Nutritional Approach to Prevention and Treatment of Cardiovascular Disease in Childhood

Abstract

Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called “first thousand days” from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.

Associations of Blautia Genus With Early-Life Events and Later Phenotype in the NutriHS

“…Considering the importance of gut colonization during this stage of life and given that these microorganisms coexist with the host throughout the life span ( Milani et al., 2017 ), the association found might prove relevant. The first 1,000 days of life are considered a critical developmental window for programming systems and influencing the risk for long-term outcomes ( Gluckman et al., 2005 ; Capra et al., 2021 ). In addition to the mode of delivery, growing evidence points to the role of early-life nutrition in shaping the offspring’s microbiota ( Arrieta et al., 2014 ; Rodríguez, 2014 ).…”

“…The importance of prenatal and postnatal events in long-term health outcomes has been consistently recognized ( Ravelli et al., 1976 ; Barker, 1990 ; Bell et al., 2017 ; Block and El-Osta, 2017 ; Cheshmeh et al., 2020 ; Capra et al., 2021 ). Nutritional factors during intrauterine life and after birth have a major impact on infant health and later in adulthood, influencing the risk for non-communicable chronic diseases ( Garmendia et al., 2014 ; Cadenas-Sanchez et al., 2017 ).…”

Nutraceuticals in Paediatric Patients with Dyslipidaemia

“…Nutraceuticals containing fibres and phytosterols should always be considered as a complement to the dietary [ 146 ] and lifestyle intervention, which remains the milestone approach in the treatment of dyslipidaemia in paediatric patients [ 147 ]. Nutraceuticals should be used for a short period and in those children who do not tolerate pharmacological therapy or who cannot yet receive it due to age limitations.…”

Nutritional Habits and Interventions in Childhood

“…Two articles [9,10] dedicated to cardiovascular diseases and familial hypercholesterolemia underline the role of the preventive and therapeutic intervention of nutrition and discuss dietary recommendations for children [9,10]. In the case of pathology, such as familial hypercholesterolemia, current guidelines support the dietary and lifestyle approach as the primary strategy of intervention in children and adolescents, but additional interventions with nutraceuticals having cholesterol-lowering effects, both as functional foods and as supplements, have been proposed.…”

“…Banderali et al in their updated literature review concluded that the use of functional foods as supplements is an interesting strategy for paediatric patients; however, it may have some risks as trials on nutraceuticals have been frequently carried out on a limited study population and the availability of nutraceuticals as supplements without medical prescription could result in uncontrolled use such as auto-prescription, therapy discontinuation, and/or excessive dose, with a consequent reduced therapeutic effect and/or increased adverse events [10]. Capra et al underline the importance of prudent diet, lifestyle modifications, and the pursuit of psychological wellbeing to prevent the development of dangerous serum lipid levels, excessive adiposity, and elevated blood pressure through intervention in childhood [9].…”