Toward a Prudent Diet for Children

Abstract

Nutritional manipulation has been suggested as a mode of decreasing atherosclerosis. Atherosclerosis is a disease process that begins with fatty streaks during infancy and childhood and progresses at a variable rate to the formation of atheromatous plaques and subsequent obstruction of arteries, which may result in coronary and cerebral thrombosis. Hypercholesterolemia, hypertension, smoking, obesity, abnormal glucose tolerance, lack of physical activity, and psychosocial tension have been identified as risk factors of arteriosclerosis in adults. Attention has been directed to advisable diets of infants and children, although arteriosclerosis and coronary artery disease are rare in these age groups. Dietary recommendations for adults, including low-fat and low-cholesterol diets, have been made to limit some of the risk factors and thus help prevent atherosclerosis. Evidence supporting and denying the importance of each of the risk factors has been reported extensively and is not reviewed here. The application of some of these dietary recommendations to children has been questioned. Dietary factors in children must be considered simultaneously with physical activity, life-style, and genetic influences. Limiting fat and cholesterol intake has been questioned because, during the first years of life, breast milk (a cholesterol-containing food) is considered the ideal food for infants. In teenagers, serum cholesterol consistently decreases from preteen levels. In addition, formation of bile acids, hormones, and special tissues may indicate a continuing need for cholesterol during the entire growth period. Furthermore, limitation of total caloric intake to maintain ideal weight and dietary variability, including vegetables, will result in a lowering of fat intake. There is controversial evidence concerning the relationship between dietary and serum lipids in infants.