Statins are one of the most frequently prescribed drugs for cholesterol lowering in adults worldwide. However, new guidelines from the American Academy of Pediatrics are recommending these drugs for "at risk" children as young as 8 years.
The recommendations have proved controversial in the US, with some health professionals extremely concerned that such drugs would be prescribed to young children.
The AAP however, believe that the drugs could benefit thousands of children who are already obese, or showing signs of high blood pressure or type II diabetes, or who have a family history of heart disease; and that such should be routinely screened for high cholesterol.
The strange thing about the AAP's recommendations is that they are completely opposite to recommendations recently issued by the U.S. Preventive Services Task Force, following an expert systematic review of 25 years.
The USPSTF had concluded that:
1. Evidence is insufficient to recommend routine screening for lipid disorders in infants, children, adolescents or young adults.
2. The benefits and harms cannot be determined.
3. There is no evidence that any intervention to lower cholesterol levels in childhood "leads to improved lipid profiles or better health outcomes in adulthood."
4. There is potential for harm of dietary and pharmacological interventions attempting to reduce cholesterol levels in young people.
The fact is, that cholesterol-lowering drugs are not approved by the FDA for use in children (except in children with FH). So, how can the AAP recommend the use of statins for children?
Are the recommendations harmful?
According to a BBC news report, Professor Andrew Neil, from the University of Oxford, said that while the safety of statins in adults was "well established," there was far less information about this in children, who might expect to use them for very long periods.
He said: "While I fully support the use of statins in children with familial hypercholesterolaemia, it is not my view that they should be used in the myriad of children with simple obesity or moderately elevated cholesterol."
The report also recommends lowering dietary fat in all children beginning at 12 months of age; and they encourage the intake of low-fat milk, and reduced-fat diets to manage weight from the age of two.
Such suggestions are potentially very harmful - previous studies have failed to show low fat diet effective in reducing obesity, cholesterol levels, or risks for heart disease, and they actually found evidence to suggest harm for children and teens, who need fats in their diets for normal development.
These new recommendations are certainly worrying. To suggest that young children should be popping pills, without in-depth research is complete fallacy, leading us to query exactly how this "policy" came into being!
What can parents do to encourage a healthier lifestyle for their kids?
• Be a role model by eating healthy foods, and exercising regularly.
• Have a positive attitude towards good health.
• Purchase and prepare healthy food and snacks.
• Positively reinforce healthy behaviour with non-food rewards.
• Create opportunities for active recreation.
• Engage in sports as a whole family.
For the majority of children a nutritional and exercise approach is all that is needed, and ultimately this the best approach all round!
What are your thoughts on the new guidelines?
Melanie Thomassian is a professional dietitian, and author of the award winning Dietriffic.com.
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Published On: July 18, 2008