Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy.
Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy.
Nutrients. 2021 Jul 10;13(7):2359. doi: 10.3390/nu13072359.
Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called "first thousand days" from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.
冠心病（CHD）是全世界成年人死亡和发病的主要原因。动脉粥样硬化过程早在出生前就开始了，贯穿儿童期，如果不加以阻止，最终会导致 CHD。因此，从生命的最早阶段开始进行预防是很重要的。CHD 的预防可以在不同的干预阶段进行：一级预防旨在预防危险因素，二级预防旨在早期发现和治疗危险因素，三级预防旨在降低已经发生 CHD 事件的患者发生进一步事件的风险。在这方面，CHD 风险分层至关重要，以便针对特定患者制定预防和治疗方案。营养干预是处于增加 CHD 风险的儿科患者的基石治疗方法。根据健康与疾病的发育起源理论，与生活方式相关的疾病起源于从受孕开始的所谓“最初的一千天”，此时无论是积极的还是消极的，都可能会造成终身的后果。营养是一种积极的表观遗传因素：在发育关键时期进行适当的营养干预，可以改变儿童期到成年期的结果。
