 Even when guidelines are clear, doctors do not always follow national screening guidelines. So how do they behave in situations which may be too unsettled for guidelines to reign? Take the example of cholesterol screening for children. The National Heart, Lung, and Blood Institute (NHLBI) comes on strong and recommends universal screening for those ages 9 to 11 years. The American Academy of Pediatrics (AAP) toes a middle ground, and the U.S. Preventive Services Task Force (USPSTF) just doesn’t believe there’s enough evidence to recommend any pediatric lipid screening. So how often are pediatricians screening for cholesterol levels?
The short answer is not very often.
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 Obesity is the scourge of the 21st century. Carrying extra weight in adulthood causes diabetes and heart disease. In childhood, obesity not only presages adult obesity, but it also leads to asthma, depression, orthopedic problems and other ills among children themselves. Rates of obesity in children and adults are just about as high as they can be in western societies, and they are rapidly increasing in the developing world. By 2030, close to a billion people across the globe will have diabetes or prediabetes.
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