Abstract
Pediatric lifestyle disease screening in Japan plays a crucial role in the early detection of obesity, dyslipidemia, hypertension, and type 2 diabetes. However, it is not mandated by national law, instead being conducted independently by local governments, which results in significant regional disparities. While many programs focus only on obese children, this approach risks missing high-risk individuals with normal weight, such as those with familial hypercholesterolemia (FH) or non-obese type 2 diabetes. Regional initiatives in cities such as Fukuoka, Niigata, Kumamoto, and Kitakyushu have demonstrated various effective models, including the use of growth and obesity curves, expanded screening parameters, and school-healthcare collaborations. National surveys show that fewer than 30% of municipalities conduct such screenings, often with limited standardization. Kagawa Prefecture presents a notable example of integrating FH screening with lifestyle checkups to achieve high participation and follow-up rates. To expand and improve its effectiveness, universal screening based on standardized criteria is essential. Efforts should also focus on public education, early intervention, and coordinated systems involving school nurses and teachers, pediatricians and family doctors, local medical associations, educational boards, and municipal health authorities. Universal screening, combined with individualized follow-up and strong community collaboration, can help healthcare providers, educators, and local governments in Japan respond more effectively to the growing prevalence of pediatric obesity and metabolic disorders. This approach also promotes equitable access to preventive care for children.