Childhoood Origins of Lifestyle-Related Risk Factors for Coronary Heart Disease in Adulthood

Research over the past 40 years clearly points to childhood as a critical period when dietary and lifestyle patterns are initiated which have longterm implications for coronary heart disease risk in adult life. Smoking, high habitual dietary intake of total fat and saturated fat, low exercise level, and excessive alcohol consumption often occur in family aggregates. They are correlated with elevated serum cholesterol, obesity, and hypertension in children, as well as with a predisposition to premature death from coronary heart disease. Intervention studies in children and adolescents show, however, that these lifestyle-risk factors are controllable through education and dietary counselling of the affected individual and their family. Equally important are the emerging data in adults showing that vigorous longterm intervention involving reduction of dietary fat and work-related stress, increased exercise, and elimination of smoking all contribute to a significant improvement in coronary perfusion. Hence, effective dietary and lifestyle management of coronary heart disease can occur at early or later stages of the disease and needs better support from health authorities at the national and international level.