Literature DB >> 11063475

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.

R M Lauer1, E Obarzanek, S A Hunsberger, L Van Horn, V W Hartmuller, B A Barton, V J Stevens, P O Kwiterovich, F A Franklin, S Y Kimm, N L Lasser, D G Simons-Morton.   

Abstract

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.

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Year:  2000        PMID: 11063475     DOI: 10.1093/ajcn/72.5.1332s

Source DB:  PubMed          Journal:  Am J Clin Nutr        ISSN: 0002-9165            Impact factor:   7.045


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