Prudent Life-style for Children: Dietary Fat and Cholesterol

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 521-525 ◽  
Author(s):  

In the 1983 AAP Committee on Nutrition statement, "Toward a Prudent Diet for Children," the evidence linking dietary factors with the risk of atherosclerosis was reviewed.1 Based on the analysis of the available information, the Committee made seven recommendations concerning steps to be taken during childhood that would reduce the risk of atherosclerotic cardiovascular disease in adults. With respect to childhood eating habits, it was noted that, after 1 year of age, a varied diet that includes items from each of the major food groups is the best assurance of nutritional adequacy. The dietary trends in the United States during the last few decades, with emphasis on decreased consumption of saturated fats, cholesterol, and salt and increased intake of polyunsaturated fats, were recommended as sensible when followed with moderation.1 OTHER FINDINGS Since publication of that Committee statement, recommendations for alteration of childhood diets have also been made by the American Heart Association, 2 by the American Health Foundation, 3 and by a Consensus Development panel sponsored by the National Institutes of Health (NIH).4 All three of these groups have recommended more restrictive childhood diets than had been recommended by the Committee on Nutrition. The American Heart Association2 recommends a total fat intake that would be approximately 30% of total calories; this 30% would include 10% or less from saturated fat, 10% from monounsaturated fat, and less than 10% from polyunsaturated fat. The recommendation for daily cholesterol intake was 100 mg/1,000 calories and not to exceed 300 mg/d, total. Similar recommendations have been made by the American Health Foundation3 to achieve a target goal of serum total cholesterol values averaging 140 mg/dL for children and young adults.

2009 ◽  
Vol 79 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Isabelle Aeberli ◽  
Giatgen A. Spinas ◽  
Roger Lehmann ◽  
Dagmar l’Allemand ◽  
Luciano Molinari ◽  
...  

Background/Objectives: Insulin resistance (IR) and hypertension are common in overweight children, and the adipocyte-derived hormones resistin, adiponectin, and leptin may modulate IR and blood pressure (BP). Few data exist in children on dietary determinants of IR, BP, or leptin, and no data exist on dietary determinants of resistin and adiponectin. Therefore, the objective of this study was to investigate dietary determinants of IR, BP, resistin, adiponectin, and leptin concentrations, as well as the interrelationship among these variables, in normal and overweight children. Subjects/Methods: In 6- to 14-year-old Swiss children (n=79), nutritional intake was assessed using two 24-hour-recalls and a one-day dietary record. Body mass index (BMI), body fat percentage (BF%), waist/hip ratio (W/H ratio), BP, glucose, insulin, resistin, adiponectin, and leptin were determined. IR was calculated using the quantitative insulin sensitivity check index (QUICKI). Results: BMI, BF%, and W/H ratio were significant predictors of leptin and insulin, QUICKI, and systolic BP, but not resistin or adiponectin. Of the overweight and obese children, 40 % were diagnosed pre-hypertensive or hypertensive. Total energy, fat, saturated fat, and protein intakes were significant predictors of fasting insulin and QUICKI, and total fat, saturated fat, and monounsaturated fat intakes were significant predictors of systolic BP, independent of BMI standard deviation score (BMI-SDS) and age. There were no associations between these dietary factors and leptin, adiponectin, or resistin. Conclusion: In children, dietary macronutrient composition is a predictor of IR and systolic BP, but not resistin, adiponectin, or leptin concentrations. Resistin and adiponectin concentrations are not correlated with IR or BP in this age range.


1990 ◽  
Vol 12 (5) ◽  
pp. 136-141
Author(s):  
Robert A. Sinkin ◽  
Jonathan M. Davis

Approximately 3.5 million babies are born each year in approximately 5000 hospitals in the United States. Only 15% of these hospitals have neonatal intensive care facilities. Six percent of all newborns require life support in the delivery room or nursery, and this need for resuscitation rises to 80% in neonates weighing less than 1500 g at birth. Personnel who are skilled in neonatal resuscitation and capable of functioning as a team and an appropriately equipped delivery room must always be readily available. At least one person skilled in neonatal resuscitation should be in attendance at every delivery. Currently, a joint effort by the American Academy of Pediatrics and the American Heart Association has resulted in the development of a comprehensive course to train appropriate personnel in neonatal resuscitation throughout the United States. Neonatal resuscitation is also taught as part of a Pediatric Advanced Life Support course offered by the American Heart Association. In concert with the goals of the American Academy of Pediatrics and the American Heart Association, we strongly urge all personnel responsible for care of the newborn in the delivery room to become certified in neonatal resuscitation. The practical approach to neonatal resuscitation is the focus of this article.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Michael Miller ◽  
Valerie Beach ◽  
Charles Mangano ◽  
Jeffrey Rhyne ◽  
Christina Dobmeier ◽  
...  

Background : While the effect of popular diets on weight loss has been extensively studied, less is known in the absence of weight loss. We hypothesized that a diet high in total and saturated fat would be associated with adverse effects on LDL-C, endothelial function and biomarkers of atherothrombosis compared to lower fat diets. Methods : We tested 3 popular diets, including Atkins (50% fat), South Beach (30% fat) and Ornish (10% fat) in a randomized and counterbalanced, crossover study. Subjects completed each of the three 4-week dietary intervention phases followed by a 4-week washout period. They were weighed weekly and caloric adjustments made if weight change exceeded 1 kg. At the completion of each dietary phase, 3-day food records were analyzed, fasting blood was sampled and brachial artery reactivity testing (BART) performed. Results : Eighteen of 26 adults (mean age: 30.6 ± 9.6 yrs, 50% female) completed all 3 dietary phases. There were no changes in weight at the conclusion of each phase. However, non-significant increases in LDL-C occurred during the Atkins phase (pre: 96.5, post: 112.9 mg/dL; P=0.12 ), whereas LDL-C was reduced during the Ornish (pre: 110.1, post: 84.6 mg/dL; P=0.006 ) and South Beach phases (pre: 101.7, post: 91.5 mg/dL; P=0.01 ). BART testing revealed a significant inverse correlation between flow-mediated vasodilation and intake of total fat (r 2 =−0.29; P=0.03 ), saturated fat (r 2 =−0.31; P=0.02 ) and monounsaturated fat (r 2 =−0.35; P=0.01 ). Microarray analysis demonstrated increased expression of several leukocyte biomarkers including, ICAM2 (37%; P=0.002 ), SELL (26%; P=0.007 ) and SOD1 (42%; P=0.04 ) at the completion of the Atkins diet compared to baseline. In contrast, expression of atherothrombotic biomarkers was not increased after the South Beach or Ornish phase. Conclusions: In the absence of weight loss, the high fat Atkins diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis. As such, these data suggest that isocaloric conversion to the Atkins diet may negatively impact cardiovascular health as compared to the South Beach or Ornish Diet.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Adnan Younus ◽  
Ehimen Aneni ◽  
Oluseye Ogunmoroti ◽  
Omar Jamal ◽  
Shozab Ali ◽  
...  

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Mariel Arvizu ◽  
Jennifer Stuart ◽  
Janet Rich-Edwards ◽  
Audrey Gaskins ◽  
Bernard Rosner ◽  
...  

Abstract Objectives Because the relationship between diet and hypertensive disorders of pregnancy (HDPs), including preeclampsia, remains unclear we aim to evaluate the association between pre-pregnancy adherence to the American Heart Association (AHA) diet recommendations and the Dietary Approaches to Stop Hypertension (DASH) dietary pattern with risk of developing preeclampsia (PE). Methods Our prospective cohort study included 20,024 pregnancies from 13,645 women enrolled in the Nurses’ Health Study II (NHS2) (1991 to 2007). Pre-pregnancy diet was measured in 1991 by a semi-quantitative food frequency questionnaire and updated every four years. Pregnancy outcomes were self-reported every 2 years during follow-up. We derived the DASH scores based on the intake of 8 food groups (fruits and fruit juices, vegetables, whole-grain, red and processed meats, nuts and legumes, sugar sweetened beverages, and sodium). The AHA score was derived from 5 food groups (fruits and vegetables, whole grain, fish, SSBs and sodium) consistent with AHA dietary guidelines to reduce hypertension in the general population. We estimated the RR and 95% CIs of PE by log-Poisson regression employing generalized estimating equations and adjusting for total energy intake, age at pregnancy, BMI, physical activity, parity, smoking status, infertility, marital status, multivitamin use, and gestational diabetes. Results HDPs were reported in 1,089 (5.4%) pregnancies, of which 505 (2.5%) were PE. The DASH score (max points = 40) ranged from 16 to 32 points and the AHA score (max score = 50) ranged from 18 to 41 points in our population. Compared to women in the lowest quintile of adherence to the AHA, the RR (95%CI) of PE in quintiles 2, 3, 4, and 5 were 0.88 (0.68, 1.14), 0.87 (0.66, 1.15), 0.83 (0.64, 1.09), and 0.79 (0.60, 1.06), respectively (p-trend = 0.09). Similarly, the RR (95%CI) of PE among women in increasing quintiles of adherence to the DASH score was 0.88 (0.68, 1.13), 0.72 (0.55, 0.94), 0.80 (0.61, 1.05), and 0.62 (0.45, 0.84) compared to women in the lowest quintile (p-trend = 0.002). Conclusions Stronger pre-pregnancy adherence to the DASH dietary pattern was inversely associated to developing PE among participants of the NHS2. Funding Sources Supported by National Institutes of Health grants UM1-CA176726, P30-DK046200, U54-CA155626, and T32-DK007703-16.


Circulation ◽  
2020 ◽  
Vol 141 (7) ◽  
pp. 592-599 ◽  
Author(s):  
Anandita Agarwala ◽  
Erin D. Michos ◽  
Zainab Samad ◽  
Christie M. Ballantyne ◽  
Salim S. Virani

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men and women have allowed for the identification of CVD risk factors and risk markers that are unique to women. The 2018 American Heart Association/American College of Cardiology Multi-Society cholesterol guideline and 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD introduced the concept of risk-enhancing factors that are specific to women and are associated with an increased risk of incident atherosclerotic CVD in women. These factors, if present, would favor more intensified lifestyle interventions and consideration of initiation or intensification of statin therapy for primary prevention to mitigate the increased risk. In this primer, we highlight sex-specific CVD risk factors in women, stress the importance of eliciting a thorough obstetrical and gynecological history during cardiovascular risk assessment, and provide a framework for how to initiate appropriate preventive measures when sex-specific risk factors are present.


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