When we think about cholesterol screening as a risk for heart disease, we immediately think of adults. But the National Heart Lung and Blood Institute in the United States is calling attention to children and the growing concern that many are at risk young in life for diseases that will present down the road.
 
For children with clear risk factors, such as obesity and family history of cholesterol and early heart disease, or those with diabetes and high blood pressure, other organizations such as the American Academy of Pediatrics have recognized the need for screening.
 
What has sounded the alarm for more widespread screening is a study that showed if we only do targeted screening, many children at risk would not be identified.
 
At this week's American Heart Association is a report presented on broader attempts to identify children at risk. All major contributors to heart disease such as obesity, smoking, diabetes, high blood pressure and high blood sugar have been looked at under the magnifying glass of evidence based medicine and more aggressive recommendations are being made about screening. Use of cholesterol lowering medications in children has also been reviewed.
 
The panel suggests that every child should be tested for cholesterol by ages 9- 11 and while medication is not being suggested as first line, aggressive attempts to treat through lifestyle modification are the first step .Screening for blood sugar and diabetes has been suggested at age 9 and repeated every two years in those children who meet the criteria for overweight and obese.
 
The growing epidemic of overweight and obesity on both sides of the border are a growing concern about where we are going in the future with this at risk population how best to identify them.
 
Autopsy studies have shown us that there are signs of heart disease before symptoms present. It is believed that by the fourth grade as many as 10% or greater of children have high cholesterol. Doctors are often not accustomed to taking blood pressure measurements in children but these guidelines call for screening starting at age 3.
 
The guidelines are quire extensive in the 48 page report. As early as age 2 the call is to identify children at high risk for obesity because of parental obesity or excessive BMI increases and focus on diet and physical activity. Closer follow up at 3 month intervals is being called for by age 6 if the BMI is greater than the 85 percentile.
Under lipid assessment universal screening is being called for at age 9 to 11. At 12 to 16 routine screening is not being called for unless there are risk factors that would indicate you should screen and again at age 17 routine screening is called for.
 
The guidelines are ac all for action to help deal with the growing epidemic of overweight and obesity seen in our youth to help stave off diseases in later years.

Here's a complete copy of the recommendations.

And here's a summary of the guidelines

• First cholesterol screening - between ages 9 and 11
• Another cholesterol screening - between ages 17 and 21
• Yearly blood pressure for children starting at age 3
• Routine anti-smoking advice when kids are ages 5 to 9
• Counsel parents of infants not to smoke in the home
• Review infants’ family history of obesity
• Start tracking body mass index, or BMI, at age 2

WATCH: My chat on Canada AM: cholesterol and kids