Cholesterol tests aren’t for adults only anymore. A National Institutes of Health expert panel and the American Academy of Pediatrics (AAP) now recommend a check for all 9- to 11-year-olds — with a retest between age 17 and 21.  My first reaction when I heard about this new health "rule" was: "Oh, no, my kid hates needles!" Then I read the fine print. Big sigh of relief!

It turns out that most kids and teens won’t need the classic “fast for 12 hours, then try not to watch while they take a big vial of blood from your arm” test of their blood fats. Children who don’t have serious heart risks (and most kids don’t) will do OK with a quick, non-fasting, finger stick check in the doctor’s office, according to the AAP. Yes, it hurts for a few seconds, but you’ll avoid all the drama of no breakfast, a special trip to a lab, and that challenging couple of minutes while you grip his or her little hand and try to create a distraction during a blood draw. Whew!

Behind kid-sized cholesterol checks there’s a big controversy. Plenty of kids’ health and heart-health experts question the wisdom and usefulness of imposing an adult test on the young. Two thoughtful recent articles in the Journal of the American Medical Association say testing all kids is an expensive, time-consuming and potentially dangerous way to find the one in 500 with familial hypercholesterolemia—an inherited, genetic glitch that boosts heart-threatening LDL cholesterol to extremely high levels. These kids may need cholesterol drugs, the writers point out. But most kids won’t.

But I think focusing on the pros and cons of cholesterol checks misses the real point for most parents: We should be doing more to protect our children's hearts against future problems now — no matter what their cholesterol numbers are.  When Northwestern University researchers reviewed the health records of 5,447 teens and preteens for a study presented at the  American Heart Association’s 2011 Scientific Sessions last fall, they came to a scary conclusion: Today’s young people will face fatal heart disease earlier in adulthood than any previous generation. Here’s why:

• Their diets were high in sodium and sugar-sweetened beverages and didn’t include enough fruits, vegetables, fiber or lean protein.
• More than 30 percent of boys and 40 percent of girls had above-healthy blood sugar levels, raising their risk for type 2 diabetes later in life. (High blood sugar is a potent risk for heart disease.)
• About one-third were overweight or obese.
• Over 60 percent of girls and nearly half of boys didn’t get enough physical activity (an hour a day is the recommendation.)
• About 35 percent of girls and 28 percent of boys didn’t have “ideal” cholesterol levels. Their LDLs were high, their protective HDLs were low or they had both problems.
• Some — about 7 percent — had high blood pressure, too.

In future entries, I’ll be asking a variety of Philadelphia-area kids’ health experts their advice for keeping kids’ hearts healthy. For now, let us know what you’re doing and what you’re thinking about this emerging health issue for kids. If your pediatrician or family doctor suggested a cholesterol check for your child, would you say yes?