Funding outcome

Heart disease remains the leading cause of death for Canadians and was responsible for 11.6% of the total cost of illness in Canada in 2009. One of the major contributors to heart disease is the accumulation of cholesterol in the blood. High blood cholesterol increases the liklihood of forming blockages in the major vessels of the heart, which result in heart attack or stroke. These end stage heart events mainly occur in adulthood, but recent research strongly suggests that heart disease progression begins in childhood. Identifying children at risk of developing heart disease early on in life could significantly reduce the burden of adult onset heart disease. Current guidelines for children rely on assessing 'traditional' blood cholesterol levels, including 'bad cholesterol' [also known as low density lipoprotein cholesterol (LDL-C)]. However, bad cholesterol is often normal in overweight or obese children, which suggests that other cholesterol sources may be involved in heart disease progression. Recent studies have shown that dietary fats (derived from the intestine) can elevate 'remnant cholesterol' and contribute to heart disease. Our laboratory has previously shown that overweight children have very high levels of remnant cholesterol, which might explain how some children might be at risk of developing heart disease. It has already been established that elevated blood lipids [remnant cholesterol and triglycerides (TG)] in adults is an independent predictor of heart disease. Fat intolerant individuals have elevated remnant cholesterol following a high fat meal and are at heightened risk of developing heart disease. Fat intolerance (elevated remnant cholesterol following a high fat meal) contributes to cholesterol accumulation in the heart and is an independent predictor of CVD risk in adults. More recently, we have demonstrated that fasting remnant cholesterol is elevated two-fold in obese, pre-pubertal children and is associated with obesity at this age. We hypothesize that overweight children with fat intolerance have the same CVD risk relative to adults with a similar condition. Our study objective is to determine both fasting and non-fasting lipids (fat tolerance) in healthyweight and unhealthy (over) weight children. The primary outcomes are to determine the amount of fasting and nonfasting blood (following a high-fat meal test at 0,2,4,6 and 8hrs) remnant cholesterol. This will be the first study of its kind to validate impaired fat tolerance in overweight children and to evaluate the extent of heart disease risk at this age.