The initiatives and outcomes for cardiovascular risks that can be achieved through paediatric counselling.

PURPOSE OF REVIEW: Atherosclerosis is a result of a lifelong process. Obesity is associated with increased serum levels of inflammatory markers in children and adolescents like in adults, promoting coronary heart disease risk in an increasing proportion of young adults. Dietary patterns have a central role in the development of coronary heart disease through effects on serum lipids and development of body fatness. It is the purpose of this review to describe progress in this field.

RECENT FINDINGS: The supervised counselling aiming at low saturated fat intake by children decreases serum total and low-density lipoprotein (LDL) cholesterol values significantly and keeps them at lower level through childhood. It is not associated with abnormal growth or defects in cognitive or pubertal development. Coronary heart disease risk factor levels measured in childhood markedly influence vascular function and structure.

SUMMARY: To diminish the risk of premature atherosclerosis, the prime target in counselling of young children and their parents should be a change in fat quality rather than fat quantity. However, to prevent obesity, excessive consumption of total fat and sucrose needs to be avoided. Early commencement of statin therapy in children and adolescents suffering from familial hypercholesterolemia is beneficial in prevention of vascular atherosclerosis.