**5. Treatment of dyslipidemia associated to childhood obesity**

Both in adults and in children, the extent of atherosclerotic lesions is significantly correlated with a modified serum lipid profile (increased total and LDL cholesterol, triglycerides, low HDL cholesterol) together with elevated blood pressure and waist circumference.

Reversal of vascular functional abnormalities with early therapy with statins and supplemen‐ tation with antioxidant vitamins and Omega-3 fatty acids has been observed in children with familial hypercholesterolemia.

According to an AHA Scientific Statement, "LDL cholesterol lowering drug therapy is recommended only in those children ≥10 years of age whose LDL cholesterol remains ex‐ tremely elevated after an adequate 6- to 12-month trial of diet therapy. Drug therapy was to be considered for children with LDL cholesterol levels ≥190 mg/dL and in those with LDL cholesterol ≥160 mg/dL together with either the presence of ≥2 other cardiovascular disease risk factors or a positive family history of premature cardiovascular disease" [34].

Omega-3 PUFA represents the first choice in treating hypertrigliceridemia in childhood obesity because they do not have adverse reactions, they are safe, and they have good tolerance. Also, different Sea-buckthorn fractions do not have side effects [110–86] and they have great future as food supplements in preventing obesity complications. Future research work will show if the beneficial changes of the supplements revert back if the treatment is stopped.

Cook and Kavey recommend that "any medication except Omega-3 fish oil in youths with combined dyslipidemia should be undertaken only with the assistance of a lipid specialist" [3].
