhere between the ages of two - 10 years of age. Children with high BMI's should also be routinely screened. Which screening test your pediatrician decides to do may depend on your own physician. There continues to be data emerging about screening using total cholesterol alone, versus fractionated cholesterol. Next time you visit your pediatrician, discuss your family history and any changes in family history that may have occurred. Discuss the possibility of cholesterol screening for your children. Another number to pay attention too. That's your daily dose, we'll chat again soon!

Your Child

Obesity Related Heart Disease Found in Children as Young as 8


All you have to do is look around, wherever children are gathered, to see that there are far too many kids that are overweight in this country.  And sadly, some of these children may already be developing heart disease according to a new study.

The study reports that obese children as young as 8 years of age, are beginning to show signs of heart abnormalities.

"It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease," said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

"Ultimately, we hope that the effects we see in the hearts of these children are reversible," Jing added. "However, it is possible that there could be permanent damage."

Researchers conducted MRI scans of 40 children between 8 and 16 years old. Half of the participants were obese; the other half was of normal weight for their age and height.

They found that the obese children had an average of 27 percent more muscle mass in the left ventricle region their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart disease, Jing said.

Among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. The children with this reduced heart capacity were considered to be at “high risk” for adult cardiac strain and heart disease.

"This should be further motivation for parents to help children lead a healthy lifestyle," Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings "alarming."

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

The study did not include kids with diabetes or those that were too large to fit inside the MRI scanning machine. Jing noted that the study might actually underestimate how many children are suffering from heart related problems associated with obesity.

Jing said it’s up to parents to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, "which is high in sugar but low in fiber," she said.

She also recommended that parents limit TV, computer and video game time and encourage more physical outdoor activities.

Childhood obesity isn’t just an American problem; it’s a global problem as well.  The World Heart Federation says that one in 10 school-aged children worldwide are estimated to be overweight. However, in the USA, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

The researchers believe that schools can play a role in helping families understand the health problems associated with obesity.

“…Schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity," said Jing.

Fonarow agreed adding, "Substantially increased efforts are needed to prevent and treat childhood obesity."

The findings were presented at the annual meeting of the American Heart Association in Orlando, Fla.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Source: Alan Mozes,




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