Hyperlipidemias: Gidding SS

Gidding SS, Dennison BA, Birch LL, Daniels SR, Gillman MW, Gilman MW, Lichtenstein AH, Rattay KT, Steinberger J, Stettler N, Van Horn L, Anonymous00030, Anonymous00031. · No affiliation provided · Circulation. · Pubmed #16186441 links to  free full text

Abstract: Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.

Gidding SS. · Department of Pediatric, Northwestern University Medical School, Chicago, Illinois, USA. · Pediatr Clin North Am. · Pubmed #10218073 No free full text.

Abstract: The prevention of coronary artery disease in adults begins in childhood. Public health strategies to lower the use of tobacco, improve nutrition, and increase physical activity are important for all children to lower the cardiovascular risk of the population. Physicians can contribute to public health strategies through office-based health counseling and as advocates for public health strategies both at local and higher levels. Children at high risk for cardiovascular disease can be identified through medical history (i.e., positive family history of coronary disease, history of tobacco use, and physical activity history), routine measurements (i.e., height, weight, and blood pressure), and selective laboratory screening (i.e., lipoprotein measurement). Children at high risk should receive special counseling on diet; physical activity; smoking cessation; and, if indicated, pharmacologic therapy.

Das S, Zhang S, Mitchell D, Gidding SS. · Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, PA, USA. · J Cardiometab Syndr. · Pubmed #17679800 No free full text.

This publication has no abstract.

Carnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR, Liu K. · Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill, USA. · JAMA. · Pubmed #14679272 links to  free full text

Abstract: CONTEXT: Low cardiorespiratory fitness is an established risk factor for cardiovascular and total mortality; however, mechanisms responsible for these associations are uncertain. OBJECTIVE: To test whether low fitness, estimated by short duration on a maximal treadmill test, predicted the development of cardiovascular disease risk factors and whether improving fitness (increase in treadmill test duration between examinations) was associated with risk reduction. DESIGN, SETTING, AND PARTICIPANTS: Population-based longitudinal cohort study of men and women 18 to 30 years of age in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants who completed the treadmill examination according to the Balke protocol at baseline were followed up from 1985-1986 to 2000-2001. A subset of participants (n = 2478) repeated the exercise test in 1992-1993. MAIN OUTCOME MEASURES: Incident type 2 diabetes, hypertension, the metabolic syndrome (defined according to National Cholesterol Education Program Adult Treatment Panel III), and hypercholesterolemia (low-density lipoprotein cholesterol > or =160 mg/dL [4.14 mmol/L]). RESULTS: During the 15-year study period, the rates of incident diabetes, hypertension, the metabolic syndrome, and hypercholesterolemia were 2.8, 13.0, 10.2, and 11.7 per 1000 person-years, respectively. After adjustment for age, race, sex, smoking, and family history of diabetes, hypertension, or premature myocardial infarction, participants with low fitness (<20th percentile) were 3- to 6-fold more likely to develop diabetes, hypertension, and the metabolic syndrome than participants with high fitness (> or =60th percentile), all P<.001. Adjusting for baseline body mass index diminished the strength of these associations to 2-fold (all P<.001). In contrast, the association between low fitness and hypercholesterolemia was modest (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.7; P =.02) and attenuated to marginal significance after body mass index adjustment (P =.13). Improved fitness over 7 years was associated with a reduced risk of developing diabetes (HR, 0.4; 95% CI, 0.2-1.0; P =.04) and the metabolic syndrome (HR, 0.5; 95% CI, 0.3-0.7; P<.001), but the strength and significance of these associations was reduced after accounting for changes in weight. CONCLUSIONS: Poor fitness in young adults is associated with the development of cardiovascular disease risk factors. These associations involve obesity and may be modified by improving fitness.