The Kiddie Cholesterol Debate

Making decisions about your health is never easy, and things get even harder when the choices involve children. That's why the latest recommendation from the American Academy of Pediatrics (AAP) to widen cholesterol-testing to include kids as young as 2 is shaking up doctors and parents alike. The academy is also urging doctors to consider treating young patients from families with a history of abnormally high cholesterol levels - a major contributor to heart disease - with medications known as statins.

Taken together, these policies represent a desperate and perhaps even radical attempt to contain the heart disease, diabetes and other metabolic consequences of an obesity epidemic that doctors believe has spiraled out of control. "We have to start somewhere," says Dr. Jatinder Bhatia, a neonatologist at the Medical College of Georgia and member of the advisory committee that spent two years devising the guidelines. Dr. David Ludwig, a pediatrician at Children's Hospital in Boston who was not involved in making the recommendations, agrees. "We have 8-year-olds who look metabolically like an obese 60-year-old. Research predicts that this generation of children will live shorter and less healthy lives than their parents because of obesity," he says.

While the guidelines target kids with a genetic risk of abnormally high cholesterol, called hyperlipidemia, they could lower the bar for prescriptions - not just for these children but for any overweight youngster whose cholesterol is not in check. Within hours of the AAP announcement on July 7, parents took to the blogs, expressing shock and unease over the aggressiveness of the guidelines. Statins are not without risks; in adults, in rare cases, they can cause muscle weakness and kidney problems, and there are limited data on how statins affect children.

Amid the uproar, the AAP is firmly defending the guidelines. "We think there will be more benefit than risk," says Dr. Nicolas Stettler, a committee member from Children's Hospital Philadelphia. Part of that risk could be a shift toward the quick-fix prescription and away from prevention programs involving diet and exercise to address obesity and surging cholesterol levels. Most pediatricians are wary of moving too quickly to medicate children, especially when the potential side effects are unknown. But it's certainly easier to scribble a prescription than it is to get young patients to eat better and exercise more. And then there's the possible cascade effect. "We can add statins to help overweight children," Stettler says. "But what about the next problem that comes up - insulin resistance and fatty liver. Are we going to keep adding drug after drug? That possibility just makes me want to cry."

Source: New York Times.
Author: Alice Park

Source: http://news.yahoo.com/

Comments: Clearly even pediatricians are not satisfied with these guidelines. One university professor from New Jersey is reported to have said "I'm embarrassed for the A.A.P. today." Indeed this should be a generic statement for any such health institutions today, such as American Medical Association or the F.D.A.

There is no data to conclusively prove that statins are helpful in preventing heart attacks in adults, nor is there any data on safety of these drugs after 50-60 years of use in children. Statins have been around only for last couple of decades; one of them is already recalled, and yet advisors are ready to push these medications to entirely untested population. Under the old guidelines, children considered at high risk for heart disease could be given statins starting at age 10. The new guidelines apply to children as young as 8 with LDL, or "bad," cholesterol of 190mg/dl, or those with LDL of 160 and a family history of heart disease or two other risk factors. Among children with diabetes, drug treatment may begin when bad cholesterol reaches 130. Use of statins at such a young age, underestimates the importance of diet and exercise that is extremely important in children. There is still a debate about widespread use of statins in adults.

Although they claim to reduce the risk of death in middle-aged men with existing heart disease, there is no evidence that they prolong life in healthy men, women or people over 70. On the other hand statins are definitely associated with increasing number of side effects as rhabdomylagia (muscle damage that could lead to kidney problems), liver function abnormalities, cognitive problems and cancer in adults. In addition, statins also deplete a very important nutrient co-q-10, which is essential for normal functioning of heart. So, with little or no evidence of efficacy, and wide range of safety issues in adults, why is it even considered for use in children? As opposed to this strategy, A.A.P. ignores the importance of healthy diet, exercise, and supplemental nutrients that are more helpful in fighting the rising rate of obesity and related metabolic disorders as heart disease, diabetes, hypertension and so on.

Dr. Rath has conclusively proven in clinical trials that supplementing appropriate nutrients help support healthy heart function, reduce atherosclerotic plaque build up, normalize cholesterol levels, and many other chronic health issues afflicting today's world. Please read more about the results of clinical trials other aspects of Dr. Rath's research on www.drrathresearch.org.