Does your 5th grader have high cholesterol?
Some health concerns that used to be reserved for middle-aged adults now apply to preteens, too.
The American Academy of Pediatrics has released its updated schedule for preventive healthcare, and among the recommendations are that children 9 to 11 years old be screened for high cholesterol levels in their blood. The organization states its concern about the growing epidemic of obesity in children as the motivation for the change.
Pediatrician Kira L. Grant, DO, of Bramblebush Pediatrics in Falmouth, said her practice screens all children for high cholesterol – not just obese patients. That’s so corrective measures can be started early in life, she said.
“Somewhere around fifth grade, we try to screen all kids,” she said.
“People who have high cholesterol levels as adults, probably had high cholesterol levels in fifth grade,” Dr. Grant continued. “Generally, kids who have a high cholesterol level at that age have a genetic disposition rather than obesity.”
She added that children with high cholesterol levels often have a health Body Mass Index or BMI, and one or both of their parents may also have high cholesterol blood levels. She said the screening is important so that changes in diet and exercise can be made earlier to lower the cholesterol level. Treatment with statins or other drugs to lower cholesterol is usually reserved for adult patients, she said.
Dr. Grant’s practice screens children again for cholesterol in middle school and at age 18.
Cholesterol screenings for preteens was just one of several recommended changes in the Academy’s periodicity schedule, which was released online recently and will be published in the January issue of Pediatrics. Among the other suggestions were that teens 16-18 be screened for HIV , the virus that causes AIDS, and that children 11-21 be screened for depression.
The Academy made the HIV recommendation because federal statistics show that one in four new infections occur in the age group of 13 to 14 years old, and that 60 percent of infected youth don’t know they’re infected.
Dr. Grant said her practice offers HIV screening to all teens who identify themselves as sexually active, and that “we universally screen (boys and girls, using a urine test) for chlamydia.”
The results are completely confidential and not shared with parents by her practice, she said.
However, because the HIV test requires taking a blood sample that is sent to a lab, and lab bills and insurance company statements are usually sent to the insurance policy holder, it can be difficult for teens to keep such testing from their parents’ eyes, Dr. Grant said. Teens may need to go to a lab themselves if they seek to keep the information private, she added.
The Academy made its recommendation for depression screening in recognition of suicide being a leading cause of death among adolescents. According to the Centers for Disease Control, suicide was second only to unintentional injury as a cause of death in 2013 for people ages 15-34.
Dr. Grant said her practice screens children of every age for signs of mental and emotional ills, starting with examining development during well baby visits, as well as new moms for post-partum depression, and specifically adding mood and depression screening during wellness visits at age 7. At age 11, young patients fill out confidential questionnaires about their mental and emotional health.
“Mental health concerns are extremely important and quite common and need to be addressed,” Dr. Grant said.