Blood Lipids in Children: Age-Related Patterns and Association with Body-Fat Indices. Project HeartBeat!

Division for Heart Disease and Stroke Prevention, CDC, 4770 Buford Highway NE, Atlanta, GA 30341-3724, USA.
American journal of preventive medicine (Impact Factor: 4.53). 08/2009; 37(1 Suppl):S56-64. DOI: 10.1016/j.amepre.2009.04.012
Source: PubMed


Longitudinal data on the normal development of blood lipids and its relationships with body fatness in children and adolescents are limited. Objectives of the current analysis were to estimate trajectories related to age for four blood lipid components and to examine the impact of change in body fatness on blood lipid levels, comparing estimated effects among adiposity indices, in children and adolescents.
Three cohorts, with a total of 678 children (49.1% female, 79.9% nonblack) initially aged 8, 11, and 14 years, were followed at 4-month intervals (1991-1995). Total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were determined in blood samples taken following fasting. Body fatness was measured by five adiposity indices-BMI; percent body fat (PBF); abdominal circumference; and the sums of six and of two skinfold thicknesses. Trajectories of change in blood lipid levels from ages 8 to 18 years were estimated by gender and race. The impact of change in body fatness on lipid levels was evaluated for each index, adjusting for gender, race, and age.
All lipid components varied significantly with age. Total cholesterol decreased by approximately 19 mg/dL from ages 9 to 16 years in girls and more steeply from ages 10 to 17 years in boys. LDL-C decreased monotonically, more steeply in boys than in girls. It was higher among nonblacks than among blacks. HDL-C increased monotonically in girls, mainly from ages 14 to 18 years, but fluctuated sharply among boys. Levels of HDL-C were higher among blacks than among nonblacks. The levels of triglycerides increased from ages 8 to 12 years among girls and, almost linearly, from ages 8 to 18 years among boys. The levels of triglycerides were higher among nonblacks than among blacks. Increase in body fatness was significantly associated with increases in total cholesterol, LDL-C, and triglyceride levels. Significant interactions between the adiposity indices (except for BMI) and gender indicated smaller impacts of change in body fatness on total cholesterol and LDL-C in girls than in boys. The estimated impact on triglycerides was weaker among blacks than among nonblacks, except for PBF. Change in body fatness was negatively associated with HDL-C. The results remained essentially unchanged after adjustments for energy intake, physical activity, and sexual maturation.
Patterns of change with age in blood lipid components vary significantly among gender and racial groups. Increase in body fatness among children is consistently associated with adverse change in blood lipids. Evaluation of blood lipid level should take into account variation by age, gender, and race. Intervention through body-fat control should help prevent adverse lipid levels in children and adolescents.

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    • "However, studies have found that dietary patterns and food choices are fairly stable in the time between adolescence and adulthood( 11 ) and from the 4th to 7th grade( 14 ) although adolescence may be a period when individuals achieve new dietary habits as well. With respect to blood lipids, a recent study of 10 years of consecutive blood lipid patterns in normocholesterolaemic children aged 8 to 18 years demonstrated only small variations in total cholesterol, LDL-cholesterol, HDL-cholesterol and TAG levels with age( 15 ). In line with our findings, Tonstad et al.( 6 ) did not find any correlations between lipid levels in FH children and dietary intakes when the dietary intake was measured by a 4-d dietary record. "
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    ABSTRACT: Familial hypercholesterolaemia (FH) leads to elevated plasma levels of LDL-cholesterol and increased risk of premature atherosclerosis. Dietary treatment is recommended to all patients with FH in combination with lipid-lowering drug therapy. Little is known about how children with FH and their parents respond to dietary advice. The aim of the present study was to characterise the dietary habits in children with FH. A total of 112 children and young adults with FH and a non-FH group of children (n 36) were included. The children with FH had previously received dietary counselling. The FH subjects were grouped as: 12–14 years (FH (12–14)) and 18–28 years (FH (18–28)). Dietary data were collected by SmartDiet, a short self-instructing questionnaire on diet and lifestyle where the total score forms the basis for an overall assessment of the diet. Clinical and biochemical data were retrieved from medical records. The SmartDiet scores were significantly improved in the FH (12–14) subjects compared with the non-FH subjects (SmartDiet score of 31 v. 28, respectively). More FH (12–14) subjects compared with non-FH children consumed low-fat milk (64 v. 18 %, respectively), low-fat cheese (29 v. 3%, respectively), used margarine with highly unsaturated fat (74 v. 14 %, respectively). In all, 68 % of the FH (12–14) subjects and 55 % of the non-FH children had fish for dinner twice or more per week. The FH (18–28) subjects showed the same pattern in dietary choices as the FH (12–14) children. In contrast to the choices of low-fat dietary items, 50 % of the FH (12–14) subjects consumed sweet spreads or sweet drinks twice or more per week compared with only 21 % in the non-FH group. In conclusion, ordinary out-patient dietary counselling of children with FH seems to have a long-lasting effect, as the diet of children and young adults with FH consisted of more products that are favourable with regard to the fatty acid composition of the diet.
    10/2013; 2. DOI:10.1017/jns.2013.27
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    • "Several methodological and physiological limitations complicate the establishment of a definition for pediatric metabolic syndrome. For example, children develop transient physiologic insulin resistance during puberty,28,29 and normal lipid levels vary by age, sex, and race.30 Reliance on a fasting blood sample makes diagnosis and detection simple and cheap yet prevents the utilization of a postglucose load sample to detect impaired glucose tolerance (which is a better marker of peripheral insulin resistance in this age group than is a fasting sample). "
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    ABSTRACT: Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity) that occur in obese children. However, metabolic syndrome can also occur in lean individuals, suggesting that obesity is a marker for the syndrome, not a cause. Metabolic syndrome is difficult to define, due to its nonuniform classification and reliance on hard cutoffs in the evaluation of disorders with non-Gaussian distributions. Defining the syndrome is even more difficult in children, owing to racial and pubertal differences and lack of cardiovascular events. Lipid partitioning among specific fat depots is associated with insulin resistance, which can lead to mitochondrial overload and dysfunctional subcellular energy use and drive the various elements of metabolic syndrome. Multiple environmental factors, in particular a typical Western diet, drive mitochondrial overload, while other changes in Western society, such as stress and sleep deprivation, increase insulin resistance and the propensity for food intake. These culminate in an adverse biochemical phenotype, including development of altered glucose metabolism and early atherogenesis during childhood and early adulthood.
    Annals of the New York Academy of Sciences 01/2013; 1281(1). DOI:10.1111/nyas.12030 · 4.38 Impact Factor
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    ABSTRACT: Project HeartBeat! was a longitudinal "growth" study of cardiovascular disease (CVD) risk factors and body composition in childhood and adolescence. Its findings demonstrate patterns of change from ages 8 to 18 years in anthropometric indicators of adiposity, blood lipid components, and blood pressure measurements, as well as the varying inter-relations among these patterns. Especially noteworthy are differences among associations between the two components of BMI (kg/m(2))-the lean or fat-free mass index, and the fat mass index-and each of several CVD risk factors. Policy development and public health recommendations for CVD prevention beginning in childhood have evolved over 30 years or more. A new impetus to action is the recognized increase in the prevalence of childhood overweight and obesity. Intervention to prevent obesity can have a major impact in preventing CVD risk factors more broadly. Opportunities to strengthen interventions for CVD prevention in childhood and adolescence include updated algorithms for monitoring body composition, blood lipids, and blood pressure throughout childhood and adolescence through use of the Project HeartBeat! study results.
    American journal of preventive medicine 08/2009; 37(1 Suppl):S105-15. DOI:10.1016/j.amepre.2009.04.013 · 4.53 Impact Factor
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