If the child has diabetes, is 8 years of age or older, with an LDL ≥ 130 mg/dl, yes, statins and other cholesterol-lowering drugs should be considered.Those are the recommendations of the nutrition committee of the American Academy of Pediatrics. The new guidelines were made public last week in the Academy's journal Pediatrics:
Lipid Screening and Cardiovascular Health in Childhood, July, 2008
The guidelines advise screening children, via a fasting lipid profile, "after 2 years of age but no later than 10 years of age" if they present with the following risk factors:
- Positive family history of dyslipidemia or CVD
- Patients for whom family history is not known
- Overweight or obesity
- Hypertension
- Cigarette smoking
- Diabetes mellitus
"Targets as low as 130 mg/dL or even 110 mg/dL may be warranted when there is a strong family history of CVD, especially with other risk factors including obesity, diabetes mellitus, the metabolic syndrome, and other higher-risk situations."The prospect of an indefinite period of pharmacological intervention, beginning in childhood, may make lifestyle changes such as diet and exercise* that much more inviting.
* The guidelines recommend adherence to the USDA's Dietary Guidelines for Americans, which list recommended servings for grains, fruits, vegetables, and milk/dairy, as well as fat and calorie limits, according to age and gender. The USDA Guidelines also recommend that "children and adolescents engage in at least 60 minutes of physical activity on most, preferably all, days of the week."
If you click on the little astronaut up there, it will take you to an interactive computer game the USDA designed for children as an introduction to the food pyramid. They can "reach Planet Power by fueling their rocket with food and physical activity."
