Pediatric Dyslipidemia – Screening + LDL (Click-Through)

No numeric entry (physician click-through). TG pathways are placeholders where labeled “Target TG”.

Path

What to do

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Reference (RFs / Diet)

Risk factors (RFs) & risk conditions (RCs)

FHx (+): MI/angina/CABG/stent/angioplasty/sudden cardiac death in parent/grandparent/aunt/uncle: male <55, female <65.

High-level RFs

Hypertension requiring drug therapy (BP ≥99th%ile + 5 mmHg)
Current cigarette smoker
BMI ≥97th%ile
Presence of high-risk conditions (below)

Moderate-level RFs

Hypertension not requiring drug therapy
BMI ≥95th%ile and <97th%ile
HDL-C <40 mg/dL
Presence of moderate-risk conditions (below)

High-risk conditions

Diabetes mellitus (Type 1 or Type 2)
Homozygous familial hypercholesterolemia (hoFH)
Chronic/end-stage renal disease or post-renal transplant
Kawasaki disease with persistent coronary aneurysms/stenoses/occlusions
Orthotopic heart transplantation

Moderate-risk conditions

Familial hypercholesterolemia (FH)
Kawasaki disease with regressed coronary aneurysms
Chronic inflammatory disease (juvenile rheumatoid arthritis; SLE)
HIV
Nephrotic syndrome

CHILD-1 (baseline diet)

Total fat: 25–30% daily kcal
Saturated fat: 8–10% daily kcal
Avoid trans fats
Mono- and polyunsaturated fat: up to 20% daily kcal
Cholesterol: <300 mg/day
Encourage high dietary fiber intake
Activity: ≥1 hour/day moderate-to-vigorous (children >5y)
Primary beverages: fat-free unflavored milk and water
Limit/avoid sugar-sweetened beverages; limit 100% juice to ≤4 oz/day

CHILD-2 (your handout) – numeric targets

Total fat: 25–30% daily calories
Saturated fat: ≤7% daily calories
Monounsaturated fat: ~10% daily calories
Avoid trans fats
Cholesterol: <200 mg/day
Activity: ≥1 hour/day moderate-to-vigorous
Screen time: <2 hours/day
Omega-3 supplement: 1–4 g/day
Psyllium: 6 g/day (2–12y); 12 g/day (≥12y)
Plant stanols/sterols: up to 2 g/day