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Rapid westernization of children's blood cholesterol in 3 countries: evidence for nutrient-gene interactions?
1Institute of Human Nutrition, the Departments of Pediatrics and Medicine, and the School of Public Health, Columbia University, New York, USA.
Insights
Children
Area of Science:
- Pediatric Nutrition
- Cardiovascular Health
- Metabolic Health
Background:
- Westernized diets and lifestyles are impacting children's health globally.
- Understanding cholesterol changes in children is crucial for long-term cardiovascular well-being.
- Cross-cultural comparisons offer insights into environmental and genetic influences on health.
Purpose of the Study:
- To investigate factors influencing blood cholesterol levels in children from Japan, Spain, and the United States.
- To compare cholesterol trends in relation to dietary and lifestyle changes in westernizing countries.
- To identify potential discrepancies between predicted and actual cholesterol levels based on dietary intake.
Main Methods:
- Comparative analysis of population data on serum cholesterol, lipoproteins, anthropometrics, and dietary intake.
- Review of data for children aged 1-18 years from Japan, Spain, and the United States.
- Application of the Hegsted equation to correlate dietary fat intake with serum cholesterol differences.
Main Results:
- Total serum cholesterol in Japanese and Spanish children now exceeds the 75th percentile for US children, driven by LDL cholesterol.
- Increased total and saturated fat intake observed in Japan and Spain, though still lower than in the US.
- Dietary fat intake predicted cholesterol changes in Spain but not in Japan, where actual cholesterol was higher than predicted.
Conclusions:
- Rapid westernization is leading to increased blood cholesterol concentrations in children in Japan and Spain.
- Dietary fat intake correlates with cholesterol changes in Spain but not Japan, suggesting other factors are at play.
- Genetic factors may influence Japanese children's response to diet, leading to higher cholesterol with lower fat intake compared to US children.
Abstract:
The aim of this study was to examine potential factors that modify blood cholesterol among children in countries in which dietary and lifestyle habits are becoming westernized. Population data on serum total and lipoprotein cholesterol, anthropometric indexes, and dietary intake were reviewed and compared for children aged 1-18 y from Japan, Spain, and the United States. The data show that total serum cholesterol in Japanese and Spanish children recently exceeded the 75th percentile for US children, primarily reflecting LDL cholesterol, although both LDL and HDL cholesterol contributed. Adiposity indexes do not explain the trends observed. Total and saturated fat intakes increased substantially in both Japan and Spain but in Japan are still lower than intakes in the United States. The Hegsted equation was used to relate differences in serum cholesterol to dietary fat intake. Changes in total serum cholesterol followed established dietary correlations among children in Spain, but not in Japan. Serum cholesterol in Japanese children was predicted to be 0.20-0.32 mmol/L lower than in US children; actual concentrations were considerably higher. These results suggest that a rapid westernization of children's blood cholesterol concentrations has occurred in Japan and Spain. Changes in fat intake predict changes in blood cholesterol in Spain, but not in Japan. Differences in genetic response to diet in certain populations, such as the Japanese, may explain higher blood cholesterol concentrations with lower fat intakes compared with the United States.