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Overrestriction of Dietary Fat Intake Before Formal Nutritional Counseling in Children With Hyperlipidemia
Abha Kaistha, MD;
Richard J. Deckelbaum, MD;
Thomas J. Starc, MD;
Sarah C. Couch, PhD, RD
Arch Pediatr Adolesc Med. 2001;155:1225-1230.
Objective To assess the nutritional adequacy of the diets of children with hyperlipidemia
following medically unsupervised low-fat diets compared with children receiving
unrestricted diets.
Design Case comparison study.
Patients and Other Participants Forty-six children were referred to the Children'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 (mean age ± SE, 9.7 ±
0.3 years; sex distribution, 24 boys [53%]; ethnicity, 26 Latinos [57%] and
20 whites [43 %]; body mass index ± SE, 22.4 ± 0.7 kg/m2), and 34 healthy children participating in well-child visits at a
local pediatric practice (mean age ± SE, 10.2 ± 0.4 years; sex
distribution, 18 boys [54%]; ethnicity, 19 Latinos [57%] and 15 whites [43%];
body mass index ± SE, 22.5 ± 1.1 kg/m2).
Main Outcome Measures Three-day food records were analyzed by a registered dietitian using
the Minnesota Nutrient Data System. Outcome measures were intakes of calories,
total and saturated fats, carbohydrate, 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 significantly
lower in the hyperlipidemic population (mean ± SE, hyperlipidemic vs
control subjects: total fat, 22.7% ± 0.7% vs 34.5% ± 0.6%, P<.001; saturated fat, 7.9% ± 0.3% vs 12.9% ± 0.4%, P<.001). The caloric intake in controls was 17% higher than in patients
with hyperlipidemia. Ninety percent of the decrease in calories in the hyperlipidemic
group could be accounted for by the decrease in total fat intake. After adjusting
for calories, no significant difference was noted between the groups for any
of the vitamins and minerals mentioned earlier.
Conclusion Our findings suggest that before formal nutritional counseling, overzealous
dietary fat restriction can occur in children with hypercholesterolemia.
From the Department of Pediatrics (Drs Kaistha, Deckelbaum, Starc,
and Couch) and the Institute of Human Nutrition (Drs Deckelbaum, Starc, and
Couch), Columbia–Presbyterian Medical Center, New York, NY. Dr Couch
is now with the Department of Health Sciences, Program in Dietetics and Nutrition
Science, University of Cincinnati Medical Center, Cincinnati, Ohio.
Corresponding author: Sarah C. Couch, PhD, RD, Department of Health
Sciences, Program in Dietetics and Nutrition Science, University of Cincinnati
Medical Center, 364 French Bldg E, Cincinnati, OH 45221-0394 (e-mail: couchsc{at}email.uc.edu). Reprints: Richard J. Deckelbaum, MD, Institute
of Human Nutrition, Columbia–Presbyterian Medical Center, PH 15E, 630
W 168th St, New York, NY 10032.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Screening and Treatment for Lipid Disorders in Children and Adolescents: Systematic Evidence Review for the US Preventive Services Task Force
Haney et al.
Pediatrics 2007;120:e189-e214.
ABSTRACT
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