Dietary intervention in a hypercholesterolemic school-aged population from Northern Spain

A. García
J.M. Gutiérrez
S. Fernández
J. Aparicio
A. Menéndez-Patterson
89

Abstract

A “before and after” intervention study, over a five year period, was done in order to find the degree of compliance to dietary recommendations and their effects on serum lipids in a hypercholesterolemic school-aged population. 383 children between 6 and 13 years of age, were identified with hypercholesterolemia (total serum levels above 4.8 mmol/1), in a previous randomized mass screening of 1095 individuals. Some dietary guidelines aimed at decreasing fat consumption and increasing fiber and carbohydrate ingestion were given to the families, and 226 of the children participated in the follow-up. Changes of address and/or school-center was the main cause of non-participation. The follow-up examination consisted in the evaluation of serum lipids and actual diet. Cholesterol serum levels decreased from a mean value of 5.4 mmol/1 to 4.8 mmol/L 59.3 % of the sample had reached serum cholesterol levels below the risk threshold. Fat ingestion diminished significantly (40.3 % of calories to 36.7 %, p < 0.001), saturated fatty acids decreased from 15.3 % of calories to 13.5 % (p < 0.001), monounsaturated fatty acids decreased from 17.1 % to 15.4 % (p < 0.001) and polyunsaturated fatty acids remained unchanged. Carbohydrate consumption increased from 45 % of the calories to 47.38 % (p < 0.001). Dietary changes were greater in individuals out of risk than those who still had high cholesterol levels. These data indicate a good family compliance to the recommendations and that changes in food habits seem to be effective in controlling hyperlipidemia. Dietary changes are better accepted by younger children.

Keywords:
Serum cholesterol, Diet, Follow-up, Childhood

Authors

A. García
J.M. Gutiérrez
S. Fernández
J. Aparicio
A. Menéndez-Patterson

References

Addis, P. B. and Warner, G. J. (1990): In "Free radicals and food additives" (Aruoma, O. I. and Halliwll, B., eds.). Taylor and Francis, London, pp. 134-150.

Alexandrov, A. A., Maslennikova, G. Y. A., Kulikov, S. M., Propirnij, G. A. and Perova, N. V. (1992): Prev. Med., 21, 53-62. https://doi.org/10.1016/0091-7435(92)90005-3

Ballabriga, A. (1993): Acta Pediatr. Esp., 51 (extra), 45-53.

Berry, E. M., Eisenberg, S., Haratz, D., Friedlander, Y., Norma, Y., Kaufman, N. A. and Stein, Y. (1991): Am. J. Clin. Niitr., 53, 899-907. https://doi.org/10.1093/ajcn/53.4.899

Boulton, T. J. C. ( 1985): Aust. NZ. J. Med., 15, 478-488 6. Castelli, W. P., Garrison, R. J., Wilson, P. W. F., Abbot, D., Kalousdian, S. and Kannel, W. B. (1986): J. Am. Med. Assoc., 256, 2835-2842.

Connor, S. L., Artaud-Wild, S. M., Classick- Kohn, C. J. (1986): Lancet, 1,1229-1232. https://doi.org/10.1016/S0140-6736(86)91384-X

Deckelbaum, R. J. (1990): Acta Pediatr. Scand., Suppl., 365, 7-12. https://doi.org/10.1111/j.1651-2227.1990.tb11578.x

Dennison, B. A., Kikuchi, D. A., Srinivasan, S. R., Webber, L. S. and Berenson, G. S. (1990): Pediatrics, 85, 472-479. https://doi.org/10.1542/peds.85.4.472

Elcarte, R., Villa, I. y Sada, J. Clin. Invest. Arterios , (Suppl. I) 2, 5.

Fetcher, E. S., Foster, N., Anderson, J. T., Grande, F. and Keys, A. (1967): Am. J. Clin. Niitr., 20, 475-492. https://doi.org/10.1093/ajcn/20.5.475

Fomon, S. J., Rogers, R. R., Ziegler, E. E., Nelson, S. E. and Thomas, L. N. (1984): Pediat. Res., 18, 1233-1238. https://doi.org/10.1203/00006450-198412000-00001

Franklin, F. A., Brown, R. F. and Franklin, C. C. (1990): Endocrinol. Metab. Clin. North Am., 19, 399-449. https://doi.org/10.1016/S0889-8529(18)30332-3

Friedewald, W., Levy, R. I. and Frcdrikson, D. S. (1972): Clin. Chem, 18,499-502. https://doi.org/10.1093/clinchem/18.6.499

Garcia, A., Gonzalez, C., Fernandez, S., Aparicio, J. and Menendez-Patterson, A. (1993): Rev. Esp. Cardiol., 46,616-622.

Gliksman, M. D., Dwyer, T. and Wlodarczyk, J. (1990): Prev. Med., 19, 291-304. https://doi.org/10.1016/0091-7435(90)90029-J

Grundy, S. M. and Denke, M. A. (1990): J. Lipid. Res., 31, 1149-1159. https://doi.org/10.1016/S0022-2275(20)42625-2

Holtzman, N. A. (1991): Pediatrics (Spanish edition), 31, 309-311.

Keys, A. (1980): Harvard University Press, Cambridge.

Lifshitz, F. and Moses, N. (1989): Am. J. Dis.Child., 143, 537-542. https://doi.org/10.1001/archpedi.1989.02150170035015

Lipid Research Clinics Program. (1984): JAMA, 251, 365-374 22. Lopez, M. L., Fernandez, J. M., de la Cal, A., Bernaldo de Quiros, J. C., Rodriguez, M. J. and Cueto, A. (1993): Acta Pediatr.Esp., 51, 28-33. https://doi.org/10.1001/jama.251.3.365

Lloyd, J. K. (1991): Acta Pediatr.Scand. Suppl., 373, 66-72. https://doi.org/10.1111/j.1651-2227.1991.tb18153.x

Machin, M.» Alonso, M., del Castillo, T., Sanchez, M. and Fornos, A. (1993): Aten. Primaria, 11,480-482.

Mata, P., Garrido, J. A., Ordovas, J. M., Blazqucz, E., Alvarez-Sala, L. A., Rubio, M. J., Alonso, R. and De Hova M. (1992): Am. J. Clin. Ntitr., 56, 77-83. https://doi.org/10.1093/ajcn/56.1.77

Mauer, A. M. (1991): Ann. Rev. Nutr., 11, 375- 391. https://doi.org/10.1146/annurev.nu.11.070191.002111

McNamara, D. J., Kolb, R., Perker, T. S., Batwin, H. and Samuel, P. (1987): J. Clin. Invest., 79, 1729-1739. https://doi.org/10.1172/JCI113013

McPherson, R. S., Nichaman, M. Z., Kohl, H. W., Reed, D. B. and Labarthe, D. R. (1990): Pediatrics, 86, 520-526. https://doi.org/10.1542/peds.86.4.520

Mietus-Snyder, M., Baker, A. L., Neufeld, E. J., Roberts, C., Dcrmarkarian, S., Beiser, A. S., Newburger, J. W. (1993): AJDC, 147, 378-381.

National cholesterol education program. (1992): Pediatrics, 89, 496-500.

Nicklas, T. A., Farris, R. P., Major, C., Franck, G. C. and Webber, L. S. (1987): Pediatrics, 80, 797-806. https://doi.org/10.1542/peds.80.5.797

NIH Consensus Development Conference statement lowering blood cholesterol to prevent heart disease (1985). pp. 7.

Ohta, T., Nakamura, R., Ikeda, Y., Hattori, S. and Matsuda, I. (1993): Enr. J. Pediatr., 152, 939-943. https://doi.org/10.1007/BF01957537

Persson, L.A. and Carlgren, G. (1984): Int.J.Epidem., 13, 506-517 . https://doi.org/10.1093/ije/13.4.506

Polonsky, S.M., Belief, P.S. and Sprecher, D.L. (1993): Pediatrics, 91, 92-96. https://doi.org/10.1542/peds.91.1.92

Primrose, E. D., Savage, J. M., Boreham, C. A., Cran, G. W. and Strain, J. J. (1994): Arch.Dis.Child, 71, 239-242 . https://doi.org/10.1136/adc.71.3.239

Rifkind, B. M. and Segal, P. (1983): JAMA, 250, 1869-1872. https://doi.org/10.1001/jama.250.14.1869

Sanchez-Bayle, M., Gonzalez-Requejo, A., Baeza, J. Arnaiz, P., Vila, S., Asensio, J. and Ruiz-Jarabo, C. (1994): Arch. Pediatr. Adolesc. Med., 148, 28-32.

Shekelle, R. B., Shryock, A. M. and Paul, O.(1981): New Eng. J. Med., 304, 65-70. https://doi.org/10.1056/NEJM198101083040201

Stuhldreher, W. L., Orchar77d, T. J., Donahue, R. P., Kuller, L. H., Gloninger, M. F. and Drash, A. L. (1991):/. Pediatr., 119, 551-556. https://doi.org/10.1016/S0022-3476(05)82403-5

Tablas de composicion de los alimentos (1990): Wander-Sandoz Nutrition, Barcelona.

The writing group for the DISC collaborative research group (1995): JAMA, 273, 1429-1435. https://doi.org/10.1001/jama.273.18.1429

Van Horn, L. V., Stumbo, P., Moag-Stahlberg, A., Obarzanek, E., Hartmuller, V. W., Farris, R. P., Kimm, S. Y. S., Frederick, M., Snctsclaar, L. and Liu, K. (1993): /. Am. Diet. /!$$., 93, 1396- 1403 . https://doi.org/10.1016/0002-8223(93)92241-O

Vartiainen, E., Tossavaincn, K., Viri, L., Niskanen, E. and Puska, P. (1991): Ann. New York Acad. Scien., 623, 332-349 https://doi.org/10.1111/j.1749-6632.1991.tb43743.x

Vazquez, C., Munoz, A. and Vazquez, J. (1987): Nutrition Clinica, 7, 33-40.

Weidman, W., Kwiterovich, P., Jesse, M. J. and Nugct, E. (1983): Circulation, f>7, 1411A.

WHO Expert Committee (1986): Technical Report Series 732, World Health Organization, Geneva. J. Physiol.


Metrics

Search GoogleScholar



Downloads

Download data is not yet available.

Section

Articles

Most read articles by the same author(s)

1 2 > >>