Doctors Search Backward for Target Group
In a way, the pediatricians were working backward.
They suspected that the children of adults with heart disease would themselves develop health problems later in life. And while the medical community is still debating the benefits of lowering cholesterol levels, they knew that too much cholesterol in a child’s diet could also lead to problems later on.
But the question posed by the doctors was: how best to find the children who would test positive for high cholesterol levels without testing every child in America?
Huntington Beach pediatrician Paul Y. Qaqundah and a team of other Orange County doctors and scientists have pared the answer down to two factors: the amount of television a child watches, and whether that child’s family has a history of heart disease.
The team, associated with UC Irvine and the American Academy of Pediatrics, studied data and blood cholesterol levels of 1,066 pediatric patients in Orange County from the ages of 2 to 20 over the course of about a year.
“The TV-watching factor, when combined with a family history of (heart attack) or high cholesterol, facilitated identification of nine out of 10 children with cholesterol levels above 200 milligrams,” said co-researcher Dr. Kurt V. Gold, a pediatric resident at UCI Medical Center. (The American Academy of Pediatrics recommends dietary therapy for children with cholesterol levels of 175 milligrams or more.)
“This is first time somebody associates TV viewing and identification of high cholesterol levels,” Qaqundah said.
The inquiry began two years ago when Qaqundah and the American Academy conducted a cholesterol check at Westminster schools and found that an alarmingly high number of children had high levels of cholesterol in their blood.
But of those children, only one-third came from families with a history of coronary problems.
“So we started thinking, how can we identify these children in another way?” Qaqundah said.
Their latest study relied on two simple methodologies. First, in a 17-question survey, the doctors decided to look at family medical history and also at the child’s eating, exercise and recreational activities. Later they tested the children’s cholesterol levels.
The first three questions have to do with the child’s age, gender and ethnicity.
In the next four questions, the doctors asked whether there is a history of heart attacks or high blood pressure or high cholesterol in the child’s family. It asked, for example, whether the parents or grandparents of the child have suffered a heart attack, and at what age.
The remaining 10 questions probe the child’s eating, exercise and leisure habits. In one, a child is asked to indicate: “Number of times per week (that you) eat at fast food restaurants: every day, 3-6 times a week, more than 4 times a week.”
Another question asks: “Continuous physical activity outside of school for at least 15 minutes at a time: less than once a week, 1-2 times a week, 3-4 times a week, or more than 4 times a week.
Another question is: “Eat eggs (with yolks): every day, 1-6 times a week, less than once/week or never.”
The final question asks the number of hours per day the child devotes to television and video games: 0-2 hours, 2-4 hours or over 4 hours a day.
After the children were tested for cholesterol, the results were matched with the survey answers. And the two elements that were most common among those children who tested for high levels of cholesterol was that they watched more than two hours of television daily, and there was a history of coronary problems in their families.
