The American Academy of Pediatrics has stirred up a controversy with its new recommendations for childhood cholesterol management. Appearing in this month’s edition of Pediatrics, the guidelines instruct doctors to begin cholesterol screening in children ages two to ten with risk factors such as obesity, diabetes and a family history of high cholesterol. For interventions, the authors recommend a healthy diet, nutritional counseling and physical activity – nothing surprising. But here’s the kicker: doctors should consider prescribing cholesterol-lowering statins for children as young as eight with high cholesterol.

This last recommendation has concerned people for a number of reasons. Although research shows that statins can lower cholesterol in adults and children, critics argue that no studies have lasted long enough to assess the long-term effects of taking the drugs so early in life. Furthermore, the article contains no conflict-of-interest disclosures from its seven authors, one of whom has worked as a consultant for Merck & Co., a company that makes statins, and another who has been involved in industry-backed clinical trials on cholesterol meds. Finally, there is concern that the recommendations will put pressure doctors to prescribe statins to kids with borderline high cholesterol – those who could otherwise control it with diet and exercise.

“This report has taken on a new urgency given the current epidemic of childhood obesity with the subsequent increasing risk of type 2 diabetes mellitus, hypertension and cardiovascular disease in older children and adults,” the authors assert. But is it possible that pushing statins for certain kids will actually worsen the obesity epidemic by shifting emphasis away from the more fundamental issues of diet and lifestyle?

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