Question:

Can you please comment on the AP latest report on anti-cholesterol medicine for children and healthy lifestyles and eating correctly instead? Thank you!

Answer:

The American Academy of Pediatrics statement is as follows:

“The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children. The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10.  The best method for testing is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years. For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. The statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.”

The key phrase with respect to medications is that “For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered.” We do not encourage random usage of any medication, but when the condition is severe (such as high LDL cholesterol) we weigh the risks and benefits of medication usage, and when the benefits outweigh the risks, we begin treatment. Certainly healthy eating and a healthy lifestyle (with decreased TV/Computer time with adequate physical activity) is critical, but in adult data these types of changes result in less than a 20% decrease in blood cholesterol levels.  If a 10 year old child has a LDL cholesterol level twice the level believed to be safe, healthy lifestyle changes will help, but will not solve the problem by itself.  Thus, in order to protect that child from the development of early cardiac disease and stroke, medications may be the best answer.

For more information:

Go to the Children’s Health health topic.