Cholesterol: All in the Family?


mom and dad with kidsRoutine immunization visits can help prevent diseases before they strike. Now, a study from the New England Journal of Medicine shows that an additional heel stick during these appointments can look for genetic markers for high cholesterol—a step that might help reduce or even prevent the risk of future heart disease in both children and parents.

The study looked at 10,059 one and two year olds who had an additional blood test during one of their regularly-scheduled immunization visits to look for genetic markers that would cause high cholesterol down the road. When a marker was found, a second test identified the parent with the same marker. For every 1,000 screenings, four children and their corresponding parent were identified with the same marker.

Not Just “Adults-Only”

High cholesterol isn’t reserved for adults. According to Shawn Skeen, MD, it can be passed down to a child by one or both parents, and can also be seen in childhood and adolescence, along with obesity, poor diet or diabetes, all of which are risk factors for heart disease. Skeen is a cardiologist at Ascension Providence. Ascension Providence is part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system.

“Our bodies use cholesterol for daily functions such as cell production,” Skeen explained. “Too much of the waxy substance can cause plaque buildup and narrowed arteries. This can limit blood flow through the arteries, and can lead to heart disease, and even heart attack or stroke.”

The Importance of Early Detection

Early detection can improve treatment options for many health conditions. Ascension Providence pediatrician Ronald Coleman, Jr., DO, said that current guidelines established by the National Heart Lung and Blood Institute and endorsed by the American Academy of Pediatrics call for a blood test that measures total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol and triglycerides to screen children as part of regular check-ups, once between the ages of nine and 11, and again between the ages of 17 and 21.

Children who have strong family history of high cholesterol or heart disease, are overweight or obese, have high blood pressure, are diabetic or smoke, should be evaluated by a doctor and screened as needed, between the ages of 2 and 21.

Skeen points out that the potential to screen children for a shared genetic marker as early as one or two years old, allows both doctors and parents to be aware of the potential health risks associated with high cholesterol, and provides doctors with better opportunities for intervention or prevention. Additionally, identifying the parent with the shared marker gives mom or dad a heads up regarding their own health as well.

“Heart disease is the number one killer in America, with high cholesterol being a known risk factor. If high cholesterol can be identified early, we can take action to manage, and often times, prevent future complications associated with heart disease,” Skeen said.

Coleman notes that that the presence of the genetic marker doesn’t necessarily mean a future with high cholesterol, nor does its absence guarantee cholesterol won’t be a concern down the road.

However, in some cases where the genetic maker is present, complications related to high cholesterol can begin at an early age.

While the study shows the potential for early high cholesterol detection, the cost benefit of the approach is uncertain when compared to the current recommended guidelines.

Genes Are Not the Only Player

Regardless of a child’s genetic risk for high cholesterol, Coleman and Skeen agree that lifestyle and diet still matter. “Parents should play an active role in modeling healthy behaviors and managing their child’s food intake,” Coleman said.

In many cases, high cholesterol can be lowered without needing medication. Try some of these family-friendly tips:

  • Take the family outdoors for walking, hiking, biking or swimming.
  • Use a gym or club membership to enjoy aerobic or spin classes together.
  • Ask your children to be involved in meal planning and preparation.
  • Plan colorful or themed meals that include baked or grilled foods, whole grains, fruits and veggies.

Parents who are concerned about their child’s risk of high cholesterol should talk to their doctor about family history and other potential risk factors to decide the best screening and treatment options.