GROWTH OF HYPERCHOLESTEROLEMIC CHILDREN COMPLETING PHYSICIAN-INITIATED LOW-FAT DIETARY INTERVENTION

Objective: To evaluate the growth of hypercholesterolemic children com pleting an innovative, physician-initiated, home-based nutrition educa tion program or standard nutrition counseling that aims to lower dieta ry fat intake. Study design: From suburban pediatric practices, 261 3. 9- to 9.9-year-old children with elevated cholesterol levels and 81 ch ildren with nonelevated cholesterol levels were identified. The childr en with hypercholesterolemia were randomly assigned to the home-based education program, standard nutrition counseling, or an at-risk contro l group. Height, weight, skinfold measures, and dietary intake were ev aluated at baseline, 3, 6, and 12 months; changes in anthropometric me asures among treatment groups were compared over time. Results: The in tervention groups demonstrated significant decreases in fat and satura ted fat intake after the interventions; however, weight z-score, heigh t z-score, weight-for-height-median, and sum of skinfolds did not vary among the treatment groups over the year. At baseline, height z-srore , weight z-score, and weight-for-height-median were positively associa ted with caloric intake, whereas weight z-score, weight-for-height-med ian, and sum of skinfolds were positively associated with fat intake. When the groups were combined and the children mere grouped by average fat intake quintiles, no association between fat intake and changes i n weight z-score, height z-score, or weight-for-height-median nas obse rved. Differences over time in sum of skinfolds among fat intake quint ile groups (suggesting a negative association between fat intake and b ody fat) that approached statistical significance (p = 0.06) were obse rved. Conclusions: These results support the safety, with respect to g rowth, 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.