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When should children be screened for elevated cholesterol levels? Children's cholesterol levels are closely correlated with those of their parents. It has been estimated that if both parents are in the low risk classification, < 5.17 mmol/L it is unlikely that their children would have a cholesterol level > 5.17 mmol/L. On the other hand, parents with elevated cholesterol levels are more likely to have children with higher levels. For example, having one parent with a cholesterol level > 6.2 mmol/L increases the odds for the child having a cholesterol level > 5.17 mmol/L to > 13 times that of a child whose parents both have low cholesterol levels. The current published guidelines by the National Cholesterol Education Panel (NCEP) are that children should be screened for hypercholesterolemia if a parent has a total serum cholesterol >6.2 mmol/L (or if a parent or grandparent had a myocardial infarction or angina pectoris before 50 years of age). If a child on screening is found to have a moderately elevated cholesterol level (5.17 - 6.2 mmol/L) it is recommended that the child be put on a step 1 diet in which the total fat averages no more than 30% of total calories and saturated fatty acids account for < 10% of the calories and cholesterol accounts for < 300mg/day. If the child's cholesterol level is markedly elevated (>6.2 mmol/L) then a step 2 diet should be recommended which is the same as the step 1 diet except the saturated fatty acids should account for < 7% of the total calories and no more than 200 mg/day of cholesterol should be consumed.
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