Child problem solving competence, behavioral adjustment and adherence to lipid-lowering diet

Dietary problem solving competence, behavioral adjustment and low density lipoprotein cholesterol (LDLC) changes were evaluated in a cross-sectional study of 55 hyperlipidemic children and adolescents more than 12 months after they had been prescribed lipid-lowering diets. Adolescents who were able to generate multiple ways to cope with dietary temptations described in hypothetical vignettes evidenced better dietary adherence than adolescents who could produce fewer coping strategies. Observation of parent-child interaction during a standard menu planning task revealed that child satisfaction with the diet was positively associated with parental attempts to solicit and reinforce the child's involvement in meal planning. Findings raise the possibility that behavioral problem solving training might improve long term dietary adherence in adolescents and encourage further research on families' responses to nutritional counseling.