Hype or logic in AAP recs for cholesterol screening and possible drugs for children?

The chair of the nutrition committee for the American Academy of Pediatrics is recommending cholesterol screening and drugs if needed for children with a family history of high cholesterol or heart disease. The new policy says screening should take place after age 2 and by age 10. If the numbers don’t look good, the policy suggests that for children older than 8, “cholesterol-reducing medications should be considered.” The thing to bear in mind is this is suggested in children believed to be in a high risk group or those who are obese. Is this more medical hype or is it a good idea?

I’d be hard-pressed to put my young child on any kind of drugs unless they’re vital to his or her staying alive. I’d ask my doctor, if I had young children, to be sure to only prescribe a drug tested for use in children. This would narrow the field, perhaps to zero. I would ask my doctor a whole lot of questions.

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.

It seems to me because of the costs associated with healthcare, we’ve become a society obsessed with prevention. I understand trying to live a healthy lifestyle. But I don’t understand the increasing number of screenings I see recommended and in some cases, mandated. Is this more hype to create another line item in the Medicare revenue chain? One media outlet says "cholesterol drugs for kids could reduce heart attacks in adulthood." Really? Please cite the study that proves this claim. The studies the AAP based the new policy on, as far as I can tell, were done via autopsy for the most part. So if a person died accidentally and happened to have clogged arteries, can conclusions be applied to all children? Were there other risk factors?

The fact we’re even talking about screening a toddler for cholesterol and giving an elementary school aged kid drugs to reduce cholesterol seems to me like killing a mosquito with a cannon ball when a fly swatter works just fine. [Text filed by Kay B. Day; graphic courtesy USDA website.]