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When and how to start prevention of atherosclerosis? Lessons from the Cardiovascular Risk in the Young Finns Study and the Special Turku Coronary Risk Factor Intervention Project

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“Give me a child until he is seven and I will give you the man”

Saint Francis Xavier (1506–1552)

The Jesuit motto coined by Saint Francis Xavier in the 16th century encapsulates what has taken modern medicine several decades of enquiry into the origins of atherosclerosis to resolve: that the clinical complications of atherosclerosis develop as a result of a lifelong process that begins in early life.

Abstract

This review provides an up-to-date summary of findings from two ongoing population-based, prospective studies conducted in Finland: The Cardiovascular Risk in Young Finns Study, and the Special Turku Coronary Risk Factor Intervention Project (STRIP), which have contributed significantly to the scientific literature concerning the childhood origin of cardiovascular disease, and whether prevention efforts in adults can be expanded to young people. From the Young Finns Study, we summarize evidence demonstrating childhood risk factors to be associated with both risk factors and preclinical markers of atherosclerosis in adulthood, and from STRIP, we summarize evidence showing that supervised dietary counseling of a low saturated fat diet effectively decreases exposure to cardiovascular risk factors without affecting growth and development of healthy children and adolescents. The evidence available from these studies supports that the ability to prevent or delay the risk of premature atherosclerosis and its clinical sequelae later in life lies in maintaining a low lifetime risk by preventing the development of risk factors in early life.

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Acknowledgements

The Cardiovascular Risk in Young Finns Study was financially supported by the Academy of Finland (grants 77841, 210283, 117832 and 121584), the Social Insurance Institution of Finland, Turku University Foundation, Kuopio, Tampere and Turku University Hospital Medical Funds, Emil Aaltonen Foundation, Juho Vainio Foundation, Finnish Foundation of Cardiovascular Research and Finnish Cultural Foundation. Mika Kivimäki is supported by the BUPA Foundation Specialist Research Grant. The sponsors had no role in preparing the manuscript.

The Special Turku Coronary Risk Factor Intervention Project (STRIP) was financially supported by the Finnish Cardiac Research Foundation; Foundation for Pediatric Research, Finland; Academy of Finland (grants 206374, 210238, 77841, 34316); The Mannerheim League for Child Welfare; Yrjö Jahnsson Foundation; Sigrid Juselius Foundation; Special Federal Research Funds for Turku University Hospital; Turku University Foundation; Turku University Hospital Foundation; Juho Vainio Foundation; Finnish Cultural Foundation; and City of Turku.

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Authors and Affiliations

  1. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Finland, Finland

    Costan G. Magnussen, Markus Juonala & Olli T. Raitakari

  2. Department of Pediatrics, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Finland, Finland

    Harri Niinikoski & Olli Simell

  3. Department of Medicine, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Finland, Finland

    Markus Juonala, Tapani Rönnemaa & Jorma S. A. Viikari

  4. Department of Clinical Physiology, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Finland, Finland

    Olli T. Raitakari

  5. Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia

    Costan G. Magnussen & Olli T. Raitakari

  6. Department of Epidemiology and Public Health, University College London, London, UK

    Mika Kivimäki

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  1. Costan G. Magnussen
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  2. Harri Niinikoski
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  5. Tapani Rönnemaa
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  6. Jorma S. A. Viikari
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  8. Olli T. Raitakari
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Correspondence to Olli T. Raitakari.

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Magnussen, C.G., Niinikoski, H., Juonala, M. et al. When and how to start prevention of atherosclerosis? Lessons from the Cardiovascular Risk in the Young Finns Study and the Special Turku Coronary Risk Factor Intervention Project. Pediatr Nephrol 27, 1441–1452 (2012). https://doi.org/10.1007/s00467-011-1990-y

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