Child Cholesterol Test at Age 10: Ashok Seth’s Advice

Heart disease is increasingly becoming a concern among younger people in India, prompting doctors to call for greater awareness of cardiovascular risk factors from childhood. At the India Today HealthWealth Summit 2026, leading specialists discussed how obesity, unhealthy eating habits, physical inactivity and undiagnosed heart conditions can affect long-term health.

During a session titled “Bimariyon ka Baap Motapa”, Dr Ashok Seth, chairman of Fortis Escorts Heart Institute, and Dr Anoop Misra, executive chairman and director at Fortis C-DOC, discussed the relationship between obesity and cardiovascular disease. They emphasised that protecting heart health requires more than monitoring body weight: identifying hidden fat, recognising inherited risks and making sustainable lifestyle changes are also important.

One of the key concerns raised during the discussion was the possibility of heart conditions remaining undetected in children and young adults. Some people who experience sudden cardiac events have underlying conditions that were never diagnosed. The doctors highlighted cholesterol testing and cardiac assessment as potential tools for identifying certain risks before complications occur.

However, screening decisions need to be based on medical guidance. While childhood cholesterol screening can help identify inherited lipid disorders, an echocardiogram is not routinely necessary for every healthy child. The appropriate tests depend on age, family history, symptoms and individual risk factors.

Why Cardiologists Are Concerned About Heart Disease in Younger Indians

Heart disease is often associated with older adults, but cardiovascular problems can also affect younger people. At the summit, Dr Ashok Seth highlighted concerns about heart attacks occurring at relatively young ages in India and cited estimates suggesting that around half of heart attacks in the country occur in people below 50.

The discussion also referred to a reported increase of approximately 200% in heart disease over the preceding 15 years. Such figures underline the importance of examining changing health patterns, although the precise scale of an increase depends on the population studied, the period covered and whether the measure refers to cases, deaths or another indicator.

Cardiovascular disease can develop over many years. High cholesterol, elevated blood pressure, diabetes, tobacco use and excess abdominal fat may contribute to risk long before a person experiences noticeable symptoms. Some inherited conditions can also increase cardiovascular risk from an early age.

This is why prevention cannot begin only when someone develops chest pain or another warning sign. Understanding family history, maintaining healthy habits and identifying relevant risk factors can help people make informed decisions about their health.

For children and adolescents, the focus should be on age-appropriate preventive care rather than assuming that every young person has a heart problem. A family history of premature cardiovascular disease, known inherited cholesterol disorders or concerning symptoms can make an early medical assessment particularly important.

Should Every Child Have a Cholesterol Test at Age 10?

Childhood cholesterol screening can identify elevated cholesterol levels before they contribute to cardiovascular problems later in life. This is particularly relevant for children with inherited conditions such as familial hypercholesterolaemia, which can cause very high levels of low-density lipoprotein (LDL) cholesterol from an early age.

LDL cholesterol is commonly described as “bad” cholesterol because elevated levels can contribute to plaque accumulation in artery walls over time. This process, known as atherosclerosis, can narrow arteries and increase the risk of cardiovascular events later in life. Inherited cholesterol disorders can accelerate this process if they remain undetected and untreated.

Children with high cholesterol usually do not experience obvious symptoms. A child may appear healthy, maintain a typical body weight and participate in sports while still having an inherited lipid disorder. A blood test is needed to measure cholesterol levels and help identify such problems.

Dr Seth’s recommendation, as reflected in the summit discussion, draws attention to the value of identifying cholesterol-related risks early. However, the headline should not be interpreted as meaning that every child automatically requires the same tests or that cholesterol screening alone can rule out heart disease.

What Do Cholesterol Screening Guidelines Generally Recommend?

Paediatric cholesterol screening recommendations vary across countries and professional organisations. In the United States, for example, commonly cited paediatric guidance includes universal lipid screening once between ages 9 and 11, alongside earlier or additional testing for children with certain risk factors. Recommendations may differ in India, and families should follow advice from their child’s paediatrician based on local guidance and individual circumstances.

A lipid profile generally measures total cholesterol, LDL cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. The results help clinicians assess whether a child’s cholesterol levels fall within expected ranges or require further evaluation.

A doctor may recommend screening earlier or more frequently when a child has a strong family history of premature heart disease, a parent with very high cholesterol, a known inherited lipid condition or other relevant risk factors. The clinician can also explain whether fasting is necessary for the particular test being ordered.

Why Early Detection Matters

Finding high cholesterol during childhood gives families and healthcare professionals an opportunity to assess its cause and address modifiable risk factors. Depending on the results, management may involve dietary changes, physical activity, follow-up testing or specialist care. Some children with inherited cholesterol disorders may also require medication under medical supervision.

Early identification can be especially important in familial hypercholesterolaemia because lifestyle changes alone may not be enough to bring LDL cholesterol to an appropriate level. Treatment decisions depend on the child’s age, cholesterol levels, family history and overall clinical assessment.

Parents should avoid starting restrictive diets, supplements or cholesterol-lowering medicines for children without medical advice. Children’s nutritional needs differ from those of adults, and treatment should support healthy growth and development.

When Might a Child Need an Echocardiogram?

The summit discussion also highlighted echocardiography as a way to assess certain heart conditions. An echocardiogram is an ultrasound examination that produces images of the heart, allowing clinicians to examine its structure, movement and function.

It can help doctors investigate certain congenital heart defects, abnormalities of heart valves, problems involving the heart muscle and other structural or functional concerns. The test does not use ionising radiation and is generally painless, although the need for one depends on the clinical situation.

Importantly, an echocardiogram is not the same as a cholesterol test. A lipid profile measures fats in the blood, while an echocardiogram examines the heart’s structure and function. Each test answers different medical questions.

Routine echocardiography is not generally recommended for every child who has no symptoms, concerning examination findings or relevant family history. A paediatrician or cardiologist may recommend it when there is a specific reason to investigate a possible heart condition.

Warning Signs That Need Medical Assessment

Although many childhood heart conditions do not cause obvious symptoms, certain signs should not be ignored. These include:

• Fainting during physical activity or exercise.
• Chest pain associated with exertion, particularly when it recurs.
• Unexplained breathlessness or a sudden reduction in exercise tolerance.
• Palpitations accompanied by dizziness, fainting or other concerning symptoms.
• A known heart murmur or another abnormal finding identified during a medical examination.
• A family history of sudden unexplained death at a young age or a known inherited heart condition.

These symptoms do not necessarily mean that a child has heart disease, but they may warrant further evaluation. Sudden collapse, severe breathing difficulty or chest pain accompanied by fainting requires urgent medical attention.

Parents should share relevant family medical history with their child’s doctor, including known inherited heart muscle conditions, rhythm disorders and unexplained early deaths. This information can help clinicians determine whether further testing or specialist referral is appropriate.

Obesity Is More Than a Number on the Weighing Scale

Beyond childhood screening, the summit focused on obesity as an important contributor to cardiovascular and metabolic disease. Dr Anoop Misra explained that excess body fat is not merely a cosmetic concern. Its location, the amount of muscle a person has and the way the body processes nutrients can all influence health.

Body weight alone does not provide a complete picture of an individual’s metabolic health. Two people with similar weights may have different proportions of muscle and fat, different levels of abdominal fat and different patterns of blood pressure, blood sugar and cholesterol.

Visceral fat is the fat stored deep inside the abdomen around internal organs. Excessive accumulation is associated with insulin resistance, abnormal blood lipid levels and an increased risk of type 2 diabetes and cardiovascular disease.

Someone can therefore have metabolic risk factors even when their weight does not appear particularly high. This is one reason clinicians may assess waist circumference, body composition and laboratory measurements alongside body mass index (BMI).

For children, weight and growth should be assessed using age- and sex-appropriate growth charts rather than adult BMI categories. A healthcare professional can interpret these measurements in the context of the child’s development and overall health.

Why Waist Circumference Can Reveal Hidden Health Risks

Waist circumference is a simple measurement that can provide additional information about abdominal fat. During the summit discussion, the doctors cited waist measurements of more than 36 inches for men and 32 inches for women as indicators of concern.

Such thresholds are used in some clinical and public health contexts, but cut-offs can vary according to the population and guideline being followed. Measurements should therefore be interpreted in the appropriate clinical context rather than treated as universal diagnostic boundaries.

A larger waist circumference can be associated with an increased likelihood of insulin resistance, type 2 diabetes, high blood pressure and abnormal cholesterol levels. However, waist size alone cannot diagnose these conditions.

Healthcare professionals may consider waist circumference alongside blood pressure, blood glucose, cholesterol levels, age, family history and other relevant information. This broader assessment can help identify people who may benefit from preventive care.

The discussion also emphasised that muscle mass matters. Regular strength-building activity and adequate nutrition can help maintain muscle, while reducing excess body fat may improve metabolic health. The goal should be a sustainable approach that supports overall health rather than a focus on weight loss at any cost.

Seven Lifestyle Factors That Can Affect Heart Health

The doctors identified several lifestyle and environmental factors that can contribute to cardiovascular risk. These factors often overlap, which means that addressing multiple habits may be more beneficial than focusing exclusively on body weight.

1. An Unbalanced Diet

A diet that frequently includes excessive amounts of salt, added sugar and saturated or trans fats can contribute to health problems over time. A balanced eating pattern that includes vegetables, fruits, whole grains, pulses, nuts and suitable protein sources can support heart health.

Portion sizes and overall dietary patterns matter more than relying on a single so-called superfood or ingredient. Families can begin by making gradual changes, such as adding more vegetables to meals, choosing whole grains more often and reducing frequent consumption of highly processed foods.

2. Smoking and Tobacco Use

Smoking damages blood vessels and increases cardiovascular risk. Exposure to second-hand smoke can also be harmful. Avoiding tobacco and seeking professional support to quit can help protect heart health.

3. Excessive Alcohol Consumption

Alcohol can affect blood pressure and contribute to other health risks, particularly when consumed in excess. Reducing consumption or avoiding alcohol can be part of a broader strategy to improve health.

4. Prolonged Sitting and Physical Inactivity

Long periods of sitting and insufficient physical activity can contribute to poor metabolic health. Breaking up sitting time with short movement breaks and incorporating regular exercise into daily routines can help.

5. Chronic Stress

Persistent stress can affect sleep, eating habits, physical activity and other behaviours associated with Cardiovascular Health. Relaxation practices, social support, adequate sleep and professional assistance when needed can help people manage stress more effectively.

6. Obesity and Excess Abdominal Fat

Excess body fat, particularly visceral fat, is associated with several cardiovascular risk factors. Sustainable nutrition and activity habits can help people manage their weight and improve metabolic health.

7. Air Pollution

Air pollution is an environmental risk factor associated with cardiovascular and respiratory disease. While individuals cannot control every source of pollution, checking local air quality, reducing exposure during severe pollution episodes and following public health advice can help limit exposure.

These risk factors do not affect everyone in the same way. Personal medical history, genetics, age and environmental circumstances also influence cardiovascular risk, making individual assessment important.

Exercise for a Healthier Heart: Why Strength Training Is Not Enough

Strength training can help build or preserve muscle mass, improve physical function and support metabolic health. However, a balanced fitness routine should also include aerobic activity that challenges the cardiovascular system.

Activities such as brisk walking, cycling, swimming and dancing can improve cardiorespiratory fitness when performed at an appropriate intensity. Combining aerobic exercise with muscle-strengthening activities supports several aspects of health.

For adults, widely used public health recommendations advise at least 150 minutes of moderate-intensity aerobic activity each week, or an equivalent amount of vigorous activity, alongside muscle-strengthening exercise on at least two days. People who are inactive can begin gradually and increase their activity as their fitness improves.

Children and adolescents need regular movement that is appropriate for their age and development. Active play, walking, cycling, sports and other enjoyable activities can help them develop healthy habits. Exercise plans should be adapted for children with known medical conditions or symptoms that require assessment.

People who experience chest discomfort, fainting, unusual breathlessness or other concerning symptoms during exercise should seek medical evaluation rather than attempting to push through them.

Does Mustard Oil Help Protect Heart Health?

During the discussion, mustard oil was highlighted as an affordable cooking option. It is widely used in several Indian cuisines, but no single cooking oil can independently prevent heart disease.

Heart health depends on the overall dietary pattern, including the types and quantities of fats consumed. Replacing foods high in saturated or trans fats with suitable sources of unsaturated fats can support healthier blood cholesterol levels, but the benefits depend on the broader diet and individual circumstances.

Cooking methods, portion sizes and the frequency of consuming fried or highly processed foods also matter. Rather than relying on one ingredient as a protective measure, families can focus on a balanced diet that provides a variety of nutrients.

Breakfast can be another opportunity to improve dietary quality. Whole grains, pulses, fruit, nuts and suitable dairy or other protein sources can help provide fibre, protein and essential nutrients. The best combination depends on individual nutritional needs, preferences and medical conditions.

Can COVID-19 Affect Cardiovascular Health?

The doctors also discussed concerns about cardiovascular complications following COVID-19. Some people experience heart or blood vessel problems during or after an infection, although the nature and likelihood of complications vary between individuals.

Potential symptoms after an infection can include persistent breathlessness, chest discomfort, palpitations or reduced exercise tolerance. These symptoms can have several causes and should not automatically be attributed to COVID-19 without assessment.

Anyone experiencing ongoing or new cardiovascular symptoms should consult a healthcare professional. Severe chest pain, collapse or serious breathing difficulty requires urgent medical care.

The broader lesson is that a person’s medical history, symptoms and examination findings should guide decisions about further investigations. Not everyone who has had COVID-19 requires routine cardiac imaging, and testing should be based on clinical need.

What Parents Can Do to Protect Their Children’s Heart Health

Parents can support children’s cardiovascular health through a combination of preventive healthcare, healthy family habits and awareness of relevant warning signs. The aim is not to create anxiety about heart disease but to identify meaningful risks and encourage habits that benefit children as they grow.

• Discuss family history: Tell the paediatrician about inherited cholesterol conditions, premature heart disease or unexplained sudden deaths in close relatives.
• Ask about cholesterol screening: Discuss whether a lipid profile is appropriate for your child’s age and risk factors.
• Recognise concerning symptoms: Seek medical advice for exercise-related fainting, recurrent exertional chest pain or unexplained breathlessness.
• Encourage active routines: Make movement and enjoyable physical activity part of everyday family life.
• Build balanced eating habits: Offer varied meals that include vegetables, fruits, whole grains and suitable protein sources.
• Protect sleep and wellbeing: Encourage consistent sleep routines and support children in managing stress.
• Avoid tobacco exposure: Keep children’s environments smoke-free.
• Follow professional advice: Use a paediatrician’s assessment to decide whether further tests, specialist referral or treatment is needed.

Parents should also avoid interpreting a normal cholesterol result as proof that a child has no possible heart condition. Cholesterol screening evaluates lipid-related risks, while other investigations may be required when symptoms or family history suggest a different problem.

Early Prevention Is More Than Testing

The central message from the India Today HealthWealth Summit 2026 was that preventing obesity-related complications and cardiovascular disease requires a broad approach. Monitoring relevant risk factors, recognising hidden abdominal fat, maintaining muscle, staying active and eating a balanced diet can all contribute to long-term health.

Childhood cholesterol screening can play an important role in identifying inherited or elevated cholesterol levels, particularly when recommended according to age and individual risk. Echocardiography can help investigate specific structural or functional heart concerns, but it is not a universal screening test for every healthy child.

For families, the most useful next step is to discuss age-appropriate preventive care with a healthcare professional, especially when there is a strong family history of early heart disease or known inherited conditions. Early assessment can provide opportunities for monitoring, lifestyle support and treatment when needed.

Heart health is shaped by genetics, environment and habits over time. By recognising risks early and making sustainable changes, families can take practical steps to protect both children’s wellbeing and their own cardiovascular health.