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Long-term exposure to even slightly elevated plasma cholesterol levels significantly increases the risk of developing cardiovascular disease (CVD). Recent evidence highlights the importance of improving plasma lipid levels, even in children without severe hypercholesterolemia. The risk-benefit profile of pharmacological treatments for pediatric patients with moderate dyslipidemia remains uncertain, leading to the testing of various cholesterol-lowering nutraceuticals. Available randomized clinical trials on this topic are typically small, short-term, and have tested different types of fibers, plant sterols/stanols, standardized red yeast rice extracts, polyunsaturated fatty acids, soy derivatives, and probiotics. These nutraceuticals can improve the lipid profile in children with dyslipidemia when combined with a well-balanced diet and regular physical activity. However, they should not be seen as alternatives to conventional lipid-lowering drugs when these are necessary. Current research indicates that nutraceuticals play a supportive role in managing dyslipidemia in children and adolescents, particularly in the context of a healthy lifestyle and diet. Their use is especially recommended in individuals with a low estimated risk of developing atherosclerotic cardiovascular disease (ASCVD) or those who are statin-intolerant. International guidelines from the American Academy of Pediatrics and European Atherosclerosis Society recommend a nutritional approach and lifestyle management as the first steps in treating hypercholesterolemia in pediatric and adult patients. Studies on the efficacy of cholesterol-lowering nutraceuticals in children and adolescents are limited, but they suggest that these substances can be beneficial. This review aims to summarize the scientific evidence supporting the use of dietary supplements and nutraceuticals in managing dyslipidemia in children and adolescents, focusing on their effects on LDL-C, triglycerides, total cholesterol, and HDL-C levels.uting to kidney disease.

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