The American Academy of Pediatrics and the National Institute of Health are now encouraging universal cholesterol screening at 10 years of age.  The previous guidelines were targeted towards screening high risk groups which seemed to make much more sense, but this mass screening may pick up a few unknown familial high cholesterol patients.   The fact that the government is interested in spending this money on mass screening speaks to the problem at hand.  

The thrust of our intervention has to be focused on teaching all people a heart healthy diet and exercise.  It is not prudent to just target those people who have abnormal screening tests.  

When a child fails lifestyle modification and has a familial history of or risk factors for diseases like premature coronary artery narrowing, diabetes, high blood pressure, etc... what do we do at this point?  Did we fail because of poor teaching? Poor compliance? What?

Are we really going to start high risk drugs in these children if their cholesterol level is elevated? I think that this is a dubious choice and requires some thought into what are the risks of providing cholesterol lowering drugs to a child from age 10 years until what?  70?  This may be necessary for some, but for the majority it is likely that persistent education is the answer.  We know that for almost all people a healthy diet works.  

We need to focus on mandatory education for all parents and children on what constitutes a healthy diet and how to get there.  We could provide mass health education in school that really teaches eating for health.  Instead of providing lunch lines that promote the exact disease that these guidelines purport to screen for, we need to lobby congress to promote healthier food.  Some schools like those in Rowan County are taking large strides, yet they are still beholden to low cost cholesterol raising foods because of federal subsidies and budget issues.