The early origins of atherosclerosis.

Atherosclerosis has a long pre-clinical phase with development of pathological changes in arteries of children and young adults decades before overt clinical manifestations of disease. Nutritional factors in both infancy and childhood have been shown to be important in this process and affect lifetime cardiovascular disease risk. Breast-feeding in particular is associated with benefits for long-term cardiovascular risk factors possibly as a consequence of a slower pattern of growth in breast-fed compared to formula-fed infants. In fact, the benefits of slower growth for later health and longevity, appears to be a fundamental biological phenomenon conserved across diverse animal species. The nutritional programming of atherosclerosis could therefore be regarded as a specific example of programming of human ageing as seen previously in programming of lifespan and telomere length in animals. The critical window for these effects is unknown, but evidence is accumulating for programming effects of growth from very early in infancy.