Problems With the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents

Garlic Extract Therapy in Children With Hypercholesterolemia

“…While pharmacologic lipid-lowering therapy has been shown to be effective in reducing cardiovascular mor-bidity and cardiovascular mortality rates and total mortality rates in adults, management of hyperlipidemia in children remains controversial. [1][2][3] Our study showed no significant reduction attributable to garlic extract therapy in recognized cardiovascular risk factors in children with familial hyperlipidemia, with the exception of a small increase in apolipoprotein A-I levels.…”

“…Data are reported as frequencies, medians with ranges, and means with SDs as appropriate. Characteristics at baseline were compared between groups using the Fisher exact test, 2 test, Kruskal-Wallis analysis of variance, and t test. Patient changes in height, weight, blood pressure, and blood test results were assessed with paired t tests for each group.…”

“…[1][2][3] Our study showed no significant reduction attributable to garlic extract therapy in recognized cardiovascular risk factors in children with familial hyperlipidemia, with the exception of a small increase in apolipoprotein A-I levels.…”

Plant-based diets for children as a means of improving adult cardiometabolic health

“…While epidemiological studies have not directly confirmed the link between the early presence of aortic fatty streaks and the occurrence of clinically significant atherosclerotic plaques in later life, 65,66 there is a relationship between the location of fatty streaks in the coronary arteries in children and atherosclerotic lesions in the same site later in life. 67 In nonblack populations, the extent of involvement of coronary artery with fatty streaks in youth predicts the extent of its involvement with raised lesions in older persons.…”

Poor Performance of Body Mass Index as a Marker for Hypercholesterolemia in Children and Adolescents

“…Consistent with the findings of other investigators, [24][25][26][27] this study found that screening based on a positive family history was no better than a random screening strategy in the population, with a sen- If neither BMI percentile nor a positive family history can accurately predict elevated cholesterol levels during childhood, this raises the question of how best to target individuals for cholesterol screening. It has been argued that cholesterol screening during child-hood, whether targeted or universal, has little utility, 28,29 based on the modest impact of a low-fat diet on LDL cholesterol levels (lowering of LDL cholesterol level by 3.23 mg/dL) among older children, 30 the lack of longterm dietary and pharmacologic intervention studies (particularly among younger children), and the lack of pharmacologic trials except among a high-risk subgroup of individuals with familial hypercholesterolemia. 31,32 Furthermore, there are also concerns regarding the potential for "labeling" children with a disease for which there may not be adverse health consequences for decades 29 and the potential difficulties that these children may face when applying for health insurance when they reach adulthood because of their "preexisting" cholesterol condition.…”