CHILDHOOD DIET AND CORONARY HEART DISEASE

Abstract

A subcommittee of the Inter-Society Commission for Heart Disease Resources recently recommended an immediate, nationwide change in dietary habits to reduce the risk of coronary heart disease in later life.1 Specifically, the Commission urges that people eat less than 300 mg of cholesterol each day, that the total calories from fat be less than 35% of the diet, and that the fat calories essentially be divided equally among saturated, monounsaturated, and polyunsaturated sources. (A commentary on these recommendations appears in this issue of Pediatrics.2) The Committee on Nutrition, realizing that pediatricians will increasingly be asked about diets for children to reduce the risk of heart disease in later life, has evaluated the Commission's report for its application to pediatric practice. The Committee stresses that such dietary intervention is, at present, experimental and recommends against dietary changes for all children. Dietary intervention may be warranted in special circumstances, but not before 1 year of age. Reasons for these recommendations will be given in this report. The evidence relating dietary cholesterol to coronary heart disease is summarized as follows: 1. Some inborn or acquired diseases with hypercholesterolemia are associated with premature atherosclerosis. 2. Serum cholesterol levels are higher than usual in persons with coronary heart disease. 3. Persons with high cholesterol levels in prospective studies developed coronary heart disease more often than those with normal levels. 4. The mortality rate from coronary heart disease in different countries varies in relation to the average blood cholesterol values (or dietary fat intake). 5. Experimentally induced hypercholesterolemia in animals is associated with atherosclerotic deposits.