Given the epidemic of childhood obesity and the dramatic increase of long term diseases such as hypertension and diabetes, the American Academy of Pediatrics has recently issued a recommendation that after age 2, and not more than 10 years of age, children should receive a full fasting lipid profile screening. Researchers have found that at age 2, children’s lipid levels approximate that of young adults, with girls usually having higher total and LDL cholesterol versus boys.

But what exactly is a lipid profile screening? This is a blood test to check cholesterol levels which basically determines the following:

• Total cholesterol
• HDL cholesterol
• LDL cholesterol
• Triglycerides

HDL or High-density lipoprotein cholesterol is known as “good cholesterol” because it prevents arterial blood vessels from becoming clogged. High HDL means lower risk for cardiovascular diseases. On the other hand, LDL or Low-density lipoprotein cholesterol is known as “bad cholesterol” because it can build up in the inner walls of arterial blood vessels causing blockade, which can lead to heart attack and stroke. High LDL means high risk for cardiovascular diseases. This type of cholesterol is the center of attention in lipid screening in children.

The recommended normal LDL cholesterol concentrations in children at screening are as follows:

For children with no risk factors ———– LDL level < 190 mg/dl
For children w/ risk factors ———– LDL level < 160 mg/dl
(e.g. obesity, hypertension, smoking,
Family history of premature cardio-
vascular diseases)
For children w/ diabetes mellitus ———– LDL level < 130 mg/dl

Children with normal lipid value at screening may be retested 3 to 5 yeas after. And for those children with abnormal lipid levels (high LDL/triglycerides or low HDL), they should receive education on diet, exercise, and lifestyle changes. Diet modification includes eating more soluble fiber found in oatmeal, beans, fruits, and vegetables, and less saturated fat and cholesterol. It is also necessary for them to have routine or frequent lipid testing to monitor blood cholesterol levels. When lifestyle changes are not enough to reach target cholesterol levels, your pediatrician may prescribe medication such as statins to help lower blood cholesterol. Remember, medications are not replacement for lifestyle changes. Your child still needs to eat the right foods and exercise regularly.

This recommendation by the American Academy of Pediatrics is valuable. It reemphasizes the need to prevent development of cardiovascular diseases as early as childhood. Early screening identifies children with high risk factors, so early intervention can be done to prevent progression of cardiovascular disease in adult life.


1.) Riordan, Michael (2008). Obesity Epidemic in Children Fuels Need for New Recommendations in Lipid Screening and Cardiovascular Health.