Studies on serum cholesterol and other coronary heart disease precursors in childhood
Boulton, Thomas John Carson
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The change in the pattern of diseases affecting children in industrialised countries during the last century has caused a shift in emphasis from curative to preventive paediatrics. Coronary heart disease (CHD) is one of the major causes of morbidity and mortality in adulthood. Its origins have been shown by epidemiological studies to lie in facets of the Western life style which are biologically disadvantageous. By the time CHD becomes symptomatic, primary prevention is too late; but what is the evidence that by starting these measures in early life benefit would result? The studies described in this thesis were planned to determine whether early deviations from the biological norm occur during childhood for factors known to be associated with CHD in adult life. These factors include blood pressure, personality type, and serum cholesterol. The concentration of cholesterol in serum was chosen because its abnormalities are unequivocally associated with an excess risk of CHD, and because it provides a model for analysis of both genetic and environmental nutritional influences. Although there has been an enormous amount of research into the various influences on serum cholesterol, there is very little data about the subject during the first two years of life when future metabolic homeostatic and nutritional patterns may become established. For that reason a longitudinal study was planned, and the data derived from it was supplemented by cross-sectional studies on older children.