Early nutritional influences of cardiovascular health

ABSTRACT

Introduction

Increasing evidence shows that nutritional choices during children’s formative years, including prenatally, impacts the development of adult onset cardiovascular diseases (CVDs), such as hypertension, myocardial infarction, or stroke.

Areas Covered

This literature review aims to synthesize the current body of evidence on nutritional factors, from conception through adolescence, which may influence a person’s risk factors for future development of CVD.

Expert Opinion

Given the escalating healthcare costs associated with CVD, it is imperative that medical professionals and scientists remain steadfast in prioritizing and promoting early CVD prevention, even within the first few years of life. Though not the only contributing risk factor, diet is a modifiable risk factor and has been shown to have a profound impact on the reduction of cardiovascular morbidity and mortality in adult literature. Nutritional choices should be targeted on multiple levels: prenatally with the mother, individually with the patient, in conjunction with their family unit, and also within the broader community wherein they reside. Healthcare providers can play a key advocacy role for local and national food environment policy changes.

KEYWORDS:

• Cardiovascular disease
• developmental origins of health and disease
• food environments
• malnutrition
• nutrition
• obesity
• pediatrics

Article highlights

• Nutritional choices during childhood, including prenatally, can impact the development of adult onset cardiovascular diseases (CVD).

• A potential and largely unrecognized window of opportunity for early detection and treatment of subclinical CVD should be optimized in at-risk neonates and youth. There is an opportunity to increase advanced fetal echocardiography techniques in this area.

• Both inadequate and excess maternal prenatal nutrition has impacts on fetal and neonatal cardiovascular development and health, which can be long-lasting.

• Further study is needed in the area of micro- and macronutrients on short- and long-term cardiovascular health. There is a need for meta-analysis to determine macronutrient pregnancy guidelines as none currently exist, and current data is contradictory.

• Children and adolescents who are overweight or obese are more likely to continue to have elevated body mass indices in adulthood and contract non-communicable diseases at a younger age.

• Diets high in fruits and vegetables, as well as limited amounts of processed foods, are associated with a significantly lower risk of CVD.

• The association between breastfeeding and cardiovascular outcomes remains unclear.

• Strong positive associations exist between sugar-sweetened beverages and risk of type 2 diabetes and coronary heart disease (CHD), independent of adiposity.

• A complete evaluation of an individual’s dietary risk factors must take into consideration multiple biologic and environmental layers.

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.