Pills or produce?

Our view : Diet, not drugs, should be primary tool for obese kids

July 14, 2008

Last week's recommendation by the American Academy of Pediatrics to give cholesterol-lowering drugs to some children as young as 8 is troubling. Millions of Americans take statins - the world's most-prescribed medications - to reduce the risk of heart disease by lowering their levels of "bad" cholesterol. These drugs have certainly prolonged the lives of thousands of middle-aged men with heart disease. But there is insufficient evidence that statins benefit other groups, notably younger children.

According to Dr. Peter O. Kwiterovich, a Johns Hopkins medical school professor and expert in cholesterol research, studies do show that adolescents with elevated cholesterol can benefit from statins. But there are no long-term data on their use in the very young. The prospect of years, perhaps decades, of treatment with a drug whose benefit is uncertain should give anyone pause. Indeed, some specialists fear that having kids pop anti-cholesterol pills could distract children and their families from the very things that are proved to reduce obesity and heart disease risk: physical activity and proper nutrition.

By contrast, the pediatricians' call for cholesterol screening of very young children is easy to embrace, as is their call for more attention to healthier diets.

That approach - targeting obesity at its source - is what a team of Hopkins researchers has in mind. The Healthy Stores Project is putting nutritious foods into corner shops, providing educational materials and even offering cooking demonstrations at the sites so inner-city residents are exposed to alternatives to low-nutrient snacks loaded with sugar, fat and salt.

Clearly, this is an uphill battle - junk food is ubiquitous and cheap, and foods such as whole wheat bread can be an acquired taste. But with rates of obesity skyrocketing, especially in the black community, it's a worthwhile fight.

Efforts like the Hopkins project that target lifestyle changes should be the first line of defense against obesity and cardiovascular disease. Giving kids medication without proof that it will help them should be a last resort.

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