Abstract
Background/Objectives The number of children with cardiovascular disease (CVD) risk factors is increasing in the United States. This review summarizes the current knowledge on the relationship between children's diets and CVD risk factors in children aged 2-18 years. Methods: A systematic literature review was conducted using Covidence (PROSPERO registration CRD42024604406) in the three databases PubMed Central, Web of Science, and Embase to include publications published in English between January 2014 and December 2024 that contained the outcome measures total cholesterol, LDL, HDL, triglycerides, and blood pressure. Two independent researchers conducted title, abstract, and full-text screenings; a tiebreaker was used to resolve any conflicts. Risk of bias was assessed using the quality assessment forms included in the Covidence software. Results: Eighty-five studies met the inclusion criteria, and the results were stratified by age group to organize results in a logical manner and increase transparency. Many studies have reported significant relationships, particularly with blood pressure and HDL, but others have found no statistically significant relationships. Conclusions: While a plethora of studies investigating the relationship between diet and CVD risk factors in children are available, the large heterogeneity between the diet factors, diet assessment, outcome measurement methodology, and outcome variable selection varied greatly, affecting the ability to arrive at conclusive results and recommendations. It would be beneficial to develop universally accepted research standards that can be applied to future studies to reduce ambiguity in the understanding of the effect of diet on CVD risk.