title: Effects of nutritional counseling on lipoprotein levels in a pediatric lipid clinic.
abstract: OBJECTIVE
  To determine the impact of nutritional counseling on lipoprotein profiles in dyslipoproteinemic children.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  An academic hospital-based pediatric lipid clinic in Boston, Mass.
  
  
  METHODS
  One hundred four newly referred children with primary dyslipoproteinemia.
  
  
  METHODS
  Nutritional recommendations were adapted from the National Cholesterol Education Program's step 2 diet. Three-day diet records were used to assess baseline and follow-up diets.
  
  
  RESULTS
  Two thirds of the children continued to have excellent diets or improved their diets after counseling, but low-density lipoprotein cholesterol (LDL-c) values decreased by 15% or more in only 19% of children. The observed change in LDL-c was not significantly associated with nutritional counseling. However, a strong correlation was evident between dietary interventions and concentration of high-density lipoprotein cholesterol (HDL-c) values in serum. Marked fat restriction lowered HDL-c levels, while liberalization of use of fat, with emphasis on monounsaturates, in a subset of children following an excessively fat-restricted diet on presentation, appeared to improve HDL-c levels.
  
  
  CONCLUSIONS
  After nutritional counseling, LDL-c levels decreased by 15% or more in only 19% of dyslipoproteinemic children referred for treatment. There were no clear predictors of LDL-c responsiveness, but changes in dietary fat intake appeared to significantly influence HDL-c levels.
authors.affiliation: Department of Cardiology, Children's Hospital, Boston, MA 02115.
authors.forename: M
authors.initials: M
authors.lastname: Mietus-Snyder
authors.forename: A L
authors.initials: AL
authors.lastname: Baker
authors.forename: E J
authors.initials: EJ
authors.lastname: Neufeld
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.forename: S
authors.initials: S
authors.lastname: Dermarkarian
authors.forename: A S
authors.initials: AS
authors.lastname: Beiser
authors.forename: J W
authors.initials: JW
authors.lastname: Newburger
mesh_terms: D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003376:Counseling; D005260:Female; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000178:diet therapy*; D008297:Male; D009747:Nutritional Physiological Phenomena; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL