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Although the significance of Yudkin’s (1972) observation relating morbidity from coronary heart disease (CHD) to excessive intake of dietary sucrose remains controversial, the metabolic effects of sucrose on CHD risk factor variables such as serum lipids, glucose and insulin are well recognized. We observed that the average intake of sucrose in Bogalusa children constituted 50% of the total carbohydrate (Frank et al. 1978). It is also generally accepted that excessive salt intake is an etiologic factor in the development of hypertension, another major CHD risk factor. In rats dietary sucrose has been shown to potentiate salt induced hypertension (Hall and Hall 1966). While manipulation of dietary fat and cholesterol continues to be extensively applied in experimental atherosclerosis, only a few studies have been concerned with the effect of dietary sucrose on the accepted CHD risk factors, viz., hyperlipidemia and hypertension, under experimental conditions, especially in nonhuman primates. In these studies we investigated the response of different nonhuman primates to the potentiating effects of sucrose on hyperlipoproteinemia and salt induced hypertension (Srinivasan et al. 1978, 1979a, 1979b).

Since atherosclerosis and essential hypertension are believed to begin asymptomatically in early life, much interest has recently been shown in the study of risk factor variables in children. Extensive information is now available on cardiovascular (CV) disease risk factor variables of children in a general population, somewhat comparable to information from similar studies of adults (Monograph 1978). Additional research is now providing longitudinal observations following time-course changes of CV risk factor variables (Voors et al. 1979b, Frerichs et al. 1979) and determining how levels during the pediatric years may relate to adulthood, when the risk of coronary heart disease or essential hypertension can be judged by morbid events. Although there is a lack of understanding of the clinical significance and aftermath of disease in children, such as it occurs in adults, there are certain advantages to studying children. Heretofore, most of the epidemiologic studies described adult disease during a time when biologic changes of risk factors are less obvious. For example, in adults, stature, body weight, and serum total cholesterol change relatively little when compared to the dramatic changes that occur in the developing infant or child (Berenson et al. in press). These temporal changes in children occur during life periods when clues to mechanisms responsible for different levels of risk factor variables are available. The observation of race and sex contrasts enhances the potential usefulness of a pediatric study.