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Cholesterol in childhood: how high is OK? Recommendations for screening, case-finding and intervention
T J Boulton1, J A Seal, A M Magarey
1Discipline of Paediatrics, University of Newcastle, NSW.
Objective:
To develop guidelines for screening and case-finding of children with raised serum cholesterol levels and to determine realistic cut-points for intervention and management.
Design:
The percentiles for serum cholesterol selected by authoritative US bodies for intervention were applied to the available Australian data on serum cholesterol levels in children.
Conclusion:
On the basis of this information we recommend a serum cholesterol level of 4.5 mmol/L as the target ceiling for Australian children; 5.5 mmol/L as the cut-point for active dietary intervention; and 6.0 mmol/L as the cut-point for specialist referral. A dual approach to intervention is recommended: population intervention through health promotion; and at a family level case-finding with individual intervention targeted to children with a serum cholesterol level greater than 5.5 mmol/L, with emphasis on dietary change in both cases.