New guidelines that recommend cholesterol testing for all children between the ages of 9 and 11 and again as young adults 17-21 years of age are likely to surprise most parents and stimulate vigorous debate among physicians.

Previously, only children with a family history of elevated cholesterol and early heart disease or with risk factors such as high blood pressure, obesity, or diabetes were screened. But this month, an expert panel selected and appointed by the National Heart, Lung, and Blood Institute and endorsed by the American Academy of Pediatrics, supported early screening as part of an effort to curb the epidemic of childhood obesity.

One third of children and teenagers in the United States are defined as obese or overweight, with minorities such as African Americans, Mexican American, and American Indian children experiencing disproportionately higher rates of obesity and an increased risk of diabetes and heart attack later in life By fourth grade up to 13 percent of American children already have abnormally elevated cholesterol levels, defined as a total cholesterol number of 200 or higher.

I believe these new guidelines represent a very important step in childhood disease prevention and health promotion. By intervening earlier, we can address the lifestyle behavior habits of poor nutrition and exercise and replace them with health-promoting behavior or medication when necessary.

Bottom line: Parents should support this new and expanded childhood cholesterol screening. The potential benefits include less heart disease and fewer heart attacks for your children when they turn 50.

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