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Effective control of hypercholesterolemia in children with dietary interventions based in pediatric practice
K S Kuehl1, J T Cockerham, M Hitchings
1Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007.
Insights
Office-based nutritional education effectively lowers cholesterol in children. While both single and multiple sessions showed similar cholesterol reduction, the multisession approach had a higher completion rate, suggesting it may be more beneficial for pediatric hypercholesterolemia management.
Area of Science:
- Pediatric Cardiology
- Nutritional Science
- Preventive Medicine
Background:
- Pediatric hypercholesterolemia management may strain existing resources.
- Efficacy of office-based dietary interventions for children is not well-established.
- Study aimed to assess two office-based nutritional therapy programs.
Purpose of the Study:
- Evaluate the effectiveness of single versus multiple sessions of family-oriented nutritional education.
- Assess impact on hypercholesterolemic children within a pediatrician's office setting.
Main Methods:
- 295 hypercholesterolemic children (> 185 mg/dl) were randomized.
- Interventions included single or four 90-min family nutritional education sessions.
- Evaluated total cholesterol, dietary intake, and anthropometrics; additionally HDL cholesterol and triglycerides in the multisession group.
Main Results:
- Both interventions equally lowered total cholesterol.
- Significant dietary changes observed: reduced fat/saturated fat intake, increased fiber/protein/carbohydrate intake.
- Higher dropout rate observed in the single-session group.
Conclusions:
- Office-based nutritional education equally effective for lowering total and LDL cholesterol and reducing unhealthy fat intake.
- Multisession program demonstrated a higher completion rate, indicating potential for greater long-term adherence and effectiveness.
Background:
Based on recent recommendations, the number of hypercholesterolemic children who would require dietary therapy could overwhelm current preventive pediatric cardiology resources. No previous studies have established the efficacy of such therapy in the pediatrician's office. The purpose of this study was to evaluate two programs of office-based therapy.
Methods:
We randomly assigned 295 children with hypercholesterolemia (> 185 mg/dl) two interventions: one single or four multiple 90-min sessions of family-oriented nutritional education, based in pediatric practices. We examined total cholesterol, 3-day food records, height and weight, and in the multisession group high-density lipoprotein cholesterol and triglycerides at the beginning and at intervals of 8.5-9 and 21 to 33 weeks (single-session and multisession groups, respectively).
Results:
Total cholesterol was lowered equally in both treatment groups over the course of the study. This was accompanied by dietary changes: a decrease in calories derived from total and saturated fats, and increased intake of fiber, protein, and carbohydrate. However, more single-session patients withdrew from the program during the study.
Conclusions:
The two interventions were equally effective in lowering total and low-density lipoprotein cholesterol and in reducing intake of total and saturated fat. However, the higher completion rate of the multisession group suggests that this approach may be the more effective.