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, Jr Franklin, S. Y.S. Kimm, N. L. Lasser, D. G. Simons-Morton

Research output: Contribution to journalArticlepeer-review

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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