By James J. Gormley
On July 7, 2008, the American Academy of Pediatrics (AAP) Committee on Nutrition issued new cholesterol screening and prescription treatment guidelines for children.
The AAP’s policy statement recommends cholesterol screening of children with a family history of high cholesterol or heart disease in children as young as toddlers just over two years of age and the prescribing of cholesterol (statin) drugs for children just over age eight. The group also wants our growing kids to drink lowfat milk.
What a sad day this is for America’s children.
But before I address the AAP, whose motto is “Dedicated to the health of all children,” let’s take a brief look at these drugs.
Statin drugs—examples of which include Zocor, Mevacor and Lipitor—are avidly prescribed and dispensed to tens of millions of people worldwide. Nevertheless, according to an August 28th, 2007, article in the Washington Post, experts say that muscle pain and other side effects occur in up to 30 percent of statin patients.
Possible side effects, which for some people can even be disabling, can include: Lou Gehrig’s disease (also called amyotrophic lateral sclerosis), liver and kidney problems, muscle aching or weakness, numbness in hands and feet, memory loss, dark or cola-colored urine, among other serious problems.
According to Sara Parker Pope in the New York Times, “there is no evidence to show whether giving statins to a child will lower the risk for heart attack in middle age.” Furthermore, the guidelines offer no guidance on how long a child should stay on these drugs. In fact, children taking these drugs could wind up being on these pharmaceuticals for the rest of their lives.
As to the AAP, in response to a reporter’s question regarding the fact that there are no long-term data on statin use in children, a member of the academy’s nutrition committee was quoted in the July 8th New York Times as saying: “We extrapolate from the information we have in adults.”
That statement brazenly flies in the very face of the academy’s founding principles.
According to the AAP, the organization was founded in 1930 by 35 pediatricians who were committed to transforming medicine in order to recognize that children have special developmental and health needs; that children should never again be treated as miniature adults.
In terms of the guidelines, the July 2004 National Cholesterol Education Program’s (NCEP) recommendations on statins and cholesterol lowering, upon which the academy’s guidelines are partly based, was headed up a panel of nine authors, eight of whom had financial ties to statin makers.
Today, most specialty medical societies receive a large part of their funding from drug companies; in fact, “approximately 70% of physicians’ continuing medical education is now paid for by the drug” companies, according to Drs. Abramson and Starfield in a 2005 paper in the Journal of the American Board of Family Practice.
Could pharmaceutical influence, either indirectly through the NCEP recommendations or directly on the AAP, be a factor here?
We already know that the influence of agribusiness and food and beverage giants on our society, and our children, is without question.
For example, when the AAP developed these guidelines, did it consider the following facts uncovered by researchers from the University of North Carolina: between 1997 and 2001 alone, overall calories from sweetened drinks went up 135%; Americans drank approximately 40% fewer calories from milk and milk consumption in kids dropped from 13.2% of total calories to 8.3%; and soda consumption doubled in children.
Doesn’t the academy know that, according to the Urban and Environmental Policy Institute, “school food programs compete against the widely available and aggressively advertised fast food, soft drink and snack foods that fill vending machines, school stores and a la carte cafeteria lines.”
Most assuredly the AAP is aware that U.S. Department of Agriculture (USDA) corn subsidies encourage the big soda makers to use high-fructose corn syrup in its drinks.
So where is the academy on all this?
Is the AAP issuing stern guidelines calling on a complete scrapping of the national school lunch program? Is it calling on schools around the country to ban soda and junk food from the schools? Is it taking on the soda and junk food companies who advertise to, and prey on, our children?
I think not.
While, in fairness, the AAP did urge that good diets and exercise be tried first, the magic bullet approach to the overweight and unhealthy of America’s children may, tragically, be an attractive one to the academy’s 60,000 members and to many parents.
On July 10th, the New York Times editorial board wrote: “We do fear that [this recommendation] will open the way for drug companies to bombard anxious parents with ads promoting these and other products and increase the number of parents insisting on prescriptions for their children.”
The editorial writers added: “The ease of popping pills should not distract parents, health professionals or policy makers from the more arduous tasks of cutting back on junk foods, promoting healthy diets and putting physical education back into the schools.” Well said.
If there is any possible good that has arisen from all this it may be this: now parents have a new “litmus test” with which to choose pediatricians.
Parents should now ask pediatricians if they are in favor of the new AAP cholesterol screening and drug treatment guidelines. If a pediatrician says that he or she is in favor of the drugging guidelines, parents will know, with certainty, that they do not want this pediatrician caring for their children.
If parents around the country were to use pediatrician adoption of these guidelines to choose, or keep, pediatricians, perhaps the message will get through to the academy.
Furthermore, if many of the 60,000 members of the academy were to call for this guideline to be immediately corrected and to refuse to implement the drug treatment recommendations, perhaps that message might get through too.
Until this happens, however, we must ask the academy to change its motto to: “Dedicated to the drugging of our children,” as the AAP’s existing motto can no longer, in good conscience, be used.
An award-winning journalist, published author, and member of the prestigious American Society of Journalists and Authors (ASJA), Gormley has 20 years of experience in health-related media communications. He is a senior policy advisor for Citizens for Health (www.citizens.org), an advisory board member of the National Health Research Institute (NHRI) and a member of the Institute of Food Technologists (IFT). From 2006 to 2008, Gormley directed three leading health-food trade magazines for VRM Inc. He is perhaps best known for having served as the longtime editor-in-chief of Better Nutrition magazine (1995 to 2002) and for having founded Remedies magazine in 2006. A consumer health advocate and industry champion, Gormley has also been a frequent guest on television and national radio where he has spoken out on a variety of health and regulatory issues.