Abstract
Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called “first thousand days” from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.
Highlights
In this narrative review we focus on nutritional intervention in children and adolescents at high cardiovascular risk, starting from the historical data of the literature up to the latest indications of the most recent guidelines
We have looked at childhood and adolescence focusing on cardiovascular-disease risk factors, so as to spot and unify all the main conditions at high Coronary Heart Disease (CHD) risk in these age groups
CHD prevention can be performed at different stages of intervention: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, whereas secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event
Summary
Coronary Heart Disease (CHD) is one of the main causes of death in adulthood in the United States and in Western countries [1,2]. Health professionals dealing with children and adolescents are the main actors of this preventive battle, and the knowledge, the detection and the treatment of CHD risk are their cornerstone swords. In this narrative review we focus on nutritional intervention in children and adolescents at high cardiovascular risk, starting from the historical data of the literature up to the latest indications of the most recent guidelines. We have looked at childhood and adolescence focusing on cardiovascular-disease risk factors, so as to spot and unify all the main conditions at high CHD risk in these age groups. Further studies will be needed to sharpen even more this approach, making nutritional intervention more tailored and effective
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