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Doctors Recommend Screening All Children Ages 9-11 for Cholesterol

All children ages 9 to 11 should have their cholesterol levels screened at least once, according to guidelines published online in the journal Pediatrics, the official journal of the American Academy of Pediatrics.

The guidelines, sponsored by the National Heart, Lung, and Blood Institute, were designed to help pediatricians promote cardiovascular health in youths. Risk factors in childhood can greatly boost the chance that a person will eventually develop heart disease as an adult.

"If we screen at age 20, it may be already too late," said one of the guideline panel members, Dr. Elaine Urbina, director of preventive cardiology at Cincinnati Children's Hospital Medical Center, to the Associated Press. "To me, it's not controversial at all. We should have been doing this for years."

Members of the expert panel who released the guidelines on Friday noted that their recommendations had to serve two purposes: to prevent risk-factor development and to prevent the future development of cardiovascular disease by managing those risk factors.

Not surprisingly, obesity was identified as the biggest risk factor for cardiovascular disease. In one recent study, 84 percent of people who had a BMI in the 95th to 99th percentile as children were also obese as adults, and all the children with a BMI above the 99th percentile were obese as adults.

High cholesterol and blood-pressure levels were also correlated as risk factors, as was a lack of physical activity, although none was as strongly linked to cardiovascular disease as obesity.

In response, the panel recommended that doctors start monitoring children at high risk of obesity because of parental obesity or sudden BMI increases starting at the age of 2.

The panel also suggested using tougher language for children with the highest BMIs. The guidelines recommend terming children with a BMI between the 85th and 95th percentile as "overweight," and a child with a BMI above the 95th percentile as "obese."

"Some may feel that 'obese' is an unacceptable term for children and parents, so as with all health conditions, the practitioner is encouraged to use descriptive terminology that is appropriate for each child and family, with a thorough explanation and discussion," the guidelines say.

On the exercise front, the panel recommends at least one hour of moderate-to-vigorous physical activity every day of the week for children older than 5, with three days of vigorous activity per week.

Meanwhile, the panel suggested that parents limit their child's screen time (TV and computers, specifically) to two hours a day, at most.

The panel found "reasonably good evidence that physical-activity patterns established in childhood are carried forward into adulthood," and thus recommended that schools promote physical activity as a way to stay healthy.

At What Age Can Obesity Be Predicted?

It's possible to predict which children will become obese by the age of 3 1/2, according to a new study from the University of Montreal.

The study, published in the Archives of Pediatric and Adolescent Medicine, focused on roughly 2,000 children whose height and weight measurements had been taken from the age of 5 months to 8 years old. The researchers identified three groups of children, based on their body mass index scores: children with low but stable BMI, children with moderate BMI, and children with BMI that was elevated and rising.

"We discovered the trajectories of all three groups were similar until the children were about two and a half," said Laura Pryor, the lead author of the study and a Ph.D candidate at the University of Montreal's Department of Social and Preventative Medicine, in a statement. "Around that point, the BMIs of the high-rising group of children began to take off. By the time these children moved into middle childhood, more than 50 percent of them were obese."

Pryor and her team identified two major risk factors for childhood obesity: the mothers' weight around the time they gave birth and whether the mothers smoked. Children whose mothers were overweight or smoked during pregnancy were much more likely to be in the high-rising BMI group.

Does that mean that mothers who don't smoke and who aren't obese are guaranteed to have skinny children? Not necessarily.

But if Pryor's team accurately identified and isolated two major risk factors for childhood obesity, these findings add yet another piece to the obesity-prevention puzzle.

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