A study of Ohio children prompts researchers to encourage schools to screen students for cholesterol and blood sugar levels.
Heart disease and diabetes are often associated with adults. But kids can get these diseases, too.
In fact, more than one-third of middle school children screened for a new pilot study were found to have high cholesterol or abnormal blood sugar levels.
The researchers say that despite recommendations from the American Academy of Pediatrics (AAP) and other major medical organizations, most children aren’t routinely screened for abnormal cholesterol or blood sugar.
The study took place in Norwood, Ohio, where researchers mailed fliers to families of seventh- and eighth-grade students.
Of 290 eligible children, 45 consent forms were returned. Two families decided not to go through with the blood draw.
The children were 12 to 14 years old. Seventy percent were white, 16 percent were African-American, and 9 percent were Hispanic.
Forty percent had private health insurance, 24 percent were covered under Medicaid, and 16 percent were uninsured.
Forty-two percent were either overweight or obese. Fifteen percent had lipid screening or HbA1c outside the normal range.
Two students had cholesterol levels over 200 milligrams/deciliter (mg/dL), with LDL (bad) cholesterol greater than 140 mg/dL.
Two had blood sugar levels in the diabetes range. Neither child had symptoms. They were referred to a pediatric endocrinologist for evaluation.
“More research is needed to understand why or why not parents want their children screened and if they prefer it be done at a doctor’s office or at school,” Dr. Robert Siegel, lead study author and director of the Center for Better Health and Nutrition at Cincinnati Children’s Hospital Medical Center, said in a statement.
“With our study, we demonstrate that if the middle school setting is used for cardiovascular screening, if it’s feasible to do so, and the yield is high,” Dr. Siegel said.
The research was supported in part by a grant from Ethicon Corporation and published in the Journal of Pediatrics.
According to the
High blood cholesterol is associated with risk for heart disease and stroke.
The American Diabetes Association estimates that 193,000 Americans under age 20 have diagnosed diabetes.
Dr. Eric Morley, MPH, is a pediatrician at MemorialCare Medical Group in Long Beach, California.
“The study found that a significant amount of kids had elevated blood sugar and cholesterol levels,” he told Healthline. “That’s the reason for the AAP’s recommendation to screen. It makes sense.”
Morley cautions against making generalizations about the whole country based on a small study.
Dr. Daniel S. Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, agrees.
“This [study]… doesn’t represent the general population in America,” he told Healthline. “It represents one inner-city school, which has a high overweight/obesity rate of 42 percent. Also, this study happened in a city without a pediatrician.”
“All children are supposed to be screened for high body mass index (BMI), family history of diabetes and heart disease, and have cholesterol testing when they’re around 10 years old, or every year if they have risk factors like high BMI,” Ganjian said.
“If they’re not being screened, it’s likely parents aren’t following up with their child’s doctor on an annual basis,” he said.
Morley explained that despite AAP recommendations, these screenings are often not done for a variety of reasons.
“It takes extra time. It gets forgotten. It involves poking the child, lack of health insurance, parents who aren’t able to get time off work for doctor visits, getting primary care in ER settings — any number of factors,” he said.
High BMI, smoking, frequent urination, or family history of diabetes or heart disease are signs and symptoms that parents should get their child screened, Ganjian said.
But sometimes there are no warning signs.
“That’s the point of the study. A parent might think their child is doing well on the growth chart and seems healthy, and it just gets forgotten,” Morley said. “Kids need to be screened regardless of signs or symptoms.”
Morley said there are some potential problems with doing routine screenings in school, including the health privacy law known as the Health Insurance Portability and Accountability Act (HIPAA) and possible embarrassment for some children.
Ganjian pointed out that more kids would get flagged for having disease, which means these routine screenings would have to be performed under the guidance of a doctor.
“It’s a waste of resources for children who are already being seen by a doctor on a yearly basis,” he said.
Ganjian stressed the importance of working together to prevent these conditions in children.
“If you’re going to use resources in the school setting, then use them to teach parents about the importance of a healthy lifestyle starting at a young age rather than waiting to catch kids once they have diseases,” he said.
Ganjean recommended that parents teach children about a healthy diet and the benefits of exercise. This includes encouraging your kids to eat five fruits and vegetables a day.
In addition, there should be no more than two hours of screen time each day to prevent a sedentary lifestyle along with one hour of exercise every day, and no sweet drinks such as juices and soda, Ganjian said.
Schools could inform kids and their families about the recommendations to have this routine screening, Morley said.
“They could encourage them to go to the doctor to get it done. This could empower people,” he said.