title: Maternal acceptability of a dietary intervention designed to lower children's intake of saturated fat and cholesterol: the Dietary Intervention Study in Children (DISC).
abstract: OBJECTIVE
  This report examined the acceptability to mothers of a dietary educational and behavioral intervention for preadolescent children with elevated levels of serum low-density lipoprotein cholesterol (LDL-C) who were enrolled in the Dietary Intervention Study in Children (DISC).
  
  
  METHODS
  DISC is a randomized, controlled clinical trial. Subjects were randomly assigned to either an intervention or usual-care (control) group.
  
  
  METHODS
  To be eligible for the study, participants were required to have the average of 2 fasting LDL-C values fall between the 80th and 98th sex-specific percentiles. Three hundred thirty-four 8-to 10-year-old children and their families were randomly assigned to an intervention group, and 329 were assigned to a usual-care (control) group. This study examined data from 232 subjects in the intervention group. Data were collected at 6 intervention sites around the United States.
  
  
  METHODS
  Those assigned to the intervention group participated in a multidisciplinary dietary intervention that included a series of group and individual sessions over a 3-year period. Children and their caretakers were taught to follow a nutritionally adequate diet that was low in total fat, saturated fat, and cholesterol and high in polyunsaturated fat.
  
  
  METHODS
  Three nonconsecutive 24-hour diet recalls were collected at baseline and at 1 year by trained and certified dietitians. A questionnaire designed to assess diet acceptability was administered at months 4, 8, 11, and 15. Demographic measures were collected at the onset of the study.
  
  
  METHODS
  Statistical procedures included factor analysis and regression analysis.
  
  
  RESULTS
  Regression analysis suggested that perceived effectiveness of the dietary intervention and mothers' having few concerns about disadvantages of the diet were significantly related to higher overall fat intake in children in one-parent families. Maternal willingness to implement the diet was significantly related to lower saturated fat intake.
  
  
  CONCLUSIONS
  In attempts to change eating behavior of children, interest and cooperation of the parents are essential to achieving successful results. These analyses further suggest that maternal acceptability translates into willingness to implement the diet and may facilitate changes that are associated with reduced saturated fat intake in children.
authors.affiliation: Children's Hospital of Omaha, Neb. 68114, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Reimers
authors.forename: K M
authors.initials: KM
authors.lastname: Brown
authors.forename: L
authors.initials: L
authors.lastname: Van Horn
authors.forename: V
authors.initials: V
authors.lastname: Stevens
authors.forename: E
authors.initials: E
authors.lastname: Obarzanek
authors.forename: V W
authors.initials: VW
authors.lastname: Hartmuller
authors.forename: L
authors.initials: L
authors.lastname: Snetselaar
authors.forename: T K
authors.initials: TK
authors.lastname: von Almen
authors.forename: J
authors.initials: J
authors.lastname: Chiostri
mesh_terms: D002648:Child; D002791:Cholesterol, Dietary / Q000008:administration & dosage; D008078:Cholesterol, LDL / Q000097:blood; D004041:Dietary Fats / Q000008:administration & dosage; D004522:Educational Status; D005227:Fatty Acids / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy*; D008297:Male; D009035:Mothers; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires
chemical_list: D002791:Cholesterol, Dietary; D008078:Cholesterol, LDL; D004041:Dietary Fats; D005227:Fatty Acids