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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1332S-1342S
JournalAmerican Journal of Clinical Nutrition
Volume72
Issue number5 SUPPL.
DOIs
StatePublished - 2000

Keywords

  • Dietary Intervention Study in Children
  • Dietary fat
  • Efficacy
  • LDL cholesterol
  • Lower-fat diets
  • Prepubertal children
  • Safety

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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