Distributions and trends of serum lipid levels among United States children and adolescents ages 4-19 years: Data from the third National Health and Nutrition Examination Survey

Background. Atherosclerosis beans in childhood and progresses into adulthoo d. The reduction of cardiovascular risk factors, such as elevated serum tot al cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, in c hildhood may reduce cardiovascular morbidity and mortality in adulthood. Li pid distributions among children and adolescents were examined using the mo st recent nationally representative data. Methods. Data from 7,499 examinees in NHANES III (1988-1994) were used to e stimate mean and percentile distributions of serum total cholesterol, LDL-C , high-density lipoprotein cholesterol (HDL-C), and triglycerides in childr en and adolescents aged 4 to 19 years. The estimates were analyzed by age, sex, and race/ethnic groups. Trends in mean total cholesterol were examined for 12- to 17-year-olds using data from NHES III (1966-1970), NHANES I (19 71-1974), and NHANES III (1988-1994). Results. For children and adolescents 4 to 19 years of age, the 95th percen tile for serum total cholesterol was 216 mg/dL and the 75th percentile was 181 mg/dL. Mean age-specific total cholesterol levels peaked at 171 mg/dL a t 9-11 years of age and fell thereafter. Females Bad significantly higher m ean total cholesterol and LDL-C levels than did males (P < 0.005). Non-Hisp anic black children and adolescents had significantly higher mean total cho lesterol, LDL-C, and HDL-C levels compared to non-Hispanic white and Mexica n American children and adolescents. The mean total cholesterol level among 12- to 17-year-olds decreased by 7 mg/dL from 1966-1970 to 1988-1994 and i s consistent with, but less than, observed trends in adults. Black females have experienced the smallest decline between surveys. Conclusions. The findings provide a picture of the lipid distribution among U.S. children and adolescents and indicate that, like adults, adolescents have experienced a fall in total cholesterol levels. Total cholesterol leve ls in U.S. adolescents declined from the late 1960s to the early 1990s by a n average of 7 mg/dL. This information is useful for planning programs targ eting the prevention of cardiovascular disease beginning with the developme nt of heathy lifestyles in childhood. (C) 1998 American Health Foundation a nd Academic Press.