Premature atherosclerosis, and its association with cardiovascular disease, is a major public health problem in this, and other industrialized countries. Considerable deliberation has recently been given to the concepts that atherosclerosis begins in childhood and that preventive efforts should begin early in life. Atherosclerosis as a pediatric problem has been the subject of several previous commentaries and reivews. Among the risk factors implicated in the development of cardiovascular disease, one of the most important is hyperlipidemia, i.e., an increased plasma concentration of either cholesterol or triglycerides or both. The article by Tsang, Fallat and Glueck in this issue of Pediatrics addresses some basic questions concerning the validity of neonatal screening for hyperlipidemia and emphasizes the importance of diet in assessing hyperlipidemia in the first year of life.