INFLUENCE OF CHOLESTEROL SCREENING AND NUTRITIONAL COUNSELING - IN REDUCING CHOLESTEROL LEVELS IN CHILDREN

The purpose of this study was to determine whether cholesterol screeni ng and nutritional counseling can reduce cholesterol concentrations in populations of otherwise unrecognized hypercholesterolemic children. A large pediatric practice in Parma Heights, Ohio, has conducted chole sterol surveillance of children over 2 years of age since 1986. The im portance of cholesterol and other recognized risk factors for the prog ression of atherosclerosis is discussed with all families, and the Ame rican Heart Association's Step-One diet is recommended. The present st udy examines data from a cohort of 894 children (473 boys, 421 girls) who had cholesterol concentrations above 185 mg/dL (4.79 mmol/L) (the 90th percentile) at baseline and, after counseling, had a repeat measu rement an average of 2.2 years later. Their mean ages were 7 years at the first testing and 9.2 years at the second. Children who had choles terol concentrations above 200 mg/dL (5.18 mmol/L) (the 95th percentil e) had lipoprotein profiles done, and if their LDL cholesterol exceede d 130 mg/dL (3.37 mmol/L) (the 95th percentile), they were referred to a nutritionist, and family members were advised to have their blood l ipids analyzed. Mean cholesterol concentration for all 894 children ov er this time period decreased by 9.4% (19.5 mg/dL [0.51 mmol/L]; 95% C I = 17.5 mg/dL [0.45 mmol/L] to 21.5 mg/dL [0.56 mmol/L]; P<0.001). A similar decrease of 8.6% (16.6 mg/dL [0.43 mmol/L]; 95% CI = 14.0 mg/d L [0.36 mmol/L] to 19.3 mg/dL [0.50 mmol/L]; P<0.001) was observed for the 463 children who had initial cholesterol concentrations between 1 85 and 200 mg/dL (4.79 and 5.18 mmol/L) and who therefore received a l ess intense intervention. Cholesterol concentrations in groups of othe rwise unidentified hypercholesterolemic children can be significantly reduced as a result of cholesterol screening and nutritional counselin g in a pediatric practice setting.