HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lauer, R. M Articles by Simons-Morton, D. G Search for Related Content PubMed PubMed Citation Articles by Lauer, R. M Articles by Simons-Morton, D. G Agricola Articles by Lauer, R. M Articles by Simons-Morton, D. G

Efficacy and safety of lowering dietary intake of total fat, saturated fat, and cholesterol in children with elevated LDL cholesterol: the Dietary Intervention Study in Children^1,2,3,4,5,6

¹ From the University of Iowa Hospitals and Clinics, Department of Pediatrics, Iowa City; the National Heart, Lung, and Blood Institute, Division of Epidemiology and Clinical Applications, Bethesda, MD; the Northwestern University Medical School, Department of Preventive Medicine, Chicago; the Johns Hopkins Hospital, School of Medicine, Department of Pediatrics, Baltimore; the Maryland Medical Research Institute, Baltimore; the Kaiser Permanente Center for Health Research, Kaiser Foundation Hospitals, Portland, OR; the Johns Hopkins Hospital, Children's Medical and Surgical Center, Baltimore; the Children's Hospital of Alabama, Department of Gastrointestinal Nutrition, Birmingham; the University of Pittsburgh School of Medicine, Department of Clinical Epidemiology and Preventive Medicine, Pittsburgh; and the New Jersey Medical School, Preventive Cardiology Program, Newark.

Background: Few studies have shown the efficacy and safety of lower-fat diets in children.

Objective: Our objective was to assess the efficacy and safety of lowering dietary intake of total fat, saturated fat, and cholesterol to decrease LDL-cholesterol concentrations in children.

Design: A 6-center, randomized controlled clinical trial was carried out in 663 children aged 8–10 y with LDL-cholesterol concentrations greater than the 80th and less than the 98th percentiles for age and sex. The children were randomly assigned to either an intervention group or a usual care group. Behavioral intervention promoted adherence to a diet providing 28% of energy from total fat, <8% from saturated fat, 9% from polyunsaturated fat, and <0.018 mg cholesterol•kJ^-1•d^-1 (not to exceed 150 mg/d). The primary efficacy measure was mean LDL cholesterol and the safety measures were mean height and serum ferritin concentration at 3 y.

Results: At 3 y, dietary total fat, saturated fat, and cholesterol were lower in the intervention group than in the usual care group (all P < 0.001). LDL cholesterol decreased in the intervention and usual care groups by 0.40 mmol/L (15.4 mg/dL) and 0.31 mmol/L (11.9 mg/dL), respectively. With adjustment for baseline concentration, sex, and missing data, the mean difference between groups was -0.08 mmol/L (95% CI: -0.15, -0.01), or -3.23 mg/dL (95% CI: -5.6, -0.5) (P = 0.016). There were no significant differences between groups in adjusted mean height or serum ferritin.

Conclusion: Dietary changes are effective in achieving modest lowering of LDL cholesterol over 3 y while maintaining adequate growth, iron stores, nutritional adequacy, and psychological well-being during the critical growth period of adolescence.Am J Clin Nutr 2000;72(suppl): 1332S–42S.

Key Words: Efficacy • safety • lower-fat diets • prepubertal children • Dietary Intervention Study in Children • dietary fat • LDL cholesterol

This article has been cited by other articles:

				F. Martino, P. Pignatelli, E. Martino, F. Morrone, R. Carnevale, S. Di Santo, B. Buchetti, L. Loffredo, and F. Violi Early Increase of Oxidative Stress and Soluble CD40L in Children With Hypercholesterolemia J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1974 - 1981. [Abstract] [Full Text] [PDF]