Childhood Obesity: Should We Give Children Cholesterol Lowering Medications?
Childhood obesity is directly related to poor eating habits, and lack of activity. So, when I heard that the use of statin medication had been approved for children as young as eight, I was quite surprised, and very skeptical.
This is the news clip I saw earlier today...
When I first heard it, it almost made sense. But, the problem with this way of addressing childhood obesity, is that you are only treating a symptom (in this case high cholesterol) of a much greater problem. Let me give you an example...
If you have a child that burns their hand on the stove, and the doctor tells you to treat it with burn ointment, that makes sense. However, if this is the tenth time your child has burned their hand on the stove??? Well, maybe it's time to address prevention and not just treatment.
I really believe that we need to focus on preventing and treating childhood obesity, and the answer won't be found in any pill. Lifestyle change and better eating habits are the only way to prevent the longterm effects of obesity. Here are a few sites that might help you improve your child's eating habits...
From Kids Health - Healthy Eating
From Mom to Mom - Unique Ways to Help Kids Eat Healthy
From PBS Parents - Encourage Kids To Eat Healthy
From WebMD - High Cholesterol in Children
So, while treating some cases of childhood high cholesterol with statins may be appropriate, it's far from a solution. I would say it's like putting a band-aide on a gaping wound...But, it's actually more like not even trying to stop the bleeding, and using blood transfusions to counter the blood loss. It just doesn't make very much sense.
I'm not the only one questioning these new recommendations, this is from The New York Times...
While some doctors applauded the idea, others were incredulous. In particular, these doctors called attention to a lack of evidence that the use of the cholesterol-lowering drugs, called statins, in children would prevent heart attacks later in life.
. . .
Other doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines.
“To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen of Hackensack University Medical Center in New Jersey, vice chairman of an academy panel on traditional and alternative medicine. He added: “Treatment with medications in the absence of any clear data? I hope they’re ready for the public backlash.”
Newsweek Health has an interesting article on the pros and cons of statins for children...
Newsweek's Mary Carmichael spoke with Peter Belamarich, a pediatrician at Children's Hospital at Montefiore Medical Center in New York City, who has prescribed statins to some kids but takes issue with the new guidelines.
Did you hear about this? What do you think? Here is some of what others are saying...
From Angie at ParentDish...
The AAP has also reversed its original stance against giving children under the age of 2 reduced fat milk. Higher fat milk was recommended because saturated fats are essential for brain development. "But now we have the obesity epidemic and people are thinking maybe this isn't such a good idea," said Dr. Frank Greer of the University of Wisconsin, co-author of the guidelines report, which appears in the July edition of Pediatrics, the group's medical journal.
Young children are now getting the fat they need from sources other than milk and the updated recommendation is based on recent research showing no harm came from younger children drinking the reduced-fat milk.
Theresa from Poked and Prodded...
Dr. Daniels says medication isn’t for every kid. “We are only talking about children who have pretty high cholesterol, cholesterol that would be high for an adult,” he says. Children who are obese and have diabetes or other risk factors are more likely to be candidates for medication.
“It’s a balancing act of risks and benefits,” Dr. Daniels says. At some point it ”tips in favor of being more aggressive in terms of treating those problems.”
From Mothership Meals...
According to the article, children's cholesterol levels have remained stable in the last few years, and their tri-glyceride levels have even dropped. So... what gives?
Meanwhile, according to this other article, also by Tara Parker-Pope, statins don't even really work: "But many statin users don’t have established heart disease; they simply have high cholesterol. For healthy men, for women with or without heart disease and for people over 70, there is little evidence, if any, that taking a statin will make a meaningful difference in how long they live."
In today's article, Pope says that the AAP is also now recommending that one-year-olds with a possibility of developing a weight problem drink low-fat milk. I- I- I... I'm speechless. Well, almost.
From Mary at Fatosphere - Just When You Thought You'd Heard It All...
Before I blow a gasket and become one of those obesity-related casualties we keep hearing about, I'm going to just go back to the specifics of this CNN article. Here are some things that are causing my left eyebrow to arch so high that it may just migrate right off my face:
(1) The AAP spokesdoctor quoted in the article, Stephen Daniels, "has worked as a consultant to Abbott Laboratories and Merck & Co." -- "but not on matters involving their cholesterol drugs". OHHHHH, thank god he wasn't working on matters involving their cholesterol drugs. Because you might think he had some impure motives in recommending his former employer's cholesterol drugs to 8 year-olds if he had worked on matters involving their cholesterol drugs, but since he didn't work on matters involving their cholesterol drugs, I can't see any possible conflict of interest, can you?
From Dr. Molly's Weblog...
What this means for your child is that my nurse will be drawing (through a vein rather than a finger poke) a sample of blood at the check up if your child has been fasting overnight and I will send it off to the lab. If your child has an appointment too late in the day to do a fasting sample at the check up, you can either take a request to the lab and have them draw the sample any morning, or return to my office for a lab draw early in the morning. After sending the blood off, I get results in a day or so and will notify you by email of the results. If the labs are abnormal, I will also send the dietary and exercise changes that are recommended and I will encourage you to implement them for a six month period after which we will do the lipid panel again. If things haven’t improved significantly, then we will discuss the pros and cons of lipid lowering medications for your child. If your child’s labs are normal, we will repeat the levels in 3-5 years.
Its a lot to chew on but it emphasizes the importance of doing what we can to keep our kids at the lowest risk. 70% of children have some degree of atherosclerosis by age 20 and although the serious complications of high cholesterol may take decades to present themselves, the eating and activity habits we encourage in our children often last a lifetime.
I’m not even sure about the screening. Have numbers been adapted to children, and how do you measure those numbers against growth spurts, something no parent can predict the timing on? How about this money-saving idea? If parents have a truly obese child or a child whose screening shows high cholesterol, would a modified diet and exercise help? And more important, would a nutrition class for the parents help? You can find a lot of information about the food pyramid and physical activity at the US Department of Agriculture website.
What do you think? Is screening young children for high cholesterol really necessary? Would you put your child on medication for high cholesterol? Should more be done to help prevent obesity in children? Let me know what you think. And, if you've blogged about this, I hope you'll leave me a link in comments.