Effects of nutritional counseling on lipoprotein levels in a pediatric lipid clinic.
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.
Mietus-Snyder
M
M
Department of Cardiology, Children's Hospital, Boston, MA 02115.
Baker
A L
AL
Neufeld
E J
EJ
Roberts
C
C
Dermarkarian
S
S
Beiser
A S
AS
Newburger
J W
JW
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
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL