Dietary intake or children at risk for CVD - Cardiovascular Disease

Nutrition Research Newsletter, March, 2004

The American Heart Association has issued guidelines to prevent cardiovascular disease beginning in childhood. Among its recommendations is to limit foods high in saturated fats and cholesterol. Since cardiovascular disease begins in childhood, and dietary patterns that are formed during childhood persist throughout adolescence into adulthood--dietary interventions to prevent obesity and chronic disease should be targeted at children.

Families with a history of cardiovascular disease may be more aware of dietary guidelines, so their children may have diets that are lower in fat and higher in other nutrients. A recent study compared the nutrient intake of children who are at risk for cardiovascular disease based on family history, with those who are not at risk.

Two hundred and ninety-seven children were screened for a family history of early CVD, which was part of the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project. Dietary intake was measured using the Youth Adolescent Questionnaire, a self-administered food frequency questionnaire (FFQ). Height, weight and fingerstick total cholesterol were measured. Children were categorized as being at risk for CVD based on the National Cholesterol Education Program (NCEP) risk factors of family history of early (< 55 years of age) cardiovascular disease or hypercholesterolemia in a parent.

Questionnaires were completed by 327 students. Sixty-eight (23%) children were at risk for CVD based on NCEP guidelines. Mean non-fasting cholesterol was significantly greater in the at-risk group compared with the not-at-risk group. There was no difference in BMI or blood pressure between groups. Twenty-five in the at-risk group and 91 in the low risk group had BMI greater than the 85th percentile. There were no differences between groups in the intake of macronutrients, fiber, cholesterol or the percentage of calories as fat. However, the percentage of calories as fat and saturated fat were higher than recommended for both groups.

Children at high risk for cardiovascular disease were no more likely to meet guidelines for heart-healthy diets than were children at low risk. Although the dietary patterns of these children appear to be adequate in most vitamins and minerals, there are notable exceptions that may have implications for chronic disease prevention. Intakes of fat and saturated fat as a percentage of energy are still greater than recommended and total energy intake is high. It is critical that public health research addresses behavior modification in children, so that we can reduce their risk of cardiovascular and other chronic diseases.

Colleen Kelley, Debra Krummel, Elizabeth Gonzales, et al. Dietary intake of children at high risk for cardiovascular disease. JADA 104:222-225 (February 2004) [Address correspondence to: Cindy W. Fitch, PhD, RD, Assistant Professor, Human Nutrition and Foods, West Virginia University,, PO Box 6124, 702 Allen Hall, Evansdale Campus, Morgantown, WV 26506-6124. E-mail: cfitch@wvu.edu]