Flashback Friday: Should All Children Have Their Cholesterol Checked?

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The current generation of American kids may be one of the first generations to be less healthy and have shorter lifespans than their parents.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

This is not a slice of pizza, but could, perhaps, be thought of as the result of too many slices of pizza. This is what the inside of our major arteries looks like in an advanced stage of atherosclerosis—lined with fat and cholesterol. We know that coronary artery disease doesn’t just “magically appear,” though. “The disease [begins] during early childhood…progressing unrecognized for several decades to its often final and unexpected endpoint of chest pain, disability, or [simply] death.”

“[W]e need to remind ourselves that atherosclerosis begins in childhood as fatty streaks” in the arteries, which are “the precursors of the advanced lesions that ultimately” kill us. By our 20s, 20% of the inner surface of the artery coming off the heart is covered in fatty streaks. So, fifty years ago, pathologists started raising the question of whether heart disease is best handled by cardiologists, or by pediatricians.

Because “[b]y their 30s, many young adults already have advanced coronary atherosclerosis,” an  intervention from our thirties on is actually what’s called “secondary prevention,” just trying to mediate the ravages of the disease rather than prevent the disease itself, “because advanced atherosclerosis [is] likely already present.”

And, we’re exporting the problem around the world. Young, thin, apparently healthy individuals, yet 97% of their collected arteries looked like this. So, even in developing countries, where they’ve acquired our eating habits, we’re seeing an epidemic of heart disease and sudden death—that is, if you’re not shot first.

“Moreover, the risk factors that correlate with the extent of such early lesions are the same risk factors that correlate with [heart attacks] later in life.” In other words, it’s the same disease, just in the early stages. So, pathologists, the ones doing the autopsies on all these young people, and seeing all this coronary artery disease, “began urging many years ago that preventive measures should be instituted earlier in life.”

We’ve known for over a century that fatty streaks exist in young children. But it wasn’t until 1994 that a task force convened by the government came up with a radical idea: “The strategic key, and the greatest opportunity in preventing [cardiovascular disease], is to prevent the development of risk in the first place.”

In my video, Heart Disease Starts in Childhood, I noted that fatty streaks, the first stage of atherosclerosis, were found in the arteries of nearly 100% of kids by age 10, raised on the Standard American Diet. In recognition of this fact, the latest Academy of Pediatrics’ recommendation is that all kids get their cholesterol tested starting between the ages of 9 and 11.

Of course, this has drug companies salivating at the thought of slipping statins into Happy Meals, but “long-term drug intervention is costly and may be associated with adverse effects.” They’re talking about “lifestyle modification.”

In my video, How Many Meet the Simple Seven?, I revealed the  breathtaking statistic that only about one in 2,000 U.S. adults met the seven American Heart Association criteria for a heart-healthy lifestyle. What about American teenagers? Of the 4,673 adolescents aged 12 through 19 that were studied, zero made the cut. What was the main sticking point?  Well, you know, most teen boys and girls don’t smoke. The white bars show the percentage meeting the criteria. Most aren’t overweight, but almost no one ate a healthy diet. Less than one percent of young men and women met a minimum of healthy diet criteria.

This sorry state of affairs is what’s behind this controversial paper suggesting that “the current generation of US children and adolescents”—our children—”may be one of the first generations to be less healthy, and have a shorter [lifespan] than their parents.”

Please consider volunteering to help out on the site.

Image credit: Kristina DeMuth (cover image) and Nicole Qualtier. Images have been modified. 

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

This is not a slice of pizza, but could, perhaps, be thought of as the result of too many slices of pizza. This is what the inside of our major arteries looks like in an advanced stage of atherosclerosis—lined with fat and cholesterol. We know that coronary artery disease doesn’t just “magically appear,” though. “The disease [begins] during early childhood…progressing unrecognized for several decades to its often final and unexpected endpoint of chest pain, disability, or [simply] death.”

“[W]e need to remind ourselves that atherosclerosis begins in childhood as fatty streaks” in the arteries, which are “the precursors of the advanced lesions that ultimately” kill us. By our 20s, 20% of the inner surface of the artery coming off the heart is covered in fatty streaks. So, fifty years ago, pathologists started raising the question of whether heart disease is best handled by cardiologists, or by pediatricians.

Because “[b]y their 30s, many young adults already have advanced coronary atherosclerosis,” an  intervention from our thirties on is actually what’s called “secondary prevention,” just trying to mediate the ravages of the disease rather than prevent the disease itself, “because advanced atherosclerosis [is] likely already present.”

And, we’re exporting the problem around the world. Young, thin, apparently healthy individuals, yet 97% of their collected arteries looked like this. So, even in developing countries, where they’ve acquired our eating habits, we’re seeing an epidemic of heart disease and sudden death—that is, if you’re not shot first.

“Moreover, the risk factors that correlate with the extent of such early lesions are the same risk factors that correlate with [heart attacks] later in life.” In other words, it’s the same disease, just in the early stages. So, pathologists, the ones doing the autopsies on all these young people, and seeing all this coronary artery disease, “began urging many years ago that preventive measures should be instituted earlier in life.”

We’ve known for over a century that fatty streaks exist in young children. But it wasn’t until 1994 that a task force convened by the government came up with a radical idea: “The strategic key, and the greatest opportunity in preventing [cardiovascular disease], is to prevent the development of risk in the first place.”

In my video, Heart Disease Starts in Childhood, I noted that fatty streaks, the first stage of atherosclerosis, were found in the arteries of nearly 100% of kids by age 10, raised on the Standard American Diet. In recognition of this fact, the latest Academy of Pediatrics’ recommendation is that all kids get their cholesterol tested starting between the ages of 9 and 11.

Of course, this has drug companies salivating at the thought of slipping statins into Happy Meals, but “long-term drug intervention is costly and may be associated with adverse effects.” They’re talking about “lifestyle modification.”

In my video, How Many Meet the Simple Seven?, I revealed the  breathtaking statistic that only about one in 2,000 U.S. adults met the seven American Heart Association criteria for a heart-healthy lifestyle. What about American teenagers? Of the 4,673 adolescents aged 12 through 19 that were studied, zero made the cut. What was the main sticking point?  Well, you know, most teen boys and girls don’t smoke. The white bars show the percentage meeting the criteria. Most aren’t overweight, but almost no one ate a healthy diet. Less than one percent of young men and women met a minimum of healthy diet criteria.

This sorry state of affairs is what’s behind this controversial paper suggesting that “the current generation of US children and adolescents”—our children—”may be one of the first generations to be less healthy, and have a shorter [lifespan] than their parents.”

Please consider volunteering to help out on the site.

Image credit: Kristina DeMuth (cover image) and Nicole Qualtier. Images have been modified. 

Doctor's Note

Here are the links to the videos I referenced:

If you think atherosclerosis by age ten is bad, check out my video Heart Disease May Start in the Womb.

I don’t think most people—doctors and patients alike—realize how relatively ineffective these drugs are. Watch, for example, The Actual Benefit of Diet vs. Drugs.

Cholesterol can do more than just build up and block off our arteries. In fact, Cholesterol Crystals May Tear Through Our Artery Lining.

What’s the Optimal Cholesterol Level? Does Cholesterol Size Matter? Watch my videos to find out.

Let’s take a step back, though. What about all the “cholesterol skeptics”? How Do We Know That Cholesterol Causes Heart Disease?

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