title: Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: the Dietary Intervention Study in Children (DISC).
abstract: BACKGROUND
  The Dietary Intervention Study in Children (DISC) is a multicenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cholesterol (LDL-C) in children with elevated LDL-C.
  
  
  RESULTS
  The effects of dietary intake of fat and cholesterol and of sexual maturation and body mass index (BMI) on LDL-C were examined in a 3-year longitudinal study of 663 boys and girls (age 8 to 10 years at baseline) with elevated LDL-C levels. Multiple linear regression was used to predict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment group effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.05).
  
  
  CONCLUSIONS
  In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were significant in determining LDL-C. Sexual maturation was the factor associated with the greatest difference in LDL-C. Clinicians screening for dyslipidemia or following dyslipidemic children should be aware of the powerful effects of pubertal change on measurements of lipoproteins.
authors.affiliation: The Johns Hopkins University, Baltimore, Md, USA.
authors.forename: P O
authors.initials: PO
authors.lastname: Kwiterovich
authors.forename: B A
authors.initials: BA
authors.lastname: Barton
authors.forename: R P
authors.initials: RP
authors.lastname: McMahon
authors.forename: E
authors.initials: E
authors.lastname: Obarzanek
authors.forename: S
authors.initials: S
authors.lastname: Hunsberger
authors.forename: D
authors.initials: D
authors.lastname: Simons-Morton
authors.forename: S Y
authors.initials: SY
authors.lastname: Kimm
authors.forename: L A
authors.initials: LA
authors.lastname: Friedman
authors.forename: N
authors.initials: N
authors.lastname: Lasser
authors.forename: A
authors.initials: A
authors.lastname: Robson
authors.forename: R
authors.initials: R
authors.lastname: Lauer
authors.forename: V
authors.initials: V
authors.lastname: Stevens
authors.forename: L
authors.initials: L
authors.lastname: Van Horn
authors.forename: S
authors.initials: S
authors.lastname: Gidding
authors.forename: L
authors.initials: L
authors.lastname: Snetselaar
authors.forename: V W
authors.initials: VW
authors.lastname: Hartmuller
authors.forename: M
authors.initials: M
authors.lastname: Greenlick
authors.forename: F
authors.initials: F
authors.lastname: Franklin
mesh_terms: D015992:Body Mass Index; D002648:Child; D002791:Cholesterol, Dietary / Q000008:administration & dosage; D008078:Cholesterol, LDL / Q000097:blood*; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy*; D008137:Longitudinal Studies; D011627:Puberty / Q000502:physiology*; D012741:Sexual Maturation / Q000502:physiology*
chemical_list: D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL; D004041:Dietary Fats