walkitout (walkitout) wrote,
walkitout
walkitout

AAP's committee on nutrition is at it again

I have issues with pediatrics as a specialty having to do with how it grew up alongside formula use. And not in an adversarial role, either.

The AAP section on breastfeeding, while unbelievably compromised in several ways, has at times issued statements about their disagreement with the nutrition committee.

Who is going to put a stop to the latest ideas out of the committee is an open question.

On the list: low fat dairy for infants over 12 months. Rationale? Hey, _some_ kids are getting a lot of fat.

But the headline grabber is amazing, even for these guys. Tara Parker-Pope over at the NYT, on day Two of coverage of the new recs, has this for a headline:

8-Year-Olds on Statins? A New Plan Quickly Bites Back

http://www.nytimes.com/2008/07/08/health/08well.html

Really. In a world in which books are being written, studies produced and articles fly around madly showing that statins do _jack shit_ for morbidity and mortality, except for _men_ who _already have heart disease_ (yes, statins reduce cholesterol in other groups; no, that doesn't have any net benefit). In THIS WORLD, the AAP's committee on nutrition wants to put pre-pubescent kids on statins.

Given that a set of the side effects (euphemistically, and hopelessly inadequate described as "muscle pain". Ya know, just call it rhabdomyolysis. If you're going to be that unclear, hell, go straight to the latin. Which I had to look up to get the spelling right, so if it's still wrong, sorry!) makes exercise, shall we say, _unlikely_, ya gotta wonder what they're thinking over there. The answer, of course, is that they aren't. They're pediatricians. If they _thought_, they'd be family practice docs. Oh, wait, that's my bias showing. Sorry about that.

Just never forget. These are the people who for a long time wanted everyone to wean at 4 months because breastmilk didn't have enough vitamin D and Sunshine is Dangerous so neither mother should get more vitamin D (which would affect the amount in her breastmilk) and heavens! Putting a _baby_! In sunlight! OMG! That might, like, cure jaundice or something. Or prevent rickets. Much better to consume formula. Or, after the committee on breastfeeding and a bunch of lactivists beat some sense into them, take vitamin D in the form of oral drops (cause, ya know, cod liver oil would be a disaster!).

After all, everyone _knows_ that slathering a newborn with a bunch of parabens (aka endocrine disrupters -- hey, wouldn't that have something to do with how sugar and fat are processed) in sunscreen is a _much_ better idea. Best of all, never let them outdoors. I mean, they might like run around and get some exercise or something.

Coverage from Day 1, which I initially avoided, because I had a strong feeling I'd respond strongly and negatively:

http://www.nytimes.com/2008/07/07/health/07cholesterol.html

"Previously, the academy had said cholesterol drugs should be considered in children older than 10 if they fail to lose weight after a 6- to 12-month effort." The age limit has been dropped to 8. It's unclear if they still have the 6-12 month weight loss thing (wouldn't just dropping the cholesterol number be adequate, even if they didn't lose weight?).

Here's a gem:

"Dr. Bhatia said that although there was not “a whole lot” of data on pediatric use of cholesterol-lowering drugs, recent research showed that the drugs were generally safe for children."

Which would be _fucking amazing_ if true, given that the drugs are increasingly not regarded as particularly safe for adults and a lot of docs are questioning putting _middle aged_ folk on them for decades when they have no other indication of heart disease -- because of safety concerns.

And they want to start screening at age 2, if the parents have cholesterol/heart issues. *2*

Here's an opposing viewpoint from the previous set of guidelines:

http://www.nytimes.com/2005/05/31/health/nutrition/31ibeg.html?fta=y

I should not be so mean about pediatricians. Really, I mean, _this_ guy is one.
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