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Why Would the AAP Recommend Lowering Cholesterol in Children With Drugs Rather Than Nutrition?
I was stunned when I heard that the American Academy of Pediatrics made recommendations for children to use cholesterol-lowering drug therapy to lower their cholesterol! Why would an association that claims to be committed to the health of all children make such outrageous recommendations? Pediatricians are the guardians of children’s health until they reach adulthood. It seems counterintuitive to me to suggest that children with high LDL cholesterol levels should be treated with cholesterol-lowering drugs that may produce adverse events. At first glance this is true, but after thinking about it for a while, I’m starting to see that there are at least a few reasons this group must have considered before making this suggestion.
I tried to put myself in the shoes of a pediatrician who has been practicing since the mid-1990s, observing the changing appearance of children 8 years and older in the waiting room. As I mentally scan the 1995 room and move forward, I notice a change in the landscape. Over time, the kids seem to grow as fast horizontally as they grow vertically, and I don’t mean cute. Far from being cute, childhood obesity is a deadly serious problem. Children who are overweight or obese are those with higher levels of LDL cholesterol. If they lose weight, cholesterol levels drop once fat stores are burned off and cholesterol is flushed out of the body.
I believe children should lose weight through changes in nutrition and physical activity, and the AAP agrees. For children younger than 8 years with high LDL cholesterol levels, weight loss, physical activity, and nutritional counseling are recommended as first-line treatments for lowering LDL cholesterol levels. Why did they decide to add cholesterol-lowering drug therapy to their recommendations for children 8 years and older?
They have to believe that when the child is 8 years old, other natural methods of lowering cholesterol have been tried and failed because the child is still overweight. They may think they’ve seen the effect of nutritional counseling and physical activity approaches on this group of kids and know that it won’t make these kids lose weight. Who is responsible for the food these children eat? I think it’s still their parents, so why do pediatricians think they can’t get parents to help their kids eat the right foods and get them off the couch?
Unfortunately, as a country, we have become so dependent on the pharmaceutical industry to solve health problems that, given time, could be solved through natural means. Synthetic drugs have their place, but they are not the first-line treatment for any chronic disease. Yet these kids didn’t become obese in one weekend and didn’t reach epidemic proportions in just one year. Childhood obesity has become an epidemic, and the future of these children is at stake.
If a child is overweight or even obese, they are likely to be overweight or obese as adults. They will experience the medical problems that come with being overweight. They are at increased risk of heart attack, stroke and other cardiovascular diseases. Also, if these children don’t already have type 2 diabetes, they are more likely to develop type 2 diabetes as they age. These doctors are seeing an increasing number of young children developing type 2 “acquired” diabetes. Childhood diabetes is also becoming an epidemic, and type 2 “acquired” diabetes is often accompanied by high cholesterol. By the way, just 15 years ago, type 2 “acquired” diabetes was taught to be seen in people over the age of 40. It is generally accepted that it takes time to develop or “acquire” the disease from a lifestyle consideration.
I have strong opinions on why this happened, but I won’t share any of them except one. I agree with doctors and their recommendation to use cholesterol lowering medications because you are using them in an emergency and there is no greater emergency in healthcare today than the growing obesity and type 2 diabetes epidemic in children. Pediatricians are on the front lines of fighting these epidemics and they need all the tools they can get their hands on.
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#AAP #Recommend #Lowering #Cholesterol #Children #Drugs #Nutrition