1 in 4 children in Brazil have high cholesterol – 03/31/2023 – Health

More than a quarter of children and adolescents in the country, or 27.47%, have high levels of total cholesterol, and about 1 in 5, or 19.29%, have changes in LDL, known as “bad cholesterol”, according to research by UFMG (Federal University of Minas Gerais).

The data, which raise awareness of risk factors for cardiovascular disease, are from a systematic review with meta-analysis (method that aggregates results from independent studies) based on data from 47 surveys with Brazilian children and adolescents between 2 and 19 years old.

To arrive at this selection, 831 articles were analyzed and those that corresponded to the objective of tracing the prevalence of lipid alterations in this group were included. Taken together, the surveys cover data from 62,530 volunteers from all regions of the country.

According to Thales Rodrigues, from the graduate program in nursing at UFMG and one of the authors of the study, most research on the subject has a regional sample, without a broader study —hence the idea of ​​conducting a meta-analysis based on of these data. “With this, we reached a prevalence closer to [para o Brasil]”, he states.

For him, the data draw attention to the high percentage of children and adolescents with altered levels of total cholesterol and LDL —low-density lipoprotein that, when at very high levels, can accumulate in the artery walls, leading to greater risk of cardiovascular diseases.

Rodrigues points out, however, that the results found in the analysis were heterogeneous. This occurred because part of the studies used a different parameter to calculate cholesterol rates.

The difference led the group of researchers to separate the data according to the two parameters used: that of the Brazilian Society of Cardiology, used in Brazil, and that of the National Heart, Lung and Blood Institute (NHLBI), an agency in the United States.

According to North American data, total cholesterol is considered high when it is above 200 mg/dL (milligrams per deciliter) —a parameter that, in the analysis, would indicate a prevalence of 17.22% of high total cholesterol among children and adolescents.

In Brazil, this evaluation occurs when the value is above 190 mg/dL for adults and 170 mg/dL for children and adolescents, according to the Brazilian Society of Cardiology and Pediatrics. With this, the percentage of children and adolescents in the country with high total cholesterol reaches 27.47%, and that of altered LDL, 19.29%.

“It is a high prevalence for a population of children and adolescents, and this occurs even when we use a more conservative cutoff point. [como o do NHLBI]”, says Rodriguez.

According to the researchers, the data reinforce the importance of knowing the lipid profile of children and adolescents in order to adopt control and prevention measures.

“There are factors that will make children and adolescents more likely to develop lipid alterations, such as family history. LDL and altered total cholesterol is also, in most cases, a secondary condition to obesity”, he says.

Data from the Sisvan platform, from the Ministry of Health, released by Sheet, show that the proportion of children with obesity and severe obesity in Brazil has grown in the last four years. In 2018, these rates were 8.9% and 4.99%, respectively, rising to 10.15% and 6.03% in 2022.

“We have an increase in sedentary lifestyle and inappropriate eating habits, such as the intake of ultra-processed foods [como biscoitos e salgadinhos]which means that this child has a greater risk of developing altered total cholesterol and LDL”, adds Rodrigues.

Currently, the recommendation is that children whose parents have high cholesterol and a history of early cardiovascular disease (such as heart attack and stroke before the age of 55) undergo an evaluation at two years of age, recalls Louise Cominato, president of the endocrinology department at the Sociedade Brasileira de Pediatria de São Paulo. Paul.

In children with obesity and other chronic diseases (such as nephrotic syndromes), the evaluation is indicated after the diagnosis, with regular follow-up. In the others, without the presence of these factors, the recommendation is that the first evaluation takes place between 9 and 11 years.

For Cominato, who did not participate in the study, the data call attention. She explains that cholesterol is part of the body and that high levels require monitoring.

“Sometimes the patient has high cholesterol at the expense of HDL, which is the good cholesterol. The big issue is the LDL, the bad cholesterol”, he points out.

In general, the association between changes in cholesterol rates and comorbidities, such as hypertension, obesity and diabetes, indicates a higher risk of cardiovascular disease.

“The higher the levels of cholesterol in childhood, the risk of cardiovascular disease in the future increases, and earlier”, he says.

Prevention

To reverse this scenario, the UFMG study suggests encouraging policies to increase the consumption of fruits and vegetables and reduce the consumption of ultra-processed foods, such as cookies, snacks and soft drinks, in addition to practicing physical activities. Measurements are also recommended on an individual basis.

Sonir Antonini, director of the department of pediatric endocrinology at SBEM, recalls that, in cases of children with very high cholesterol rates (above 250 mg/dL, usually linked to genetic and family issues), drug treatment may also be necessary. In the others, changing habits is recommended. He, too, views the data with concern.

According to Thales Rodrigues, one of the authors of the study, in the research, data from children and adolescents inserted in the school context or in communities and regions in general were used. Studies that worked with children with a history of factors that increased the chances of having altered LDL (in the case of comorbidities) were excluded.

Still according to the researchers, when analyzing the data, the study identified an increasing trend in the prevalence rates of high levels of total cholesterol and LDL. “This shows that there was probably a change in behavior, both in sedentary lifestyle and in the consumption of ultra-processed foods”, observes Rodrigues.

Data from Enani (National Study of Child Food and Nutrition) for 2019 show that the consumption of ultra-processed foods among children under five years of age was 93% in the country, while that of fruits and vegetables was 27.4%. The most recent report, for 2022, has yet to be released.