Abstract
Atherosclerosis is the underlying cause of major cardiovascular events. The development of atherosclerotic plaques begins early in life, indicating that dietary interventions in childhood might be more effective at preventing cardiovascular disease (CVD) than treating established CVD in adulthood. Although plant sterols are considered safe and consistently effective in lowering plasma cholesterol, the health effects of early-life supplementation are unclear. Studies suggest there is an age-dependent effect on plant sterol metabolism: at a younger age, plant sterol absorption might be increased, while esterification and elimination might be decreased. Worryingly, the introduction of low-cholesterol diets in childhood may unintentionally favor a higher intake of plant sterols. Although CVD prevention should start as early as possible, more studies are needed to better elucidate the long-term effects of plant sterol accumulation and its implication on child development.
Highlights
Childhood nutrition is known to play a major role in the onset of chronic diseases later in life
Evidence that prolonged exposure to low plasma low-density lipoprotein (LDL)-C levels is associated with markedly greater reduction in cardiovascular disease (CVD) risk, compared to current strategies aimed at lowering LDL-C in middle age, has been provided by meta-analysis of Mendelian randomization studies, involving polymorphisms in six distinct genes of cholesterol metabolism, including the protein convertase subtilisin/kexin type 9 (PCSK9)
Plant sterol ester-enriched margarine significantly changed total plasma cholesterol (TC), LDL-C high-density lipoprotein (HDL)-C, apolipoprotein B, and the LDL-C/HDL-C ratio compared to the control margarine
Summary
Childhood nutrition is known to play a major role in the onset of chronic diseases later in life. A large body of evidence has convincingly shown that childhood obesity is correlated with risk factors for cardiovascular disease (CVD), metabolic syndrome, and early development of atherosclerosis in adulthood. Unhealthy childhood nutrition (i.e., low fruit and vegetable intake) are linked to an overweight BMI, but to adulthood CVD risk factors and to early vascular changes predicting the risk of CVD [3]. These findings have emphasized the importance of prevention and early management of obesity in the young, including both dietary and physical activity modification, as well as pharmacologic interventions [1,2]. Evidence that prolonged exposure to low plasma LDL-C levels is associated with markedly greater reduction in CVD risk, compared to current strategies aimed at lowering LDL-C in middle age, has been provided by meta-analysis of Mendelian randomization studies, involving polymorphisms in six distinct genes of cholesterol metabolism, including the protein convertase subtilisin/kexin type 9 (PCSK9)
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