REDUCTION OF ELEVATED LDL-CHOLESTEROL LEVELS OF 4-YEAR-OLD TO 10-YEAR-OLD CHILDREN THROUGH HOME-BASED DIETARY EDUCATION

Objective. To assess the effects of a home-based, parent-child autotut orial (PCAT) dietary education program on the dietary knowledge, lipid consumption, and plasma low density lipoprotein-cholesterol (LDL-C) o f 4- to 10-year-old children with elevated plasma LDL-C. Methods. ''At -risk'' children (screening total cholesterol, (TC), exceeded 4.55 mmo l/L and average LDL-C from two fasting samples was between 2.77 and 4. 24 mmol/L for boys or 2.90 and 4.24 mmol/L for girls) were randomized to the PCAT program (N = 88), for dietary counseling with a registered dietitian (N = 86), or to an at-risk control group (N = 87). Dietary knowledge, diet, and LDL-C of these groups were assessed at baseline a nd after the educational period (3-month follow-up). The knowledge and diet of a not-at-risk (TC below 4.22 and 4.34 mmol/L for boys and gir ls, respectively) control group (N = 81) was also assessed and compare d with that of the at-risk control group. Results. At the S-month foll ow-up, the PCAT children's knowledge scores had increased three times more than those of the counseling and at-risk control groups (P < .001 ). Mean grams of total and saturated fat consumed by PCAT and counseli ng groups declined while that of the at-risk control group increased s lightly; these differences were significant (P < .05). The mean LDL-C decline of the PCAT group was significantly different (P < .05) from t he decline of the at-risk control group (0.26 vs 0.09 mmol/L), and app roached significance (P = .07) when compared with that of the counseli ng group (0.26 vs 0.11 mmol/L). The at-risk control group's knowledge and diet did not differ from that of the not-at-risk group. Conclusion . The PCAT program offers a mechanism for providing effective dietary education to children with elevated cholesterol and to their families.