Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: The Dietary Intervention Study in Children (DISC)

Peter O. Kwiterovich, Bruce A. Barton*, Robert P. McMahon, Eva Obarzanek, Sally Hunsberger, Denise Simons-Morton, Sue Y.S. Kimm, Lisa Aronson Friedman, Norman Lasser, Alan Robson, Ronald Lauer, Victor Stevens, Linda Van Horn, Samuel Gidding, Linda Snetselaar, Virginia W. Hartmuller, Merwyn Greenlick, Frank Franklin

*Corresponding author for this work

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Background: The Dietary Intervention Study in Children (DISC) is a multicenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cholesterol (LDL-C) in children with elevated LDL-C. Methods and Results: The effects of dietary intake of fat and cholesterol and of sexual maturation and body mass index (BMI) on LDL-C were examined in a 3-year longitudinal study of 663 boys and girls (age 8 to 10 years at baseline) with elevated LDL-C levels. Multiple linear regression was used to predict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment group effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.05). Conclusions: In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were significant in determining LDL-C. Sexual maturation was the factor associated with the greatest difference in LDL-C. Clinicians screening for dyslipidemia or following dyslipidemic children should be aware of the powerful effects of pubertal change on measurements of lipoproteins.

Original languageEnglish (US)
Pages (from-to)2526-2533
Number of pages8
JournalCirculation
Volume96
Issue number8
DOIs
StatePublished - Oct 21 1997

Keywords

  • Coronary disease
  • Diet hyperlipoproteinemia
  • Lipoproteins
  • Pediatrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Kwiterovich, P. O., Barton, B. A., McMahon, R. P., Obarzanek, E., Hunsberger, S., Simons-Morton, D., Kimm, S. Y. S., Friedman, L. A., Lasser, N., Robson, A., Lauer, R., Stevens, V., Van Horn, L., Gidding, S., Snetselaar, L., Hartmuller, V. W., Greenlick, M., & Franklin, F. (1997). Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: The Dietary Intervention Study in Children (DISC). Circulation, 96(8), 2526-2533. https://doi.org/10.1161/01.CIR.96.8.2526