What over-the-counter preparation to use in case of elevated cholesterol in a child?

The manufacturer of the MonArte dietary supplement has not conducted studies of this preparation in a group of people under 18 years of age, hence the information on the packaging. The main ingredient that is responsible for lowering cholesterol in the described preparation is monacolin, a substance obtained from red rice. It is a substance called a "natural statin" because of its mechanism of action. In 2011, a randomized clinical trial was conducted in a group of children aged 8 - 16 years with lipid disorders, including hypercholesterolemia. These children were given m.in 3 mg of monacolin K for a period of 8 weeks. A significant reduction in total cholesterol, or LDL-C, was achieved in the absence of side effects. However, this study cannot be a reason to recommend MonArte in a group of children, because in addition to monacolin, it also contains other ingredients. Bearing in mind the guidelines for the treatment of lipid disorders in children, first of all, I would like to emphasize the need to change the lifestyle. I mean the introduction and consolidation of proper nutrition, emphasis on increasing physical activity, normalizing body weight or preventing passive smoking. It is recommended to increase the intake of dietary fiber (in amounts of approx. 15 g bearing in mind the age of the daughter), sea fish, vegetables, fruits, nuts and seeds, consumption of skimmed milk, introduction of sterols and plant stanols into the diet (up to 20 g / d). Pharmacotherapy is introduced after 6 months of lifestyle changes, when therapeutic goals have not been achieved. The drugs of choice are statins in the smallest possible doses, however, before their implementation, m.in transaminase examination is performed. I suggest that as an addition to lifestyle changes, e.g. preparations with garlic should be included. Longer use of garlic leads to a decrease in cholesterol levels, at the same time increasing immunity, and it will be a much safer solution than the multi-component MonArte preparation. An example of such a preparation can be Naturell Garlic Forte, the availability of which can be checked here: https://www.gdziepolek.pl/produkty/20853/naturell-czosnek-forte-kapsulki/apteki. In this case, we have specified that the preparation can be used over 6 years of age. More preparations with garlic, as well as a more detailed description of the action can be found in this article: https://www.gdziepolek.pl/kategorie/preparaty-z-czosnkiem.