title: Effect of a low-fat diet enriched either with rapeseed oil or sunflower oil on plasma lipoproteins in children and adolescents with familial hypercholesterolaemia. Results of a pilot study.
abstract: OBJECTIVE
  There is convincing evidence that unsaturated fatty acids exert favourable effects on plasma cholesterol levels. However, it is not clear which type of oil has the most pronounced effect, especially not in paediatric patients. The aim was to compare two low-fat diet regimes enriched with either monounsaturated fatty acids by rapeseed oil (RO) or polyunsaturated fatty acids by sunflower oil (SO) in children affected with familial hypercholesterolaemia (FH).
  
  
  METHODS
  Twenty-one children aged 6-18 years affected with FH were enrolled in this randomized and double-blind pilot trial. The subjects and their families were trained to adhere to a low-fat/low-cholesterol diet. All visible fats were to be replaced by either RO or SO (14-27 g/day) for 13 weeks. Dietary adherence was controlled by repeated 4-day dietary records; plasma lipids, lipoproteins and risk markers were assessed at baseline and post-intervention. Out of 21 subjects, 16 could be followed-up after 6 months.
  
  
  RESULTS
  Both fat-modified diets resulted in significant reduction in total cholesterol concentrations of 9.4% (RO P<0.005 vs SO P<0.05) and low-density lipoprotein (LDL) cholesterol concentrations of 12.7% (P<0.005) for RO and 11.3% (P<0.05) for SO. The reduction of the LDL/high-density lipoprotein (HDL) cholesterol ratio (RO 9% vs SO 3.5%) and high-sensitivity C-reactive protein (RO 16.8% vs SO 1.7%) were not statistically significant, respectively. In most participating families, a change in eating habits could be observed.
  
  
  CONCLUSIONS
  A fat-modified diet enriched with RO seems to have very similar effects on cholesterol levels as with SO. However, our study suggests that RO has possibly more favourable effects concerning cardiovascular risk profile. Both diets appear to be feasible and were well accepted among our subjects. Although these results are promising, larger trials will be required to validate our findings.
authors.affiliation: Division of Clinical Nutrition and Prevention, Department of Paediatrics and Adolescents Medicine, Vienna Medical University, Vienna, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Negele
authors.affiliation: Department of Medical Statistics, Vienna Medical University, Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Schneider
authors.affiliation: Department of Medical Statistics, Vienna Medical University, Vienna, Austria.
authors.forename: R
authors.identifier: 0000000241639236
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Clinical Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna Medical University, Vienna, Austria.
authors.forename: T M
authors.initials: TM
authors.lastname: Stulnig
authors.affiliation: Department of Angiology, Vienna Medical University, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Willfort-Ehringer
authors.affiliation: Austrian Academic Institute for Clinical Nutrition, Alserstraße 14/4, Vienna, Austria.
authors.forename: O
authors.initials: O
authors.lastname: Helk
authors.affiliation: Division of Clinical Nutrition and Prevention, Department of Paediatrics and Adolescents Medicine, Vienna Medical University, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Widhalm
mesh_terms: D000293:Adolescent; D029741:Brassica rapa / Q000737:chemistry*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018752:Diet, Fat-Restricted; D004042:Dietary Fats, Unsaturated / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005229:Fatty Acids, Monounsaturated; D005247:Feeding Behavior; D005260:Female; D006368:Helianthus / Q000737:chemistry*; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000178:diet therapy*; D008297:Male; D010865:Pilot Projects; D010938:Plant Oils / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D000074262:Rapeseed Oil; D000074242:Sunflower Oil
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004042:Dietary Fats, Unsaturated; D005229:Fatty Acids, Monounsaturated; D010938:Plant Oils; D000074262:Rapeseed Oil; D000074242:Sunflower Oil; D002097:C-Reactive Protein; D002784:Cholesterol