Growth of hypercholesterolemic children completing physician-initiated low-fat dietary intervention

• Published in: The Journal of pediatrics 1998-07, Vol.133 (1), p.28-34
• Main Authors: Tershakovec, Andrew M., Jawad, Abbas F., Stallings, Virginia A., Zemel, Babette S., McKenzie, Jeannie M., Stolley, Paul D., Shannon, Barbara M.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Body Height; Body Weight; Child; Child, Preschool; Diet, Fat-Restricted; Dietary Fats - administration & dosage; Disorders of blood lipids. Hyperlipoproteinemia; Female; Growth; Health Education - methods; Humans; Hypercholesterolemia - diet therapy; Hypercholesterolemia - physiopathology; Male; Medical sciences; Metabolic diseases; Nutritional Physiological Phenomena; Reference Values; Skinfold Thickness
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(98)70173-8

Objective: To evaluate the growth of hypercholesterolemic children completing an innovative, physician-initiated, home-based nutrition education program or standard nutrition counseling that aims to lower dietary fat intake. Study design: From suburban pediatric practices, 261 3.9- to 9.9-year-old children with elevated cholesterol levels and 81 children with nonelevated cholesterol levels were identified. The children with hypercholesterolemia were randomly assigned to the home-based education program, standard nutrition counseling, or an at-risk control group. Height, weight, skinfold measures, and dietary intake were evaluated at baseline, 3, 6, and 12 months; changes in anthropometric measures among treatment groups were compared over time. Results: The intervention groups demonstrated significant decreases in fat and saturated fat intake after the interventions; however, weight z-score, height z-score, weight-for-height-median, and sum of skinfolds did not vary among the treatment groups over the year. At baseline, height z-score, weight z-score, and weight-for-height-median were positively associated with caloric intake, whereas weight z-score, weight-for-height-median, and sum of skinfolds were positively associated with fat intake. When the groups were combined and the children were grouped by average fat intake quintiles, no association between fat intake and changes in weight z-score, height z-score, or weight-for-height-median was observed. Differences over time in sum of skinfolds among fat intake quintile groups (suggesting a negative association between fat intake and body fat) that approached statistical significance ( p = 0.06) were observed. Conclusions: These results support the safety, with respect to growth, of physician-initiated dietary intervention and lower fat diets for children with hypercholesterolemia. In addition, low dietary fat intake was associated with lower body fat. (J Pediatr 1998;133:28-34.)