Use of cholesterol measurements in childhood for the prediction of adult hypercholesterolemia: the Muscatine study

Article Abstract:

Recommendations made by the National Cholesterol Education Program (NCEP) include testing every five years to determine blood cholesterol levels, with treatment for people with borderline (between 200 and 239 milligrams per deciliter) blood cholesterol and two risk factors, or people with high blood cholesterol (more than 240 milligrams per deciliter). These guidelines apply to all adults over age 20 years. The extent to which high cholesterol in childhood predicts subsequent coronary heart disease has not been determined, although adults with elevated cholesterol are known to be at increased risk. To learn more concerning the value of screening school-age children, a study was carried out of 2,367 children (aged 8 to 18) who were followed-up when they were between 20 and 30. The study took place in Muscatine, Iowa. Special attention was paid to children whose levels placed them above the 75th or 90th percentiles. Adult levels at or above 200 milligrams per deciliter were chosen as the ''disease'' that was or was not predicted by childhood values. Sensitivity, specificity, and positive and negative predictive values of the childhood results are described. Three-quarters of the girls and 56 percent of the boys whose cholesterol levels were above the 75th percentile would not have needed treatment as adults, according to NCEP guidelines. For those with childhood levels above the 90th percentile, equivalent figures were 57 and 30 percent of girls and boys, respectively. The results show that high cholesterol levels in childhood do not predict high levels in adulthood. This may be partly the result of measuring total cholesterol, rather than lipoprotein fractions such as high-density and low-density lipoprotein cholesterol. In conclusion, testing of cholesterol in children, even when the test is repeated several times, can be misleading if used as a predictor of cholesterol levels in the future. Children with high cholesterol levels often show normal levels as young adults. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Demographic aspects, Blood cholesterol

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Nutrition

Article Abstract:

The field of nutrition attempts to educate people regarding chronic diseases known to be caused or influenced by diet. These include obesity, coronary heart disease (CHD, disease of the arteries which supply blood to the heart muscle), cancer, and illnesses due to chemical hazards that may be in foods. There are an estimated 34 million obese people in the US, with a long list of associated risk factors. Obesity is a condition that intensifies virtually any health problem. Obese people are often sedentary and at risk for hypertension (high blood pressure), which itself is associated with CHD and stroke (sudden loss of blood to a region of the brain because of a blood clot or hemorrhage). The association between hypercholesterolemia (levels of blood cholesterol that are abnormally high) and diet continues to be debated, but recommendations have been made for dietary reductions of saturated fats and cholesterol. Such a program could result in the avoidance of foods containing other important nutrients, depriving people (especially the elderly) of them. Disagreement also exists about cholesterol screening among children, with some arguing that it is necessary, and others, that such findings as fatty streaks in the lining of arteries do not imply subsequent CHD. The relationship between diet and cancer has not been characterized, and no epidemiological relationship has been determined. However, many foods have been investigated in this regard. Concern about food additives and pesticides is unwarranted, since damage to health from these substances, used as directed, has never been documented. Physicians can educate the public about these misconceptions. Basic common sense and awareness of the four major food groups will guide good nutritional habits. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Reports, Food additives, Cancer, Diet, Diet therapy, Diet in disease

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Nutrition

Article Abstract:

Proper nutrition is useful to delay or diminish the onset of heart disease, stroke, some forms of cancer, diabetes, osteoporosis and kidney disease. The American Cancer Society's guidelines recommend maintaining appropriate body weight, eating a varied diet that includes fruits, vegetables and high-fiber foods and limiting the amounts of total fat, alcoholic beverages and nitrite-preserved foods. Upper body obesity increases the risk for diabetes and heart disease. Calcium may blunt the effect of a high-fat diet on the risk of colon cancer, and may also help to control hypertension and osteoporosis. The interaction of nutrients with each other, with drugs and other dietary constituents has been found to be important. Vitamin E can help zinc deficiency. Some nutritional deficiencies may protect individuals from developing certain diseases. This is true for vitamin B2 deficiency, which protects against malaria.

Nutritional requirements

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