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Dietary intervention study in children (DISC) with elevated low-density-lipoprotein cholesterol. Design and baseline
Insights
The Dietary Intervention Study in Children (DISC) evaluated a low-fat diet for children with high LDL cholesterol. The study assessed long-term efficacy and safety of this dietary approach in pediatric populations.
Area of Science:
- Pediatric Nutrition
- Cardiovascular Health in Children
- Dietary Interventions
Background:
- Elevated low-density-lipoprotein cholesterol (LDL-C) in children poses cardiovascular risks.
- Limited data exists on the long-term efficacy and safety of pediatric lipid-lowering diets.
Purpose of the Study:
- To assess the efficacy of a specific lipid-lowering diet in reducing LDL-C levels in children aged 8-10 years.
- To evaluate the safety of this dietary intervention on growth and nutrient status in growing children.
Main Methods:
- A multicenter prospective study randomized 663 children into a dietary intervention or usual-care group.
- The intervention group received education on a diet low in fat and cholesterol.
- Efficacy measured by LDL-C changes at 36 months; safety assessed via growth and biochemical markers.
Main Results:
- Baseline characteristics were similar between the dietary intervention and usual-care groups.
- The study is designed to compare changes in LDL-C levels over 36 months.
- Primary safety outcomes include linear growth and serum ferritin levels, with secondary outcomes assessing various nutritional and developmental markers.
Conclusions:
- The Dietary Intervention Study in Children (DISC) aims to provide crucial data on the long-term impact of dietary modifications for pediatric hyperlipidemia.
- Findings will inform clinical practice regarding the use of therapeutic diets in managing cholesterol in children.
Abstract:
The Dietary Intervention Study in Children (DISC) is a multicenter prospective study designed to assess the efficacy and safety of a lipid-lowering diet in 8- to 10-year-old children with moderately elevated low-density-lipoprotein cholesterol (LDL-C) levels. Six-hundred sixty-three children were randomized to a dietary intervention group (n = 334) and a usual-care group (n = 329). At baseline, mean LDL-C levels, nutrient intakes, anthropometric measures, and blood pressures were similar in the two groups. The intervention consists of a series of group and individual sessions to teach children and their families to follow a diet containing 28% of calories as total fat (< 8% as saturated fat, up to 9% as polyunsaturated fat, 11% as monounsaturated fat) and dietary cholesterol intake less than 75 mg/1000 kcal (< 150 mg/d) and designed to meet nutritional requirements of growing children. The usual-care group was provided with a packet of general dietary information only. Efficacy of the intervention will be assessed by comparing changes in LDL-C levels between the two groups at 36 months. Primary safety outcome assessments will involve comparisons of linear growth and serum ferritin levels. Secondary safety outcomes include serum zinc, folate, retinol, and albumin levels; ratio of LDL-C to high-density-lipoprotein cholesterol; sexual maturation; cognitive development; and child behavior. Thus, DISC aims to address long-term efficacy and concerns about the overall safety of dietary modifications in growing children.