OPINION

Children and cholesterol

What is acceptable in cholesterol levels in blood has undergone a significant change in recent years. Expert panels and medical bodies round the world have come up with a series of stricter as well as more nuanced guidelines. For instance, the normal levels for LDL (Low Density and Lipoprotein) and triglycerides — ‘bad’ fats that can cause artherosclerosis by building up in the walls of arteries— have been lowered. Such revisions have led to an increase in the number of people treated with cholesterol-lowering drugs such as statins, which inhibit the build-up of arterial plaque and lower the risk of heart attacks. It is estimated that the guidelines issued in May 2008 by the United Kingdom’s National Institute for Health and Clinical Excellence could result in 1.5 million additional “statin patients.” Earlier this month, the American Academy of Pediatrics recommended the creation of a new class of statin patients: children. The Academy’s new guidelines suggest the use of cholesterol-fighting drugs for children, eight years of age and above, who have too much LDL or trigylcerides alongside other risk factors. Other recommendations are blood screening for children (two to 10 years of age) with a family history of high cholesterol; and consumption of toned milk for all those above one year “for whom overweight or obesity is a concern.”

The American Academy of Pediatrics explains that the new guidelines are based on an alarming increase in obesity in children and increasing evidence that heart disease, the country’s biggest killer, begins early in life. Predictably, the thought of anti-cholesterol drugs for children has sparked off an animated debate. Some paediatricians express concern over the side effects of a lifetime of consuming statins. Others fear that the stress on drugs will distract from natural therapies such as alterations in diet and exercise regimens. There is also that old nagging suspicion: are regularly revised cholesterol guidelines influenced by the multi-billion-dollar drug industry that makes huge profits out of cholesterol-lowering drugs? While the medical jury is out on the question of when and under what conditions people need to be put on such medication, there is little doubt that it is effective in delaying progressive arterial damage and reducing coronary events such as strokes and heart attacks. The consumption of statins and related drugs can cause liver problems and muscle pain in some patients. But for millions of people, they are life-savers.

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