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Nutrition in acute and chronic diseases

Lipid and saturated fatty acids intake and cardiovascular risk factors of obese children and adolescents



To test the hypothesis that lipid intake is associated with triglycerides to HDL-cholesterol ratio (TG/HDL-cholesterol), a predictor of the development of cardiovascular disease, in obese children and adolescents, independently from the level of overweight, insulin resistance, blood pressure, and non-alcoholic fatty liver disease (NAFLD).

Study design

One hundred and eighty non-diabetic obese children/adolescents (age range 6–16 years) were enrolled. Diet (3-day weighed dietary record), physical and biochemical parameters and liver ultrasonography were measured. The impact of lipid intake on TG/HDL-cholesterol ratio >2.2 was measured by regression models, adjusting for covariates (age, gender, height, weight, systolic and diastolic blood pressure, NAFLD positivity, HOMA-IR, and total energy intake).


Independently from covariates, children consuming a diet with a fat content higher than 35% of total energy had a significantly higher chance [OR = 3.333 (95% CI: 1.113–9.979), P = 0.031] to have a TG/HDL-cholesterol >2.2 than children consuming less than 35% of fat. Moreover, if saturated fatty acids (SFA) intake was higher than 13% of total energy, children had a significantly higher chance [OR = 4.804 (95% CI: 1.312–17.593), P = 0.018] to have a TG/HDL-cholesterol >2.2 than children consuming less than 13% of SFA in their diet.


High fat intake, especially SFA intake, is associated with TG/HDL-cholesterol levels of obese children and adolescents, independently from other cardiovascular risk co-factors. Further intervention studies will contribute to clarify the potential role of changes in the composition and amount of fat in the diet of obese children and adolescents, on their cardiovascular risk factors.

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We are sincerely indebted to the children and adolescents who participated in the study and to their families. We thank the dedicated staff of the Pediatric Diabetes and Metabolic Disorders Unit of the University Hospital in Verona for their support during the clinical study.


This research was funded by grants (FURMAF2019) from the University of Verona to CM.

Author information




CM designed the study, analyzed data, and wrote the manuscript. MC and FO researched data and co-wrote the manuscript. FT, MT, IB, EF, and AM researched data. CM is the guarantor of this work and, as such, had full access to all the data in the study and take responsibility for the integrity and the accuracy of the data analysis.

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Correspondence to Claudio Maffeis.

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Maffeis, C., Cendon, M., Tomasselli, F. et al. Lipid and saturated fatty acids intake and cardiovascular risk factors of obese children and adolescents. Eur J Clin Nutr 75, 1109–1117 (2021).

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