High cholesterol in early childhood predicts high cholesterol later

June 09, 2003

HONOLULU, June 9 - Three- and four-year-old children who have high cholesterol levels are likely to have high cholesterol levels later in childhood, which is a concern because elevated cholesterol levels that appear early in life tend to persist to adulthood, researchers report at the American Heart Association's Second Asia Pacific Scientific Forum.

Barbara Strobino, Ph.D., associate research scientist with Columbia University College of Physicians and Surgeons, and colleagues presented data on 448 children enrolled in New York Head Start preschool programs who were following the Healthy Start program. Healthy Start is a preschool-based program of food service intervention and health education designed to reduce dietary intake of total and saturated fat in school meals and increase nutrition knowledge in children.

The study was initiated in 1995-97, when the children were 3 and 4 years old. The children were followed for five years, until they were about 8 years old.

The researchers measured the children's total cholesterol levels at enrollment, as well as their levels of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), and levels of triglycerides.

Children with the highest levels of cholesterol when they were 3 and 4 years old tended to be those with the highest levels five years later. Specifically, for those with cholesterol levels in the top 10 percent in preschool, more than half (57 percent) continued to have cholesterol levels in the top 10 percent.

Children with "high normal" cholesterol levels in preschool, with total cholesterol levels measuring on average 164 milligrams per deciliter at ages 3 and 4, were five times more likely to have high cholesterol levels when they were 8 years old. Similarly, preschool children with low levels of HDL, tended to have low levels of HDL later. High HDL levels reflect a lower risk of heart disease.

Good eating habits and restricting fat and cholesterol to lower heart disease risk need to begin early in life, Strobino says. "Autopsy studies in children have found that precursors of coronary heart disease, such as fatty streaks and lesions in the arteries, are associated with cholesterol and other fats in the blood. "Preventing coronary heart disease can begin as early as 3 and 4 years of age, by identifying those at risk, and close observation and possibly intervention," Strobino advises. "It is during these years that primary prevention may be most effective."

"We have shown in our Healthy Start program that total cholesterol decreased in those schools assigned to the heart-healthy intervention. Although this is a short-term study, it is quite possible that a longer intervention or permanent dietary modification would have a long-term effect on total cholesterol in children."

Many Head Start preschools are practicing heart-smart nutrition. Strobino points out that these centers are serving low-fat milk, "which is the first good heart-healthy step after age 2." The Healthy Start educational curriculum is also being used in some centers and is available for any school at www.healthy-start.com, she notes.
Co-authors are Christine L. Williams, M.D., Principal Investigator of the Healthy Start Program and Jane Brotanek, M.D.; Lynn Campanaro, R.N. and Marguerite Bollella, R.D.

American Heart Association

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