| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Vitamin E reduces cholesterol esterification and uptake of acetylated low density lipoprotein in macrophages Shige, H., T. Ishikawa, et al. (1998), Lipids 33(12): 1169-75. Abstract: The effects of vitamin E on cholesteryl ester (CE) metabolism in J774 cells were examined. Pretreatment of J774 cells with vitamin E at concentrations above 50 microM significantly decreased acetylated low density lipoprotein (LDL)-induced incorporation of 14Coleate into CE in cells in a dose-dependent manner. This was partly due to vitamin E also significantly inhibiting the uptake of 3HCE-labeled acetylated LDL by J774 cells. A trend existed toward suppression of acyl-CoA:cholesterol acyltransferase (ACAT) activity in the cell lysate at high vitamin E concentration, but there was no effect on hydrolysis of CE. These data indicate that vitamin E reduces the uptake of modified LDL and suppresses ACAT activity, resulting in less cholesterol esterification in macrophages: a novel mechanism underlying the antiatherogenic properties of vitamin E. |
| Vitamin E restores endothelium dependent vasodilatation in cholesterol fed rabbits: in vivo measurements by photoplethysmography Klemsdal, T. O., T. L. Andersson, et al. (1994), Cardiovasc Res 28(9): 1397-402. Abstract: OBJECTIVE: Pulse curve plethysmography was used to examine the effect of vitamin E on endothelium dependent and independent vasodilatation in unanaesthetised cholesterol fed rabbits in vivo. The height of the dicrotic notch was used as an index of general arterial vasodilatation. METHODS: Twenty eight rabbits were divided into three study groups; a control group (group 1, n = 8), a group fed 1% cholesterol (group 2, n = 10), and a group fed 1% cholesterol with the addition of 0.2% vitamin E after four weeks (group 3, n = 10). After six weeks on diet the vasodilator responses to acetylcholine and glyceryl trinitrate were measured by photoplethysmography of the rabbit ear. Recordings were made during light sedation at baseline and during infusion of acetylcholine (1.5, 3.0, 6.0, and 12 micrograms.min-1) and glyceryl trinitrate (3.75, 7.5, and 15.0 micrograms.min-1). In a second set of experiments with control fed rabbits (n = 5), acetylcholine infusions were given before and after infusion of L-nitro-arginine (15 mg). RESULTS: The relative height of the dicrotic notch (which predominantly indicates arterial tone in the larger vessels) was reduced by acetylcholine in a dose dependent manner, but in cholesterol fed rabbits (group 2) this response was significantly decreased. Rabbits receiving concomitant dietary vitamin E responded in a similar manner to controls. The difference was most prominent using acetylcholine at a dose of 3.0 micrograms.min-1, where the mean change from baseline was 11(SEM 4)% in group 2, compared to 31(6)% in group 1 (p = 0.01), and to 26(5)% in group 3 (p = 0.02). Similar differences between the groups were observed for the increase in heart rate during acetylcholine infusions. In contrast, the responses to glyceryl trinitrate were similar in all groups. After infusions of L-nitro-arginine, the responses to acetylcholine were blunted. CONCLUSIONS: Supplementation with vitamin E restored the otherwise reduced vascular response to acetylcholine in cholesterol fed rabbits. Analysis of photoplethysmographic pulse curves is a simple non-invasive method of evaluating arterial vasodilator effects. However, the nature of the measured dilator response needs to be characterised further. |
| Vitamin E reverses cholesterol-induced endothelial dysfunction in the rabbit coronary circulation Andersson, T. L., J. Matz, et al. (1994), Atherosclerosis 111(1): 39-45. Abstract: Hypercholesterolaemia and atherosclerosis are associated with impaired endothelium-dependent vasodilation. In this study we have examined the effects of vitamin E on cholesterol-induced endothelial dysfunction in the rabbit coronary circulation. Rabbits were maintained for 4 or 8 weeks on one of three experimental diets: (a) control chow, (b) 1% cholesterol or (c) 1% cholesterol for the first half of the treatment period followed by 1% cholesterol + 0.2% vitamin E during the last half of the treatment. After sacrifice, vasodilator responses to acetylcholine and sodium nitroprusside in the isolated perfused heart were studied. Responses to sodium nitroprusside were similar between the groups whereas responses to acetylcholine were significantly impaired in cholesterol-fed rabbits after both 4 and 8 weeks when compared to controls. In the cholesterol + vitamin E group, responses to acetylcholine were similar to controls and significantly greater than in the group receiving cholesterol alone. These results show that both 4 and 8 weeks of cholesterol-feeding induces an endothelial dysfunction in the coronary circulation of the rabbit, and that vitamin E protects against this dysfunction. By comparing responses to acetylcholine in the 4 week cholesterol group with the 8 week cholesterol + vitamin E group it was shown that vitamin E may not only prevent further deterioration of the endothelial function in the rabbit heart, but may also reverse the adverse effects of hypercholesterolaemia. |
| Vitamin K2 and serum cholesterol in patients on continuous ambulatory peritoneal dialysis Nagasawa, Y., M. Fujii, et al. (1998), Lancet 351(9104): 724. |
| VLDL, apolipoproteins B, CIII, and E, and risk of recurrent coronary events in the Cholesterol and Recurrent Events (CARE) trial Sacks, F. M., P. Alaupovic, et al. (2000), Circulation 102(16): 1886-92. Abstract: BACKGROUND: Plasma triglyceride concentration has been an inconsistent independent risk factor for coronary heart disease, perhaps because of the metabolic heterogeneity among VLDL particles, the main carriers of triglycerides in plasma. METHODS AND RESULTS: We conducted a prospective, nested case-control study in the Cholesterol and Recurrent Events (CARE) trial, a randomized placebo-controlled trial of pravastatin in 4159 patients with myocardial infarction and average LDL concentrations at baseline (115 to 174 mg/dL, mean 139 mg/dL). Baseline concentrations of VLDL-apolipoprotein (apo) B (the VLDL particle concentration), VLDL lipids, and apoCIII and apoE in VLDL+LDL and in HDL were compared in patients who had either a myocardial infarction or coronary death (cases, n=418) with those in patients who did not have a cardiovascular event (control subjects, n=370) in 5 years of follow-up. VLDL-cholesterol, VLDL-triglyceride, VLDL-apoB, apoCIII and apoE in VLDL+LDL and apoE in HDL were all interrelated, and each was a univariate predictor of subsequent coronary events. The significant independent predictors were VLDL-apoB (relative risk RR 3.2 for highest to lowest quintiles, P:=0.04), apoCIII in VLDL+LDL (RR 2.3, P:=0.04), and apoE in HDL (RR 1.8, P:=0.02). Plasma triglycerides, a univariate predictor of coronary events (RR 1.6, P:=0.03), was not related to coronary events (RR 1.3, P:=0.6) when apoCIII in VLDL+LDL was included in the model, whereas apoCIII remained significant. Adjustment for LDL- and HDL-cholesterol did not affect these results. CONCLUSIONS: The plasma concentrations of VLDL particles and apoCIII in VLDL and LDL are more specific measures of coronary heart disease risk than plasma triglycerides perhaps because their known metabolic properties link them more closely to atherosclerosis. |
| VLDL-resembling phospholipid-submicron emulsion for cholesterol-based drug targeting Shawer, M., P. Greenspan, et al. (2002), J Pharm Sci 91(6): 1405-13. Abstract: The objective of the current study was to develop and evaluate VLDL-resembling phospholipid-submicron emulsion (PSME) as a carrier system for new cholesterol-based compounds for targeted delivery to cancer cells. BCH, a boronated cholesterol compound, was originally developed in our laboratory to mimic the cholesterol esters present in the LDL and to follow a similar pathway of cholesterol transport into the rapidly dividing cancer cells. The VLDL-resembling system was then designed to solubilize BCH, facilitate the interaction with LDL, and thus assist the BCH delivery to cancer cells. BCH-containing PSME was prepared by sonication. Chemical compositions and particle sizes of different PSME fractions were determined. The lipid structure of PSME and location of BCH in the formulation were assessed based on experimental results. Density gradient ultracentrifugation fractionated the emulsion into three particle-size populations with structures and compositions resembling native VLDL. In vitro interaction between PSME and LDL was evident by agarose electrophoresis, as both formed a single band with an intermediate mobility. The transfer of BCH from PSME to LDL was also observed in the presence of other serum components including serum proteins. Cell culture data showed sufficient uptake of BCH in rat 9L glioma cells (> 50 microg boron/g cells). In conclusion, this system has the capability to incorporate the cholesterol-based compound, interact with native LDL, and assist the delivery of this compound into cancer cells in vitro. |
| Walking and serum cholesterol in adults Tucker, L. A. and G. M. Friedman (1990), Am J Public Health 80(9): 1111-3. Abstract: We measured the association between walking for exercise and the ratio of total cholesterol/HDL cholesterol in 3,621 adults. After controlling for age, gender, income, body fat, alcohol use, exercise other than walking, and cigarette smoking, adults in the high, moderate, and low duration walking categories were compared to those in the no walking-no exercise category. The relative risk for total/HDL ratios of 5.0 or more were.46 (95% CI =.27.80).48 (95% total/HDL ratios of 5.0 or more were.46 (95% CI =.27.80).48 (95% CI =.30.76), and 1.11 (95% CI =.81, 1.53) respectively. |
| Walking program maintenance in women with elevated serum cholesterol Ready, A. E. (1996), Behav Med 22(1): 23-31. Abstract: Health benefits are commonly reported in supervised exercise studies but it is not known whether participants remain active upon completion of the program. The walking habits of 21 older women (M = 62.0 +/- 4.8 years) with moderately elevated serum cholesterol were monitored for 12 months following completion of a supervised walking program. The average amount they walked per week decreased significantly--from approximately 4.5 hours to less than 3 hours after 3 and 6 months. After 12 months, one third of the participants continued to walk for more than 4 hours per week, 50% walked from 2 to 4 hours per week, and 20% had quit walking. Walking maintenance was not significantly associated with fitness level, percentage of body fat, or change in weight during the supervised program. Those who achieved the greatest reduction in serum cholesterol, however, were more likely to maintain walking levels after 12 months. Perceived lack of control over their physical activity levels by older women and loss of socialization and feedback may explain the decrease in activity observed after completion of a supervised program. |
| Walking program reduces elevated cholesterol in women postmenopause Ready, A. E., D. T. Drinkwater, et al. (1995), Can J Cardiol 11(10): 905-12. Abstract: OBJECTIVE: To examine the effect of a moderate exercise regimen on total serum cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body composition and cardiovascular fitness (VO2 max) in mildly hyperlipidemic women, postmenopause. DESIGN: Randomized assignment to walking (n = 24) or control (n = 16) groups. SETTING: Community based intervention. PARTICIPANTS: Over 300 volunteers were screened to obtain the sample of 40 eligible women. Participants were mildly hyperlipidemic, postmenopause (mean age 62.0 +/- 5.7 years), sedentary, nonsmokers and not on hormone replacement therapy. Results are reported for the 25 subjects (15 walkers, 10 controls) who completed the study. INTERVENTION: Exercisers walked an average of 54.3 +/- 7.7 mins/day, 4.9 +/- 1.7 days/week, at an intensity of 54% maximum heart rate reserve, for six months. Participants were counselled not to change their diets. MAIN RESULTS: Total serum cholesterol, triglyceride, total serum cholesterol: HDL-C ratio, weight and fat mass decreased significantly in the walkers compared with the controls (P < 0.05), as did body mass index (P < 0.01). Walking resulted in a significant increase in VO2 max (P < 0.01). Changes in serum lipids were significantly related to changes in body fat, but not to change in aerobic fitness. There were no changes in dietary intake. CONCLUSIONS: A moderate intensity exercise program induces favourable alterations in total serum cholesterol and other atherogenic indices in hyperlipidemic women postmenopause, and these changes are related more to loss of body fat than to increased fitness level. |
| Walnuts lower serum cholesterol in Japanese men and women Iwamoto, M., M. Sato, et al. (2000), J Nutr 130(2): 171-6. Abstract: Recent studies have shown that incorporating moderate quantities of walnuts into the recommended cholesterol-lowering diet in the U.S. decreased serum concentrations of total cholesterol in normal American men. To explore whether walnut consumption would also prove effective as part of the Japanese diet, we studied the effects of walnut consumption on serum lipids and blood pressure in Japanese subjects. We randomly assigned 20 men and 20 women to two mixed natural diets, each to be consumed for 4 wk in a crossover design. Both diets conformed to the average Japanese diet (reference diet) and contained identical foods and macronutrients, except that 12.5% of the energy of the walnut diet was derived from walnuts (43-57 g/d) (offset by lesser amounts of fatty foods, meat and visible fat). Total cholesterol concentration was 0.16 mmol/L lower for men (P = 0.05) and 0.21 mmol/L lower for women (P<0.01) when they consumed the walnut diet than when they consumed the reference diet. The LDL cholesterol concentrations were 0.18 mmol/L lower for men (P = 0.13) and 0.22 mmol/L lower for women (P<0.01) when they consumed the walnut diet. The ratio of LDL cholesterol to HDL cholesterol and the apolipoprotein B concentration were also lowered by the walnut diet (P<0.05). Blood pressures did not differ between the walnut and reference diet periods. Incorporating moderate quantities of walnuts into the average Japanese diet while maintaining the intake of total dietary fat and energy decreases serum total cholesterol concentrations and favorably modifies the lipoprotein profile in Japanese, particularly in women. |
| Watching the levels of serum cholesterol in a town in Catalonia. Results from the year 2001 Deniel Rosanas, J., J. Prat Quinzanos, et al. (2003), Aten Primaria 31(7): 460-2. |
| Water quality has a pronounced effect on cholesterol-induced accumulation of Alzheimer amyloid beta (Abeta) in rabbit brain Sparks, D. L., J. Lochhead, et al. (2002), J Alzheimers Dis 4(6): 523-9. Abstract: Increased circulating cholesterol is known to promote risk of coronary artery disease. It is now emerging that cholesterol promotes production and accumulation of amyloid beta (Abeta) deposited in the hallmark pathologic lesion of Alzheimer's disease (AD), the senile plaque, perhaps by shifting away from normal metabolism of amyloid beta protein precursor (AbetaPP) to beta. Previous studies employing the cholesterol-fed rabbit model of AD demonstrated that induction of AD-like Abeta accumulation in brain could be reversed by co-administration of cholesterol lowering drugs or removing cholesterol, prompted initiation of an AD Cholesterol-Lowering (Statin) Treatment Trial. We now present data that identify a previously unrecognized role for dietary water quality on the severity of neuropathology induced by elevated cholesterol. Neuronal accumulation of Abeta induced by increased circulating concentrations of cholesterol in the New Zealand white rabbit is attenuated when distilled drinking water is administered compared to use of tap water. The numbers of neurons in cholesterol-fed rabbits that exhibited Abeta immunoreactivity, relative to normal chow-fed controls, increased approximately 2.5 fold among animals on tap water but only approximately 1.9 fold among animals on distilled water. This yielded a statistically significant approximately 28% reduction due to the use of distilled water. In addition, the subjectively assessed intensity of neuronal Abeta immunoreactivity was consistently reduced among cholesterol-fed rabbits allowed distilled drinking water compared to cholesterol-fed rabbits on tap water. As intensity of antibody immunoreactivity is likely related to concentration of antigen, the identified difference among cholesterol-fed rabbits allowed distilled drinking water may hold greater importance than a significant reduction in numbers of affected neurons. The effect on neuronal Abeta immunoreactivity intensity was observable among cholesterol-fed rabbits reared and allowed tap water when performing studies in three distinct locales. Pilot data suggest the possibility of increased clearance of Abeta from the brain, identified as increased blood levels, among cholesterol-fed rabbits administered distilled water compared to animals on tap water. The agent(s) occurring in tap water, excluded by distillation, promoting accumulation of neuronal Abeta immunoreactivity is(are) yet undisclosed, but arsenic, manganese, aluminum, zinc, mercury, iron and nitrate have tentatively been excluded because they were not identifiable (below detection limits) in the tap water of the three locales where the cholesterol-induced neuropathologic difference was observable. These findings suggest that water quality may impact on human health in the setting of increased circulating cholesterol levels, and could illustrate a truly simple life-style change that could be of benefit in AD. |
| Water-soluble cholesteryl-containing phosphorothioate monogalactosides: synthesis, properties, and use in lowering blood cholesterol by directing plasma lipoproteins to the liver Roelen, H. C., M. K. Bijsterbosch, et al. (1991), J Med Chem 34(3): 1036-42. Abstract: The synthesis of several monogalactoside-terminated phosphorothiolated cholesteryl derivatives is described. Monogalactosyl derivatives are coupled by phosphorothiolation to cholesterol by using ethylene glycol units as hydrophilic spacer moieties. The resulting compounds are easily soluble in water. Upon addition of such solutions to human serum (to 2 mM final concentration) the compounds are readily incorporated into lipoproteins. Isolated low-density lipoprotein (LDL) and high-density lipoprotein (HDL), preloaded with the compounds, are rapidly cleared from the circulation by the liver. The hepatic association is blocked by N-acetylgalactosamine, which indicates that galactose-specific recognition sites are responsible for the increased liver uptake. The plasma clearance and hepatic uptake of LDL loaded with the compounds is substantially higher (about 2-fold) than clearance and uptake of HDL containing the compounds. The selectivity of the effects of monogalactoside-terminated phosphorothiolated cholesteryl derivatives on the in vivo behavior of LDL as compared to that of HDL indicates that these compounds might be used to lower specifically LDL levels in patients with a high LDL-cholesterol level. |
| Water-soluble dietary fiber and low-density lipoprotein cholesterol Masse, J. (1992), Am J Cardiol 70(7): 840. |
| Water-soluble viscous substance of Jew's mellow leaves lowers serum and liver cholesterol concentrations and increases fecal steroid excretion in rats fed a high cholesterol diet Innami, S., K. Nakamura, et al. (1995), J Nutr Sci Vitaminol (Tokyo) 41(4): 465-75. Abstract: The effect of Jew's mellow leaf powder and its water soluble viscous substance on cholesterol metabolism in rats fed a high cholesterol diet was examined. When compared to the controls, total serum and liver cholesterol concentrations were significantly decreased or tended to decrease in the groups given dry powder of fresh Jew's mellow leaves, dry powder purchased from the market or residual powder after extracting with ethanol, whereas no difference was observed in those given residual powder after extracting with water. There were significant increases or increasing tendencies in the fecal excretion of bile acids, total neutral sterols and cholesterol in those fed the experimental diets when compared to the control group. Rats fed a diet containing a water-soluble viscous substance (1.7%, about 1% as dietary fiber) obtained from the dry powder of Jew's mellow leaves showed significant decreases in serum and liver cholesterol concentrations and increases in fecal excretions of bile acids and neutral sterols. Based on the above, the component of dry powder of Jew's mellow leaves that is effective in decreasing serum and liver cholesterol concentrations was found to be a soluble dietary fiber, and the mechanism was assumed to be largely due to the increased excretion of bile acids and neutral sterols. |
| Weight change and change of total cholesterol and high-density-lipoprotein cholesterol. Results of the MONICA Augsburg cohort study Eberle, E., A. Doering, et al. (1991), Ann Epidemiol 1(6): 487-92. Abstract: Data from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg cohort were used to study the effect of weight change on changes in serum levels of total and high-density-lipoprotein cholesterol. Weight gain was associated with rising levels of total cholesterol and falling levels of high-density-lipoprotein cholesterol in both sexes, more so in men than in women. Moreover, these relationships weakened with advancing age in women, but not in men. The results support the view that weight loss may more favorably affect lipid levels in men than in women, particularly at older ages. |
| Weight cycling and high-density lipoprotein cholesterol in women: evidence of an adverse effect: a report from the NHLBI-sponsored WISE study. Women's Ischemia Syndrome Evaluation Study Group Olson, M. B., S. F. Kelsey, et al. (2000), J Am Coll Cardiol 36(5): 1565-71. Abstract: OBJECTIVES: We undertook an analysis of weight cycling, coronary risk factors and angiographic coronary artery disease (CAD) in women. BACKGROUND: The effect of weight cycling on cardiovascular mortality and morbidity is controversial, and the impact of weight cycling on cardiovascular risk factors is unclear. METHODS: This is a cross-sectional population study of 485 women with coronary risk factors undergoing coronary angiography for evaluation of suspected myocardial ischemia enrolled in the Women's Ischemia Syndrome Evaluation (WISE). Reported lifetime weight cycling-defined as voluntary weight loss of at least 10 lbs at least 3 times--coronary risk factors including core laboratory determined blood lipoproteins and CAD, as determined by a core angiographic laboratory, are the main outcome measures. RESULTS: Overall, 27% of women reported weight cycling--19% cycled 10 to 19 lbs, 6% cycled 20 to 49 lbs, and 2% cycled 50+ lbs. Reported weight cycling was associated with 7% lower high-density lipoprotein cholesterol (HDL-C) levels in women (p = 0.01). The HDL-C effect was directly related to the amount of weight cycled with women who lost > or = 50 lbs/cycle having HDL-C levels 27% lower than noncyclers (p = 0.0025). This finding was independent of other HDL-C modulators, including estrogen status, physical activity level, alcohol intake, body mass index, diabetes, beta-blocker use, cigarette smoking and race. Weight cycling was not associated with an increased prevalence of CAD in this population. CONCLUSIONS: Weight cycling is associated with lower HDL-C in women of a magnitude that is known to be associated with an increased risk of cardiac events as demonstrated in prior clinical trials. |
| Weight loss due to energy restriction suppresses cholesterol biosynthesis in overweight, mildly hypercholesterolemic men Di Buono, M., J. S. Hannah, et al. (1999), J Nutr 129(8): 1545-8. Abstract: Mechanisms explaining the decrease in circulatory cholesterol levels after weight loss remain ill defined. The objective was to examine effects of weight loss as achieved through energy restriction upon human in vivo cholesterol biosynthesis. Six subjects (64-77 y, body mass index, 30.3 +/- 3.8 kg/m(2)) were recruited into a two-phase prospective clinical trial. In the first phase, subjects complied with American Heart Association (AHA) Step I diets for 3 mo with no change in their usual energy intake. After this weight-stable phase, subjects consumed an AHA Step I diet with a targeted reduction in energy intake of approximately 1000 kJ/d for 6 mo to achieve negative energy balance leading to weight loss. The incorporation rate of deuterium from body water into erythrocyte membrane free cholesterol over 24 h was utilized as an index of cholesterogenesis at the end of both phases. Subjects' mean weights decreased (P < 0.05) from 89.3 +/- 12.5 kg to 83.2 +/- 11.5 kg (6.8 +/- 2.6% of initial body weight) across phases. Circulating concentrations of total and LDL-cholesterol, and triglycerides also decreased (P < 0. 05) across phases. HDL-cholesterol concentrations were unchanged (P > 0.05). Cholesterol fractional synthetic rate (FSR) after phase 2 (3.04 +/- 1.90%/d) was lower (P < 0.05) than that after phase 1 (8. 42 +/- 3.90%/d). Absolute synthesis rate (ASR) after phase 2 0.59 +/- 0.38 g/(kg. d) also was lower (P < 0.05) than that after phase 1 1.66 +/- 0.84 g/(kg. d). These data suggest that, in obese men, energy restriction resulting in even modest weight loss suppresses endogenous cholesterol synthesis, which contributes to a decline in circulating lipid concentrations. |
| Weight-for-height measurement and saturated fatty acid intake are predictors of serum cholesterol level in children Wilson, D. K. and N. M. Lewis (1992), J Am Diet Assoc 92(2): 192-6. Abstract: To assess the relationship of serum cholesterol level to anthropometric measurements and dietary intake, we measured serum cholesterol, height, weight, triceps skinfold, and 24-hour dietary intake in 80 children (mean age = 9.8 years) during April 1989. The mean serum cholesterol level was 3.95 mmol/l. In comparison with national data, weight-for-height and triceps skinfold measurements exceeded the 90th percentile in 18 (23%) and 26 (33%) of the children, respectively. Mean cholesterol and fat intakes were 114 mg/1,000 kcal and 36% of energy, respectively. In multiple stepwise regression analyses, weight-for-height measurement and saturated fatty acid intake were most predictive of serum cholesterol levels. Diets of children who consumed 30% of energy or less from fat (low-fat group) met or exceeded the Recommended Dietary Allowances except for energy and vitamin E and were higher in percentage of energy from carbohydrate, dietary fiber, magnesium, iron, and copper than were diets of children who consumed 31% of energy or more from fat (high-fat group). Children in the high-fat group ate more red/processed meats, baked desserts, and fats/oils than children in the low-fat group. Our data indicate that programs to reduce risk of cardiovascular disease in children may need to focus on maintaining ideal body weight and reducing saturated fatty acid intake. |
| What are acceptable cholesterol levels for children and adolescents? Cunningham, E. (2005), J Am Diet Assoc 105(3): 485. |