Health  Vol.9 No.1 , January 2017
Factors Affecting Children’s Cholesterol Levels with a View to Prevent Cardiovascular Disease—The Unique Benefits of Health Screening at the Elementary School
Abstract: Background: The prevention of cardiovascular disease (CVD) can substantially contribute to reducing the mortality rate across countries. The level of interest in cholesterol among experts increases when the subjects are elderly and obese individuals. However, specialists do not recommend that children should receive the cholesterol test. The objective of this study was to investigate the distribution of cholesterol levels among the children of public school and their parents’ life s that are associated with cholesterol levels, and to assess the need for and utility of cholesterol testing in school settings. Methods: The study investigated a group of 226 fourth-grade public school children aged between 9 and 10 years and guardians in Akitakatacity of Hiroshima Prefecture, Japan. Multiple regression analyses were performed with the logarithmic value of cholesterol levels as a response variable, awareness about life s and health of children as an explanatory variable, and child’s sex and body mass index (BMI) as moderating variables. Using questionnaires about life s, the step-down procedure was applied in multiple regression analyses to narrow down relevant life variables. Results: The percentage of children with the high total cholesterol (TC) value was about 15 and with low-density lipoprotein (LDL) cholesterol value was about 10. Children with low high-density lipoprotein (HDL) cholesterol value were 5%. Treatment was not required according to the comprehensive assessment. Cholesterol levels were associated with the situation of the children and their guardians as follows, guardian need to consider the food, and child has the correct knowledge about food like how to eat snacks. Conclusions: Children had poor cholesterol levels. From childhood, along with the parents, there is a need to learn about appropriate level of cholesterol for CVD prevention.
Cite this paper: Kihara, A. , Kawasaki, H. , Yamasaki, S. , Nishiyama, M. and Rahman, M. (2017) Factors Affecting Children’s Cholesterol Levels with a View to Prevent Cardiovascular Disease—The Unique Benefits of Health Screening at the Elementary School. Health, 9, 172-188. doi: 10.4236/health.2017.91012.

[1]   World Health Organization (2016) Cardiovascular Diseases (CVDs): Fact Sheet.

[2]   The Ministry of Health, Labour and Welfare, Japan (2015) Summary Report of Vital Statistics of Japan (Final Data) Cause-of-Death Classification. (In Japanese)

[3]   Berenson, G.S., Srinivasan, S.R., Bao, W., Newman, W.P., Tracy, R.E. and Wattigney, W.A. (1998) Association between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults. The Bogalusa Heart Study. The New England Journal of Medicine, 338, 1650-1656.

[4]   Cleeman, J.I. and Lenfant, C. (1998) The National Cholesterol Education Program: Progress and Prospects. Journal of the American Medical Association, 280, 2099-2104.

[5]   Jousilahti, P., Vartiainen, E., Tuomilehto, J. and Puska, P. (1999) Sex, Age, Cardiovascular Risk Factors, and Coronary Heart Disease: A Prospective Follow-Up Study of 14786 Middle-Aged Men and Women in Finland. Circulation Journal, 99, 1165-1172.

[6]   Lakatta, E.G. (2002) Age-Associated Cardiovascular Changes in Health: Impact on Cardiovascular Disease in Older Persons. Failure Heart Reviews, 7, 29-49.

[7]   Nguyen, D., Kit, B. and Carroll, M. (2015) Abnormal Cholesterol among Children and Adolescents in the United States, 2011-2014. NCHS Data Brief, 228, 1-8.

[8]   Raitakari, O.T., Juonala, M., Kähönen, M., Taittonen, L., Laitinen, T. and Mäki-Torkko, N., et al. (2003) Cardiovascular Risk Factors in Childhood and Carotid Artery Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study. Journal of the American Medical Association, 290, 2277-2283.

[9]   Tan, F., Okamoto, M., Suyama, A. and Miyamoto, T. (2000) Tracking of Cardiovascular Risk Factors and a Cohort Study on Hyperlipidemia in Rural Schoolchildren in Japan. Journal of Epidemiology, 10, 255-261.

[10]   Yamazaki, Y. (2008) Relation of Adiposity Rebound Age to Serum Small Dense Low-Density Lipoprotein in Young Childhood. Dokkyo Journal of Medical Sciences, 35, 7-12.

[11]   Kouda, K., Nakamura, H., Tokunaga, R. and Takeuchi, H. (2004) Trends in Levels of Cholesterol in Japanese Children from 1993 through 2001. Journal of Epidemiology, 14, 78-82.

[12]   Okada, T., Murata, M., Yamauchi, K. and Harada, K. (2002) New Criteria of Normal Serum Lipid Levels in Japanese Children: The Nationwide Study. Pediatric International, 44, 596-601.

[13]   Kit, B.K., Carroll, M.D., Lacher, D.A., Sorlie, P.D., De Jesus, J.M. and Ogden, C. (2012) Trends in Serum Lipids among US Youths Aged 6 to 19 Years, 1988-2010. Journal of the American Medical Association, 308, 591-600.

[14]   Margolis, K.L., Greenspan, L.C., Trower, N.K., Daley, M.F., Daniels, S.R., Lo, J.C., et al. (2014) Lipid Screening in Children and Adolescents in Community Practice: 2007 to 2010. Circulation: Cardiovascular Quality and Outcomes, 7, 718-726.

[15]   Kwiterovich, P.O. and Gidding, S.S. (2012) Universal Screening of Cholesterol in Children. Clinical Cardiology, 35, 662-664.

[16]   Tokgözoglu, L., Ros, E., Kastelein, J.P., Blom, D. and Deanfield, K. (2014) Premature Heart Attacks: Bad Lifestyle, Bad Luck, or Bad Genes? Summary of Presentations from the Aegerion Pharmaceuticals-Supported Symposium. European Medical Journal Cardiology, 2, 46-53.

[17]   McCrindle, B.W., Kwiterovich, P.O., McBride, P.E., Daniels, S.R. and Kavey, R.E. (2012) Guidelines for Lipid Screening in Children and Adolescents: Bringing Evidence to the Debate. Pediatrics, 130, 353-356.

[18]   Vinci, S.R., Rifas-Shiman, S.L., Cheng, J.K., Mannix, R.C., Gillman, M.W. and de Ferranti, S.D. (2014) Cholesterol Testing among Children and Adolescents during Health Visits. Journal of the American Medical Association, 311, 1804-1807.

[19]   Schroeder, A.R. and Redberg, R.F. (2012) Cholesterol Screening and Management in Children and Young Adults Should Start Early—NO! Clinical Cardiology, 35, 665-668.

[20]   National Heart, Lung, and Blood Institute (2012) Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report.

[21]   Marks, D., Thorogood, M., Neil, H.A., Wonderling, D. and Humphries, S.E. (2003) Comparing Costs and Benefits over a 10 Year Period of Strategies for Familial Hypercholesterolaemia Screening. Journal of Public Health Medicine, 25, 47-52.

[22]   Haney, E.M., Huffman, L.H., Bougatsos, C., Freeman, M., Steiner, R.D. and Nelson, H.D. (2007) Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force. Pediatrics, 120, e189-e214.

[23]   Pang, J., Martin, A.C., Mori, T.A., Beilin, L.J. and Watts, G.F. (2016) Prevalence of Familial Hypercholesterolemia in Adolescents: Potential Value of Universal Screening? The Journal of Pediatrics, 170, 315-316.

[24]   Wilson, D.P., Davis, S., Matches, S., Shah, D., Leung-Pineda, V., Mou, M., et al. (2015) Universal Cholesterol Screening of Children in Community-Based Ambulatory Pediatric Clinics. Journal of Clinical Lipidology, 9, S88-S92.

[25]   Ministry of Education, Culture, Sports, Science and Technology-Japan (2016) The Detailed Contents of The Purpose of Health. (In Japanese)

[26]   De Ferranti, S.D. (2012) Declining Cholesterol Levels in US Youths: A Reason for Optimism. Journal of the American Medical Association, 308, 621-622.

[27]   Benuck, I. (2015) Point: The Rationale for Universal Lipid Screening and Treatment in Children. Journal of Clinical Lipidology, 9, S93-S100.

[28]   Ministry of Agriculture, Forestry and Fisheries (2015) Be Careful of Overeating of Confectionery. (In Japanese)

[29]   Kadota, A., Hozawa, A., Okamura, T., Kadowak, T., Nakmaura, K., Murakami, Y., et al. (2007) Relationship between Metabolic Risk Factor Clustering and Cardiovascular Mortality Stratified by High Blood Glucose and Obesity. Diabetes Care, 30, 1533-1538.