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Growth of hypercholesterolemic children completing physician-initiated low-fat dietary intervention
A M Tershakovec1, A F Jawad, V A Stallings
1Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, PA 19104-4399, USA.
Insights
Physician-led nutrition programs safely lowered fat intake in hypercholesterolemic children. Low dietary fat intake was linked to reduced body fat, supporting growth safety.
Area of Science:
- Pediatric Nutrition
- Cardiovascular Health in Children
- Growth Monitoring
Background:
- Hypercholesterolemia in children necessitates effective dietary interventions.
- Physician-initiated programs may offer a structured approach to managing pediatric lipid levels.
- Assessing the impact of dietary fat reduction on growth parameters is crucial.
Purpose of the Study:
- To evaluate the impact of a home-based nutrition education program versus standard counseling on the growth of hypercholesterolemic children.
- To determine if physician-initiated dietary interventions aimed at lowering fat intake affect children's growth metrics.
- To investigate the association between dietary fat intake and body composition in children.
Main Methods:
- Randomized controlled trial involving hypercholesterolemic children (ages 3.9-9.9 years).
- Comparison of a home-based nutrition program, standard counseling, and a control group.
- Anthropometric measures (height, weight, skinfolds) and dietary intake assessed over 12 months.
Main Results:
- Intervention groups showed significant reductions in fat and saturated fat intake.
- No significant differences in weight z-score, height z-score, or weight-for-height-median were observed among groups.
- A trend suggested lower fat intake was associated with reduced body fat (p=0.06).
Conclusions:
- Physician-initiated dietary interventions are safe for children's growth.
- Lowering dietary fat intake in hypercholesterolemic children is associated with decreased body fat.
- Home-based nutrition education can effectively reduce fat consumption in pediatric populations.
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-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-media 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.