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I'm Rob Logan, Ph.D. senior staff National Library of Medicine substituting this week for Donald Lindberg, M.D, the Director of the U.S. National of Medicine.

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Recent and aggressive recommendations from the American Academy of Pediatrics to screen and treat high risk children with statins, or cholesterol lowering drugs, resulted in some public criticism. While the Academy's recommendations underscore a concern about childhood obesity in the U.S., some of the recent, critical public comments seem to be based on misunderstandings about the Academy's suggestions. In turn, these reveal the situational difficulties that sometimes make it challenging to communicate health information through the news media to the public.

In the July issue of Pediatrics, the American Academy of Pediatrics revised its decade-old recommendations on cholesterol in children. The former guidelines suggested that statins were appropriate for children at high risk for heart disease starting at age 10. Among the new guidelines, pediatricians are encouraged to:

• Give cholesterol lowering drugs to kids starting at age 8 who have high LDL levels, which is the 'bad' cholesterol linked to clogged arteries and heart disease
• Screen children starting as young as age 2 and no later than age 10 if they have a family history of heart disease or high cholesterol
• Test cholesterol levels in children with an unknown family history of cholesterol when the child also is obese, has high blood pressure, or diabetes.

The article's seven authors explain their recommendations are a response to increasing childhood obesity and unhealthy cholesterol levels in the U.S. Among other clinical problems at any age, obesity is clinically associated with high levels of 'bad' cholesterol (or LDL), which is a significant risk factor for heart disease. The authors note that from 30 to 60 percent of children and teens with unhealthy cholesterol levels are missed by current screening efforts.

To back up, the American Academy of Pediatrics is the official professional organization of the nation's pediatricians, or physicians who provide medical care to children. So the Academy's recommendations and treatment plans influence the care children receive in the U.S.

While statins, or cholesterol lowering medications, are the most prescribed drugs in the world, their use is widely perceived as a medication given to middle aged adults. Indeed, middle aged men and women often were the patients who participated in clinical trials about statins' ability to lower bad cholesterol.

Some sharp and interesting public criticism surrounding the Academy's recommendations (found on interactive websites, such as the New York Times' health page) surfaced almost immediately after news reports appeared.

One of the early criticisms (on the Times' health page) was the American Academy of Pediatrics should emphasize healthy nutrition, diet, and improve kid's eating habits rather than focusing on statins to treat children with high LDL, or bad cholesterol, levels.

In fairness, in the published recommendations the Academy's first counsel is to improve a child's diet. The authors encourage dietary guidelines for children recently proposed by the American Heart Association. These are available on the internet by typing 'American Heart Association diet guidelines for children' in Google, or other search engines.

The Academy also specifically recommended that overweight children should be encouraged to drink low fat milk after 12 months.

As sometimes occurs, the news media did not report all the details within the Academy's seven major recommendations. Indeed, the length of the recommendations was longer than most of the space or time news organizations routinely devote to cover a breaking health story. So, some news reports may have created the inadvertent impression that the Academy stressed drug therapy and deemphasized diet and nutritional recommendations.

The latter illustrates how longer, complex recommendations from well-intentioned medical organizations sometimes overwhelm the available space and time in news services and foster an inadvertent public response. To put this another way, from a journalism perspective the 'news' in the Academy's recommendations may have been the expanded use of statins for kids -- rather than efforts to provide a more balanced, healthy diet. So, the news media's emphases and limited space could have accidentally fostered the impression that the recommendations were focused on drug therapy.

Along the same lines, other complaints about the Academy's recommendations suggested the study's authors were stewards for the nation's pharmaceutical companies. However, the New York Times reported none of the study's authors reported financial relationships with statin manufacturers.

Meanwhile, the Pediatrics article acknowledges the public health challenge that underlies new recommendations includes childhood obesity (and its link to cholesterol, clogged arteries, and heart disease). MedlinePlus' obesity in children health topic page provides an array of resources designed to help treat, anticipate and counter weight challenges for toddlers through teens.

A site called 'helping your overweight child' provides a primer on how to: encourage healthy eating habits, provide nourishing snack ideas, encourage exercise, as well as where to turn for additional information. The site, provided by the National Institute of Diabetes and Digestive and Kidney Diseases, is in the 'start here' section of MedlinePlus' obesity in children health topic page.

The health topic page also includes: other news stories about childhood obesity, carefully selected information on treatment, prevention and nutrition, a body mass calculator, some of the latest research findings, as well as information written specifically to help teens.

To find it, type 'child obesity' in the search box on MedlinePlus.gov's home page. Then, click on 'obesity in children (National Library of Medicine).'

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