Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: the Dietary Intervention Study in Children (DISC).
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.
Kwiterovich
P O
PO
The Johns Hopkins University, Baltimore, Md, USA.
Barton
B A
BA
McMahon
R P
RP
Obarzanek
E
E
Hunsberger
S
S
Simons-Morton
D
D
Kimm
S Y
SY
Friedman
L A
LA
Lasser
N
N
Robson
A
A
Lauer
R
R
Stevens
V
V
Van Horn
L
L
Gidding
S
S
Snetselaar
L
L
Hartmuller
V W
VW
Greenlick
M
M
Franklin
F
F
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*
D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL; D004041:Dietary Fats