Utilization of resources for nutritional education and counsel- ing is encouraged. 2. Lifestyle-modification interventions in childhood and adolescence show short- and long-term benefits to lipid levels and subclinical atheroscle- rosis measures in RCTsS4.4.4.3-5 S4.4.4.3-8 and obser- vational studies of children and adolescents with lipid disorders.S4.4.4.3-3,S4.4.4.3-9 No adverse effects on growth or maturation have been The impact of these inter- ventions on lipid levels and subclinical atheroscle- rosis is small; no studies report CVD event rates. There are likely other unmeasured health benefits of lifestyle-modification interventions for chronic disease outcomes (eg, obesity, diabetes mellitus, and cancer). These benefits support the recom- mendation to treat children and adolescents with lipid disorders with lifestyle-modification interven- tions, generally by using a family-based approach and promoting a heart-healthy diet, plenty of physical activity, avoidance of cigarette smoking, maintenance of a healthy weight, maintenance of normal blood pressure, and maintenance of nor- mal glycemia. CLINICAL STATEMENTS AND GUIDELINES 3. Statins and nonstatins lower TC and LDL-C in chil- dren and adolescents with FH,S4.4.4.3-30 and other health conditions that put them at increased risk of CVD.S4.4.4.3-31,S4.4.4.3-32 Evidence from these RCTs demonstrates low short- and medium-term adverse event rates (abnormalities in liver func- tion test, creatine kinase [CK] levels, and reported myopathy) with statin use in children and ado- lescents with FH.S4.4.4.3-30 Limited data show ben- efit from statins to subclinical atherosclerosis in FH. These data, coupled with the increased risk of CVD in untreated severe hypercholester- olemia, support the use of statins in children and adolescents at ages 10 years who have and have not responded to 3 to 6 months of lifestyle therapy. 