Overrestriction of dietary fat intake before formal nutritional counselingin children with hyperlipidemia

Objective: To assess the nutritional adequacy of the diets of children with hyperlipidemia following medically unsupervised low-fat diets compared wit h children receiving unrestricted diets. Design: Case comparison study. Patients and Other Participants: Forty-six children were referred to the Ch ildren's Cardiovascular Health Center, Columbia-Presbyterian Medical Center , New York, NY, for treatment of hyperlipidemia who had achieved the Step I diet recommendations for total fat before formal nutritional counseling (m ean age +/- SE, 9.7 +/- 0.3 years; sex distribution, 24 boys [53%]; ethnici ty, 26 Latinos [57%] and 20 whites [43%]; body mass index +/- SE, 22.4 +/- 0.7 kg/m(2)), and 34 healthy children participating in well-child visits at a local pediatric practice (mean age +/- SE, 10.2 +/- 0.4 years; sex distr ibution, 18 boys [54%]; ethnicity, 19 Latinos [57%] and 15 whites [43%]; bo dy mass index +/- SE, 22.5 +/- 1.1 kg/m(2)). Main Outcome Measures: Three-day food records sota Nutrient Data System. Ou tcome measures were intakes of calories, total and saturated fats, carbohyd rate, protein, essential fatty acids, fat-soluble vitamins, folate, vitamin C, calcium, iron, and zinc. Results: The percentage of calories from fat and saturated fat was signific antly lower in the hyperlipidemic population (mean SE, hyperlipidemic vs co ntrol subjects: total fat, 22.7% +/- 0.7% vs 34.5% +/- 0.6%, P < .001; satu rated fat, 7.9% +/- 0.3% vs 12.9% +/- 0.4%, P < .001). The caloric intake i n controls was 17% higher than in patients with hyperlipidemia. Ninety perc ent of the decrease in calories in the hyperlipidemic group could be accoun ted for by the decrease in total fat intake. After adjusting for calories, no significant difference was noted between the groups for any of the vitam ins and minerals mentioned earlier, Conclusion: Our findings suggest that before formal nutritional counseling, overzealous dietary fat restriction can occur in children with hypercholes terolemia.