Safety of a fat-reduced diet: the Dietary Intervention Study in Children (DISC).
OBJECTIVE
To assess the relationship between energy intake from fat and anthropometric, biochemical, and dietary measures of nutritional adequacy and safety.


METHODS
Three-year longitudinal study of children participating in a randomized controlled trial; intervention and usual care group data pooled to assess effects of self-reported fat intake; longitudinal regression analyses of measurements at baseline, year 1, and year 3.


METHODS
Six hundred sixty-three children (362 boys and 301 girls), 8 to 10 years of age at baseline, with elevated low-density lipoprotein cholesterol, who are participants of the Dietary Intervention Study in Children.


METHODS
Energy intake from fat assessed from three 24-hour recalls at each time point was the independent variable. Outcomes were anthropometric measures (height, weight, body mass index, and sum of skinfolds), nutritional biochemical determinations (serum ferritin, zinc, retinol, albumin, beta-carotene, and vitamin E, red blood cell folate, and hemoglobin), and dietary micronutrients (vitamins A, C, E, thiamin, riboflavin, niacin, vitamins B-6, B-12, folate, calcium, iron, zinc, magnesium, and phosphorus).


RESULTS
Lower fat intake was not related to anthropometric measures or serum zinc, retinol, albumin, beta-carotene, or vitamin E. Lower fat intake was related to: 1) higher levels of red blood cell folate and hemoglobin, with a trend toward higher serum ferritin; 2) higher intakes of folate, vitamin C, and vitamin A, with a trend toward higher iron intake; 3) lower intakes of calcium, zinc, magnesium, phosphorus, vitamin B-12, thiamin, niacin, and riboflavin; 4) increased risk of consuming less than two-thirds of the Recommended Dietary Allowances for calcium in girls at baseline, and zinc and vitamin E in boys and girls at all visits.


CONCLUSIONS
Lower fat intakes during puberty are nutritionally adequate for growth and for maintenance of normal levels of nutritional biochemical measures, and are associated with beneficial effects on blood folate and hemoglobin. Although lower fat diets were related to lower self-reported intakes of several nutrients, no adverse effects were observed on blood biochemical measures of nutritional status. Current public health recommendations for moderately lower fat intakes in children during puberty may be followed safely.
Obarzanek
E
E
National Heart, Lung, and Blood Institute, Division of Epidemiology and Clinical Applications, Bethesda, Maryland 20892-7936, USA.
Hunsberger
S A
SA
Van Horn
L
L
Hartmuller
V V
VV
Barton
B A
BA
Stevens
V J
VJ
Kwiterovich
P O
PO
Franklin
F A
FA
Kimm
S Y
SY
Lasser
N L
NL
Simons-Morton
D G
DG
Lauer
R M
RM
D000273:Adipose Tissue; D000367:Age Factors; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D004041:Dietary Fats; D002149:Energy Intake; D004912:Erythrocytes / Q000737:chemistry; D005069:Evaluation Studies as Topic; D005260:Female; D005492:Folic Acid / Q000097:blood; D006452:Hemoglobinometry; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008903:Minerals / Q000008:administration & dosage; D009752:Nutritional Status; D012044:Regression Analysis; D012449:Safety; D012737:Sex Factors; D012885:Skinfold Thickness; D013997:Time Factors; D014131:Trace Elements / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage
D008078:Cholesterol, LDL; D004041:Dietary Fats; D008903:Minerals; D014131:Trace Elements; D014815:Vitamins; D005492:Folic Acid