The Role of Dietary and Plasma Lipids in Childhood Atherogenesis

Maria Daria Haust, MD, has made many significant contributions to our understanding of atherogenesis in children, particularly in associating the earliest lesions (fatty spots and streaks) with the normal growth and remodeling of arteries. It is my privilege to link her early work to more recent findings which show that the early lesions seen in the arteries of children before puberty bear no relationship to the risk of atherosclerosis in later life. Furthermore, present evidence supports the view that intervening in childhood (2-15 years) with low-fat low-cholesterol diets or even worse, lipid-lowering drugs to prevent atheroslerotic plaques in adulthood is wasted effort. Overzealous parents may unwittingly induce malnutrition in their children and many children with restricted access to palatable foods, will yearn for them even more as they become older leading to over weightness. Pediatricians from various scientific bodies around the world vary in their advice to mothers regarding diets for children. The program adopted by Health Canada on the advice of pediatricians in that country, which is also supported by the European Society of Pediatrics, Gastroenterology and Nutrition, recommends that the fat content of diets for children should be tapered gradually from 40% of energy at 2 years of age to 30% of energy at the conclusion of linear growth (late adolescence).