by Marion Nestle
Jul 6 2008

Statin drugs for 8-year-olds?

The nutrition committee of the American Academy of Pediatrics has just issued a new set of recommendations for cholesterol screening.  The advice of this august body?  Screen 2-year-olds for high cholesterol and start prescribing statin drugs at age 8.  OK, they are just recommending this for kids with risk factors, such as high LDL cholesterol (the bad one), family history of heart disease, obesity, diabetes, metabolic syndrome, etc.   This sounds great for doctors, testing labs, and drug companies.  Is it a good idea for kids?  Which kids?  Who is going to pick up the tab for this?

Comments

  • tmana
  • July 6, 2008
  • 9:06 pm

Umm… is this an academic group of and for pediatricians, or has it been co-opted by the pharmaceutical industry? And given the way the various Child Protective Service agencies have been going, why not have them force the parents to give the kids a healthy diet on pain of… everything else they’ve been doing to wrest the kids from the parents?

[...] continues at Marion brought to you by diabetes.medtrials.info and [...]

  • Jack
  • July 6, 2008
  • 11:43 pm

Just shaking my head in disgust.

Imagine how much cheaper it would be to eliminate the fake food from kids’ diets and instead feed them whole, unprocessed foods. But that’s got to be a big stretch for the medical community, which still hasn’t come to terms with the fact that we are what we eat.

  • Sheila
  • July 7, 2008
  • 2:52 pm

What a Pandora’s box this will be.
It absolutely would be preferable to get the families to adjust the diet and exercise for the child and family to modify the risk factors/weight/diabetes/cholesterol of these children. But, after practicing medicine for almost 2 decades, I can tell you the number of families willing to do this is astoundingly small. I wish I had better news, but many of these children have parents who have been unwilling to modify their own lifestyle choices, so getting them to modify the behaviors for the whole family is just not likely to happen on a large scale basis. When we attempt to have families modify the child’s diet, we routinely meet with strong resistance. Common excuses are it will upset the child, it is too much work/time, it is too expensive.
That said, it also is concerning to me to start the statin drugs on small children…I just have not seen great studies yet regarding the safety of these drugs in children.
What we do know, however, is that most adults eat and exercise like what they did as children, unless they have had a great motivation to change, which is rare. Thus, I see the great importance of continued emphasis on school health and physical fitness programs, school nutrition programs, and social pressures on food manufacturers and restaurant chains to modify their offerings to improve the nutrition and activity levels.

  • Sheila
  • July 7, 2008
  • 2:52 pm

What a Pandora’s box this will be.
It absolutely would be preferable to get the families to adjust the diet and exercise for the child and family to modify the risk factors/weight/diabetes/cholesterol of these children. But, after practicing medicine for almost 2 decades, I can tell you the number of families willing to do this is astoundingly small. I wish I had better news, but many of these children have parents who have been unwilling to modify their own lifestyle choices, so getting them to modify the behaviors for the whole family is just not likely to happen on a large scale basis. When we attempt to have families modify the child’s diet, we routinely meet with strong resistance. Common excuses are it will upset the child, it is too much work/time, it is too expensive.
That said, it also is concerning to me to start the statin drugs on small children…I just have not seen great studies yet regarding the safety of these drugs in children.
What we do know, however, is that most adults eat and exercise like what they did as children, unless they have had a great motivation to change, which is rare. Thus, I see the great importance of continued emphasis on school health and physical fitness programs, school nutrition programs, and social pressures on food manufacturers and restaurant chains to modify their offerings to improve the nutrition and activity levels.

  • Sheila
  • July 7, 2008
  • 3:16 pm

Oops, sorry, didn’t mean to hit the send button twice. Maybe moderator can delete one of those duplicate entries?

  • darya
  • July 7, 2008
  • 11:43 pm

is there any doubt that these children can have managable cholesterol with a change of habits? maybe it’s their parents that need the drugs….

  • Bix
  • July 8, 2008
  • 5:17 am

When do they go off them? Do they stay on statins for 40, 50, 60 years?

Whether it’s right or wrong, it’s a boon for drug companies.

Marion asked … who will pick up the tab? I think insurance premiums and/or taxes will rise for everyone.

  • Sheila
  • July 8, 2008
  • 10:49 am

The issue of who will pick up the tab is probably a larger issue than immediately meets the eye. Yes, the monthly cost per prescription is high, although as these drugs come off patent, generic versions will become more available. But, the larger, unseen cost is who will pay for the cardiovascular disease treatment that inevitably will arise in people who have ignored their body weight/fitness/diabetes/cholesterol their entire lives? US society has not yet come to grips with the idea that a carefully chosen diet is not a form of imprisoment or punishment, but a joyful way to improve the odds of a healthier, longer life. We all will pay and are currently paying, millions of dollars each year for the care of atherosclerotic vascular disease in the form of heart care and stroke care and care of legs threatened by clogged arteries, and even in some men, the care of erectile dysfunction. We all pay for these things in the form of insurance premiums, taxes to support Medicare and Medicaid, and higher charges at hospitals and clinics to cover the cost of care that doesn’t get paid by anybody.
So, we can continue to pay for the very expensive, painful, not always successful back end treatment, or we could decide as a society that we value preventive care enough to make it a personal and national priority. The most successful, least expensive form of preventive care in this case is…you guessed it…a carefully chosen diet and regular exercise. So, let’s focus on putting our money where it gets results in the private sector and on commercial revisions of product offerings and advertising. Let’s get children and families to make this a priority, and there will be far fewer children or adults needing expensive intervention. Some of the persnal revisions could be very simple. For starters, I don’t know why commercial milk production is so focused on making whole milk. Very few US residents older than 2 years really need the extra fat present in whole milk. The vast majority of school age children in USA could do well on skim milk instead of whole milk. Yet, many schools and families still serve whole milk. This is one example of an easy adjustment that could be made at very small expense.

  • elfling
  • July 11, 2008
  • 4:08 pm

This is so creepy.

I hope at the very least that if docs are prescribing statins to kids who haven’t even entered puberty that they’re being enrolled in a study, so that we can track the outcomes.

  • Jon
  • April 4, 2009
  • 11:47 pm

Officially, heart attacks have gone into Darwinian time. Remember when this was an old man’s disease?

  • Eduardo
  • February 27, 2012
  • 1:49 am

Hi. When you quote LDL as “the bad one” which kind of LDL are you reffering to? Small dense or the big less dense one? Besides that until when is this anti cholesterol still going on? It’s all been published! This potent antioxidant, this component of each cell in our body, this building block for all sex hormones and for the very necessary vit.D, this liver-produced substance used to heal the damages of the excess of free radicals and other lunging factor onto the endothelium has been unfairly and cunnungly demonized by instances that profit the most by advertising and selling their products, including the “health food” industry with it’s whole grains and omega-6 rich-prone-to-rancidity (free radicals) veg.oils The mindset has been made up. Let’s not forget the Framingham Study, whose director had to make some amendments about the common sense on this subject. And let’s not forget the groundbreaking work of Ufe Ravnskof and Chris Masterjohn. I challenge anyone to look into these researcher’s work. About whole vs skim milk: yes, aparently the evolution was waiting for the mankind to come up with a process to take all fat form food to finally offer something healthy to noorish us, let alone all the grains after the invention of agriculture. 2 million years weren’t enough to shape our physiology? Intriguing. Comparing the “westernized” civilization with pacific islanders who still thrive on a grain, dairy and sugar free diet or even with the Okinawa people, with their diet very rich in animal fat, guess who is the healthiest one? Why even consider the evidences when one has a belief system, right?

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