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One in Five U.S. Kids Has Unhealthy Cholesterol Levels: Study

A student keys in her payment code as she orders a healthy school lunch.

A student keys in her payment code as she orders a healthy lunch at Marston Middle School in San Diego, California March 7, 2011. San Diego's Healthy Works Project received the countries largest grant, 16 million dollars, from the American Recovery and Reinvestment Act 2009 to help combat obesity. Mike Blake / Reuters, file

One in five Americans kids has unhealthy cholesterol levels, and more than 8 percent have the most worrisome high cholesterol levels, a new survey finds.

Older children and teenagers had the worst cholesterol levels -- nearly 27 percent of 16- to 19- year-olds had at least one measure of unhealthy cholesterol, the National Center for Health Statistics found. And the heavier children were more likely to have unhealthy cholesterol measures.

More than 43 percent of obese kids had bad cholesterol levels, the survey found.

"While it's not a surprise that they have more abnormalities than non-obese kids, it is pretty frightening," said Dr. Julie Brothers, a preventive cardiologist at Children's Hospital of Philadelphia, who was not involved in the study.

"It's quite high."

The findings definitely support recommendations to start screening even young children for cholesterol, Brothers said. The American Academy of Pediatrics recommends cholesterol screening all children age 9-11.

Unhealthy cholesterol levels can mean arteries are already being blocked with hardening "plaques" that can cause heart attacks and strokes.

Many studies have shown heart disease starts young — with artery-clogging blockages starting sometimes as young as age 3. Ultrasound examinations of children as young as 10 have shown they can have arteries that are already as clogged as those in some middle-aged people.

A study published last year showed that nearly a third of kids screened at pediatric clinics in Houston had unhealthy cholesterol levels by age 9 to 11.

Kids can inherit a genetic form of high cholesterol called familial hypercholesterolemia, but a bigger cause is poor diet. Sugary and fatty foods can both boost cholesterol levels. A lack of exercise can skew cholesterol levels too.

The NCHS team looked at data from 2011 to 2014 taken from a very large survey of health in the U.S.

"One in five youths had high total cholesterol, low high-density lipoprotein (HDL) cholesterol, or high non-HDL cholesterol," they wrote. The actual number was 21 percent.

Thirteen percent had low levels of high-density lipoprotein (HDL or "good" cholesterol). HDL scoops up the "bad" cholesterol and carries it away, so having high levels is important. It's linked most with poor diet, Brothers said.

"I look at things like what they are drinking throughout the day. The majority are drinking a lot of sugar drinks," she said. Cutting back on sugary drinks can help, she's found. So can adding exercise.

"It's very worrisome that their HDLs are getting lower, probably because kids are not as active as they used to be," she said.

Another 8.4 percent had high LDL -- the low-density or LDL cholesterol that is the bad actor in clogging arteries.

More than 14 percent of children aged 6-8 had abnormal cholesterol levels and 26.9 percent of teens aged 16 to 19 did, they found.

Brothers said it's never too soon to start turning things around for a child. "I always start with diet, even with familial hypercholesterolemia," she said.

"The sugary drinks are a huge thing," she said. "Then I work on fiber."

She recommends that kids eat one fruit or vegetable with every meal or snack to try to get to the five-servings-a-day recommended minimum.

"The vast majority of the overweight or obese kids that I see do not need medicine," Brothers said. "I wish I could tell them there is a little pill they can take. The only pill really is hard work."

Exercise can also raise HDL levels, she said. "I work with those kids to really focus on aerobic activity. It's important for everything," she said.

But some children do have dangerous cholesterol levels and for them, cholesterol-lowering drugs can be important, Brothers said.

"We want our kids to live longer than we do and at this point they are not going to," she said.