In case you hadn't heard, last week the American Academy of Pediatrics recommended that kids between the ages of 2 and 10 be screened for cholesterol problems if they have risk factors for problems therein.
Risk factors would include strong family histories, obesity, high blood pressure or diabetes.
The Academy goes on to recommend that for kids over 8 with high cholesterol, medications be considered.
On the one hand, perhaps that makes sense. We know high cholesterol to be a risk factor for heart disease and these kids therefore have at least two risk factors. Presumably lowering cholesterol will therefore reduce long term cardiac risk in these children.
The problem is, given that generally we haven't been treating 8 year olds with cholesterol lowering medications, we actually don't know that there will be a long term benefit, we just assume there will be one and that there won't be any surprising long term complications from starting these drugs during years that their bodies and brains are developing.
On the other hand, by giving these kids drugs, at least in kids whose secondary risk factor is not a strong family history (in which case they may well have genetically high cholesterol levels), we're not addressing the root cause of their effectively middle-aged bodies - lifestyle.
Given that 8 year old kids don't cook for themselves, don't shop for food for themselves, don't pack their own lunches for themselves and all in all live the way their parents have taught and allowed them to live, I think it's a crying shame that there's no pill that we can prescribe to their parents to help them learn, set, live and lead better examples.
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AMEN DOCTOR AMEN! You hit the nail so squarely on the head it is awesome!
ReplyDeleteThe problem (aside from high genetic disposition) with kids who have high blood pressure or high cholesterol is the parents. Parents are so afraid of "hurting the child's feelings" and "damaging their self esteem" that the concept of saying NO to bad processed easy foods and pissing off their little gaffers is unheard of. You see it everywhere; the second a child gets upset with a parent's decision that the child doesn't like parents cave in rather than stand their ground and let the child work through the concept of not getting what they want. TOUGH! Suck it up kiddo! No twinkies being bought for the cupboards of our home. Piss them off and drive them nuts, in the long run...all the "emotional" harm you are doing by being a firm parent will build a strong adult who isn't struggling with numerous health problems throughout their adult life. Their health damage GROSSLY out weighs the perceived emotional damage of being firm.
REFUSE TO BUY THE JUNK! It really isn't that hard. If you don't buy it, they can't eat it at home!
The original article in Pediatrics did emphasize diet and lifestyle management, but admitted that this would be difficult because parents often do not want to change their own diet and lifestyle (despite the likelihood that they have similar risks), and that it could be financially or logistically difficult for parents to make these changes (medical insurance pays for drugs, but there is no assistance to buy fruits and veggies -- which are often unavailable, even canned or frozen, in low-income urban areas). They also did not address Junior taking his lunch money to buy a large bag of Doritos and a two-liter Coke instead of the overcooked, canned, spoiled foods served in the school cafeteria.
ReplyDeleteInterestingly, one method of institutionalizing lifestyle management might be through the use of Child Protective Services (goes by different names depending on your legal jurisdiction): they currently proactively remove children from homes where there is the least suspicion of physical or emotional abuse (including total withholding of food). This abuse can be incidental (single parent unable to pay for food, makes too much money to qualify for assistance) or deliberate. If these social workers were to check to assure appropriate nutrition rather than to remove parental rights for asserting appropriate discipline, parents would no longer be afraid to say "no" to the $200 designer jeans: they'd be afraid to say "yes" to the potato chips and full-fat ice cream...
The AMA also now recommends that 1 year olds start on 2% over whole milk if they are larger babies. As a mother of a 10.5 month old who is in the 75%-90% for weight and height, who is also very dedicated to healthy eating and exercise, to what level do I "diet" my child. I lived my childhood overweight. Not obese, but on the pudgier side of normal. While I don't want my munchkin girl to suffer the psychological and physical effects of living an overweight life, I also don't want to put my toddler on a diet! Like most parents, I work hard to get healthy food into a finicky little eater. But somedays are easier than others. Somedays are healthier than others. I am saddened that I have to consider weight management with a 10.5 month old girl. Health Canada hasn't made this same recommendation for "larger" babies yet. What are your thoughts? Does a young toddler need fat management?
ReplyDeleteThe only milk in our home currently is skim. I don't even like 1%. I also don't drink it. Just for cereal and coffee. I just assumed I would have to start my toddler with whole milk in Sept since it is recommended everywhere I look. Perhaps my thinking is wrong. This parenting stint is a tough job :)
Not knowing your child it's impossible for me to make any real recommendations other than to chat with your pediatrician. If it helps at all, my children all got whole milk until the age of 2 at which point we stepped directly down to skim.
ReplyDeleteMy advice regarding parenting is straight forward. You need to live the life you want your children to live and then hope for the best.