EFFECTS OF DIET AND SEXUAL-MATURATION ON LOW-DENSITY-LIPOPROTEIN CHOLESTEROL DURING PUBERTY - THE DIETARY INTERVENTION STUDY IN CHILDREN (DISC)

Background The Dietary Intervention Study in Children (DISC) is a mult icenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cho lesterol (LDL-C) in children with elevated LDL-C. Methods and Results The effects of dietary intake of fat and cholesterol and of sexual mat uration and body mass index (BMI) on LDL-C were examined in a 3-year l ongitudinal study of 663 boys and girls (age 8 to 10 years at baseline ) with elevated LDL-C levels. Multiple linear regression was used to p redict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment grou p effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stag e 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<. 05). Conclusions In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were signi ficant in determining LDL-C. Sexual maturation was the factor associat ed with the greatest difference in LDL-C. Clinicians screening for dys lipidemia or following dyslipidemic children should be aware of the po werful effects of pubertal change on measurements of lipoproteins.