{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T21:59:42Z","timestamp":1787781582164,"version":"build-2784847793"},"reference-count":54,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Childhood dyslipidemia is an important risk factor for developing cardiovascular disease in adulthood. Our study aimed to investigate a possible correlation between nutritional, lifestyle, behavioral and socioeconomic factors and serum lipid levels in children with dyslipidemia. Methods: In this retrospective, observational study, in 31 children with dyslipidemia, aged 3\u201314 years, dietary habits, physical activity, hours watching television or playing video games, family\u2019s socioeconomic status, weight of children and parents, and duration of breastfeeding were recorded. The children\u2019s adherence to the Mediterranean diet was also evaluated by KidMed index. Statistical analysis was performed using SPSS.22. Results: Children with increased physical activity had lower triglyceride levels, compared to those with lower physical activity (p = 0.001). Children who consumed only one meal per day, had increased levels of total cholesterol (p = 0.01), LDL-cholesterol (p = 0.01), ApoB (p = 0.001) and lipoprotein (a) (p = 0.018), compared to those who consumed more than 3 meals per day (p &lt; 0.05). Children who were breastfed less than 6 months had significantly increased LDL-C levels (p = 0.022), compared to children who were breastfed more than 6 months. All other parameters investigated did not differ significantly. Conclusions: This study showed association between lipid profile of children with dyslipidemia and specific nutritional and socioeconomic factors, such as increased physical activity, increased meals consumption during the day, and exclusive breastfeeding for more than 6 months. Nevertheless, further research is needed, in order to confirm these findings.<\/jats:p>","DOI":"10.3390\/nu12061600","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T11:49:21Z","timestamp":1591012161000},"page":"1600","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Association between Serum Lipid Levels in Greek Children with Dyslipidemia and Mediterranean Diet Adherence, Dietary Habits, Lifestyle and Family Socioeconomic Factors"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria","family":"Lampropoulou","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, University of the Aegean, Mitropoliti Ioakim 2, 81440 Myrina, Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chaini","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, University of the Aegean, Mitropoliti Ioakim 2, 81440 Myrina, Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0779-6649","authenticated-orcid":false,"given":"Nikolaos","family":"Rigopoulos","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, University of the Aegean, Mitropoliti Ioakim 2, 81440 Myrina, Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Evangeliou","sequence":"additional","affiliation":[{"name":"4th Department of Pediatrics, Aristotle University of Thessaloniki, \u201cPapageorgiou\u201d General Hospital, 54453 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriaki","family":"Papadopoulou-Legbelou","sequence":"additional","affiliation":[{"name":"4th Department of Pediatrics, Aristotle University of Thessaloniki, \u201cPapageorgiou\u201d General Hospital, 54453 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5137-0499","authenticated-orcid":false,"given":"Antonios E.","family":"Koutelidakis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, University of the Aegean, Mitropoliti Ioakim 2, 81440 Myrina, Lemnos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Schaefer, E., and Ernst, J. (2010). High Density Lipoproteins, Dyslipidemia, and Coronary Heart Disease, Springer. [1st ed.]. Available online: https:\/\/www.springer.com\/gp\/book\/9781441910585.","DOI":"10.1007\/978-1-4419-1059-2"},{"key":"ref_2","first-page":"274","article-title":"A review of guidelines for dyslipidemia in children and adolescents","volume":"111","author":"Peterson","year":"2012","journal-title":"WMJ"},{"key":"ref_3","unstructured":"Williams, L., and Wilson, D. (2020). Nutritional management of pediatric dyslipidemia. Endotext, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK395582\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.5223\/pghn.2014.17.2.85","article-title":"Dyslipidemia in children and adolescents: When and how to diagnose and treat?","volume":"17","author":"Yoon","year":"2014","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e189","DOI":"10.1542\/peds.2006-1801","article-title":"Screening and treatment for lipid disorders in children and adolescents: Systematic evidence review for the US preventive services task force","volume":"120","author":"Haney","year":"2007","journal-title":"Pediatrics"},{"key":"ref_6","first-page":"26","article-title":"10-Year trends in serum lipid levels and dyslipidemia among children and adolescents from several schools in Beijing, China","volume":"5","author":"Ding","year":"2016","journal-title":"J. Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/HCO.0000000000000249","article-title":"Dyslipidemia and cardiovascular changes in children","volume":"31","author":"Pires","year":"2016","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1093\/eurheartj\/ehv157","article-title":"Familial hypercholesterolaemia in children andadolescents: Gaining decades of life by optimizing detection and treatment","volume":"36","author":"Wiegman","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_9","first-page":"751","article-title":"Working group by Japan atherosclerosis society for making guidance of familial hypercholesterolemia. Guidelines for diagnosis and treatment of familial hypercholesterolemia","volume":"25","author":"Arai","year":"2018","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1038\/s41366-020-0527-5","article-title":"Quality Cohort Collaborative Group. Tune out and turn in: The influence of television viewing and sleep on lipid profiles in children","volume":"44","author":"Manousaki","year":"2020","journal-title":"Int. J. Obes."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1007\/s00394-012-0424-3","article-title":"Increased physical activity combined with more eating occasions is beneficial against dyslipidemias in children. The healthy growth study","volume":"52","author":"Moschonis","year":"2013","journal-title":"Eur. J. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.2337\/dc16-1565","article-title":"Childhood socioeconomic status in predicting metabolic syndrome and glucose abnormalities in adulthood: The cardiovascular risk in young finns study","volume":"39","author":"Puolakka","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e20183075","DOI":"10.1542\/peds.2018-3075","article-title":"Breastfeeding in infancy and lipid profile in adolescence","volume":"143","author":"Hui","year":"2019","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.appet.2015.03.023","article-title":"Association of distorted eating behaviors with cardiometabolic risk indices in preadolescents. The healthy growth study","volume":"91","author":"Moschonis","year":"2015","journal-title":"Appetite"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4200","DOI":"10.1210\/jc.2008-1270","article-title":"Recognition and management of dyslipidemia in children and adolescents","volume":"93","author":"Kwiterovich","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jada.2009.10.035","article-title":"Associations between lifestyle patterns and body mass index in a sample of Greek children and adolescents","volume":"110","author":"Kontogianni","year":"2010","journal-title":"J. Am. Diet Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"b2337","DOI":"10.1136\/bmj.b2337","article-title":"Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study","volume":"338","author":"Trichopoulou","year":"2009","journal-title":"BMJ"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Elmaliklis, I.-N., Liveri, A., Ntelis, B., Paraskeva, K., Goulis, I., and Koutelidakis, A.E. (2019). Increased functional foods\u2019 consumption and mediterranean diet adherence may have a protective effect in the appearance of gastrointestinal diseases: A case\u2013control study. Medicines, 9, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30970582.","DOI":"10.3390\/medicines6020050"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s00394-011-0283-3","article-title":"Adherence to Mediterranean diet and close dietetic supervision increase total dietary antioxidant intake and plasma antioxidant capacity in subjects with abdominal obesity","volume":"52","author":"Kolomvotsou","year":"2013","journal-title":"Eur. J. Nutr."},{"key":"ref_20","unstructured":"Martirosyan, D. (2016). The effects of functional food and bioactive compounds on biomarkers of cardiovascular diseases. Functional Foods Text Book, Functional Food Center. [1st ed.]. Available online: https:\/\/www.researchgate.net\/publication\/313058156_The_effects_of_functional_food_and_bioactive_compounds_on_biomarkers_of_cardiovascular_diseases_In_Functional_Foods_Text_book_Martirosyan_D_Ed_Functional_Food_Center_USA_1st_Edition_pp_89-117."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Konstantinidi, M., and Koutelidakis, A.E. (2019). Functional foods and bioactive compounds: A review of its possible role on weight management and obesity\u2019s metabolic consequences. Medicines, 6, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31505825.","DOI":"10.3390\/medicines6030094"},{"key":"ref_22","unstructured":"Watson, V.P.R. (2015). Mediterranean diet in children and adolescents. the Mediterranean Diet. An Evidence-Based Approach, Preedy. [1st ed.]."},{"key":"ref_23","first-page":"289","article-title":"Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10\u201312 years old children: The PANACEA study","volume":"22\u2013283","author":"Arvaniti","year":"2011","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Novak, D., \u0160tefan, L., Prosoli, R., Emeljanovas, A., Mieziene, B., Milanovi\u0107, I., and Radisavljevi\u0107-Jani\u0107, S. (2017). Mediterranean diet and its correlates among adolescents in Non-Mediterranean European Countries: A population-based study. Nutrients, 9, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28241432.","DOI":"10.3390\/nu9020177"},{"key":"ref_25","unstructured":"(2020, April 15). Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Report of the Expert Panel, Available online: https:\/\/www.nhlbi.nih.gov\/health-topics\/integrated-guidelines-for-cardiovascular-health-and-risk-reduction-in-children-and-adolescents."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Priftis, K., Panagiotakos, D.B., Anthracopoulos, M., Papadimitriou, A., and Nikolaidou, P. (2007). Aims, methods and preliminary findings of the Physical Activity, Nutrition and Allergies in Children Examined in Athens (PANACEA) epidemiological study. BMC Public Health, 7, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1934355\/.","DOI":"10.1186\/1471-2458-7-140"},{"key":"ref_27","first-page":"1","article-title":"Validation of a food frequency questionnaire designed for children 10\u201312 years: THE PANACEA-FFQ","volume":"2","author":"Antonogeorgos","year":"2013","journal-title":"Perioper. Nurs."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1079\/PHN2004556","article-title":"Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean Diet Quality Index in children and adolescents","volume":"7","author":"Majem","year":"2004","journal-title":"Public Health Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/j.1467-789X.2009.00639.x","article-title":"Overweight and obesity in infants and pre-school children in the European Union: A review of existing data","volume":"11","author":"Cattaneo","year":"2010","journal-title":"Obes. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/oby.2007.35","article-title":"Socioeconomic status and adiposity in childhood: A systematic review of cross-sectional studies 1990\u20132005","volume":"16","author":"Shrewsbury","year":"2008","journal-title":"Obesity"},{"key":"ref_31","first-page":"743","article-title":"Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents","volume":"105","author":"Rampersaud","year":"2005","journal-title":"J. Am. DietAssoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1017\/S1368980010000765","article-title":"Breakfast skipping and its relation to BMI and health-compromising behaviours among Greek adolescents","volume":"14","author":"Kapantais","year":"2011","journal-title":"Public Health Nutr"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/j.1467-789X.2011.00936.x","article-title":"Selected eating behaviours and excess body weight: A systematic review","volume":"13","author":"Mesas","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.3945\/ajcn.2010.30101","article-title":"Skipping breakfast: Longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study","volume":"92","author":"Smith","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_35","first-page":"803","article-title":"Dietary behaviors, health-related lifestyle and blood lipid profile of obese children in Incheon","volume":"7","author":"Lee","year":"2002","journal-title":"Korean J. Community Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00394-013-0548-0","article-title":"Effect of green tea on postprandial antioxidant capacity, serum lipids, C Reactive Protein and glucose levels in patients with coronary artery disease","volume":"53","author":"Koutelidakis","year":"2013","journal-title":"Eur. J. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/jhn.12639","article-title":"Association of meal and snack patterns with micronutrient intakes among Greek children and adolescents: Data from the Hellenic National Nutrition and Health Survey","volume":"32","author":"Mitsopoulou","year":"2019","journal-title":"J. Hum. Nutr. Diet"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.numecd.2014.08.001","article-title":"Consumption of ultra-processed food products and its effects on children\u2019s lipid profiles: A longitudinal study","volume":"25","author":"Rauber","year":"2015","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_39","first-page":"2390","article-title":"KIDMED test; prevalence of low adherence to the Mediterranean Diet in children and young; a systematic review","volume":"32","author":"Nissensohn","year":"2015","journal-title":"Nutrici\u00f3n Hospitalaria"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.atherosclerosis.2011.04.003","article-title":"Very high childhood obesity prevalence and low adherence rates to the Mediterranean diet in Greek children: The GRECO study","volume":"217","author":"Farajian","year":"2011","journal-title":"Atherosclerosis"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Arcila-Agudelo, A., Ferrer-Svoboda, C., Torres-Fern\u00e0ndez, T., and Farran-Codina, A. (2019). Determinants of adherence to healthy eating patterns in a population of children and adolescents: Evidence on the Mediterranean diet in the city of Matar\u00f3 (Catalonia, Spain). Nutrients, 15, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6520885\/.","DOI":"10.3390\/nu11040854"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1017\/S1368980008003431","article-title":"Level of adherence to the Mediterranean diet among children from Cyprus: The CYKIDS study","volume":"12","author":"Lazarou","year":"2009","journal-title":"Public Health Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s11136-012-0219-2","article-title":"Health-related quality of life of Greek adolescents: The role of the Mediterranean diet","volume":"22","author":"Costarelli","year":"2013","journal-title":"Qual. Life Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1007\/s00431-012-1735-3","article-title":"Correlation of blood pressure, obesity, and adherence to the Mediterranean diet with indices of arterial stiffness in children","volume":"171","author":"Lydakis","year":"2012","journal-title":"Eur. J. Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.numecd.2009.11.008","article-title":"Metabolic syndrome in adolescents in the Balearic Islands, a Mediterranean region","volume":"21","author":"Martinez","year":"2011","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0828-282X(10)70400-1","article-title":"Dose-response relationship between physical activity and dyslipidemia in youth","volume":"26","author":"LeBlanc","year":"2010","journal-title":"Can. J. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1001\/archpedi.155.3.360","article-title":"Television watching, energy intake, and obesity in US children","volume":"155","author":"Crespo","year":"2001","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/s10995-018-2641-8","article-title":"Association between breastfeeding and childhood cardiovascular disease risk factors","volume":"23","author":"Umer","year":"2019","journal-title":"Matern. Child Health J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.maturitas.2019.01.007","article-title":"Lactation and maternal cardiovascular disease risk in later life","volume":"122","author":"Zachou","year":"2019","journal-title":"Maturitas"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Kocaoglu, B., Moschonis, G., Dimitriou, M., Kolotourou, M., Keskin, Y., Sur, H., Hayran, O., and Manios, Y. (2005). Parental educational level and cardiovascular disease risk factors in schoolchildren in large urban areas of Turkey: Directions for public health policy. BMC Public Health, 4, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15693995.","DOI":"10.1186\/1471-2458-5-13"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"246","DOI":"10.14310\/horm.2002.1408","article-title":"Eating habits and factors affecting food choice of adolescents living in rural areas","volume":"12","author":"Bargiota","year":"2013","journal-title":"Hormones"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.sbspro.2013.06.278","article-title":"The comparison of socio-economic status of families and social support of parents for the physical exercises of their children","volume":"82","author":"Hashemi","year":"2013","journal-title":"Procedia-Soc. Behav. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/07315724.2005.10719448","article-title":"A review of family and social determinants of children\u2019s eating patterns and diet quality","volume":"24","author":"Patrick","year":"2005","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_54","first-page":"323","article-title":"Family dyslipidemia and associated factors with changes in lipid profile in children","volume":"24","author":"Aparecida","year":"2019","journal-title":"Ci\u00eancia Sa\u00fade Coletiva"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/6\/1600\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:33:44Z","timestamp":1760175224000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/6\/1600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,29]]},"references-count":54,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["nu12061600"],"URL":"https:\/\/doi.org\/10.3390\/nu12061600","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,29]]}}}