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May 16, 1990


JAMA. 1990;263(19):2672-2673. doi:10.1001/jama.1990.03440190128069

Developments in the field of pediatrics over the past year or two have centered on a changing major subfield, neonatology, where events have either surprised or overtaken us, and on genetics, which is foreshadowing the future of pediatric care. Two controversial issues have also emerged: to test or not to test universally for cholesterol levels in children and how to react to the advertising of infant formula to the public.

The argument for universal testing of children for cholesterol levels includes the following considerations1: (1) Atherosclerosis is the basis for more deaths in later life than any other cause. (2) Testing adult cholesterol levels leads to interventions that reduce coronary artery disease; therefore, it may have a similar beneficial effect in children. (3) Atherosclerosis begins in late childhood; therefore, early dietary intervention will be useful. (4) Testing only children from "high-risk" families misses many (some say as much as