title: Plant-based, no-added-fat or American Heart Association diets: impact on cardiovascular risk in obese children with hypercholesterolemia and their parents.
abstract: OBJECTIVE
  To perform a randomized trial to determine whether there is cardiovascular disease (CVD) risk reduction from a plant-based (PB), no-added-fat diet and the American Heart Association (AHA) diet in children.
  
  
  METHODS
  A 4-week (April 20, 2013 to May 18, 2013), prospective randomized trial was undertaken in a large, Midwestern hospital system's predominantly middle class outpatient pediatric practices. Thirty children (9-18 years of age) parent pairs with a last recorded child body mass index >95th percentile and child cholesterol >169 mg/dL were randomized to PB or AHA with weekly 2-hour classes of nutrition education.
  
  
  RESULTS
  Children on PB had 9 and children on AHA had 4 statistically significant (P < .05) beneficial changes from baseline (mean decreases): body mass index z-score(PB) (-0.14), systolic blood pressure(PB) (-6.43 mm Hg), total cholesterol(PB) (-22.5 mg/dL), low-density lipoprotein(PB) (-13.14 mg/dL), high-sensitivity C-reactive protein(PB) (-2.09 mg/L), insulin(PB) (-5.42 uU/mL), myeloperoxidase(PB/AHA) (-75.34/69.23 pmol/L), mid-arm circumference(PB/AHA) (-2.02/-1.55 cm), weight(PB/AHA) (-3.05/-1.14 kg), and waist circumference(AHA) (-2.96 cm). Adults on PB and AHA had 7 and 2, respectively, statistically significant (P < .05) beneficial changes. The significant change favoring AHA was a 1% difference in children's waist circumference. Difficulty shopping for food for the PB was the only statistically significant acceptability barrier.
  
  
  CONCLUSIONS
  PB and the AHA in both children and adults demonstrated potentially beneficial changes from baseline in risk factors for CVD. Future larger, long-term randomized trials with easily accessible PB foods will further define the role of the PB in preventing CVD.
authors: Department of General Pediatrics, Cleveland Clinic Children's, Cleveland, OH.
authors: Michael
authors: M
authors: Macknin
authors: Department of Nutrition, Case Western Reserve University, Cleveland, OH.
authors: Tammie
authors: T
authors: Kong
authors: Department of Nutrition, Case Western Reserve University, Cleveland, OH.
authors: Adam
authors: A
authors: Weier
authors: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors: Sarah
authors: S
authors: Worley
authors: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors: Anne S
authors: AS
authors: Tang
authors: Department of Pediatric Gastroenterology, Cleveland Clinic Children's, Cleveland, OH.
authors: Naim
authors: N
authors: Alkhouri
authors: Center for Lifestyle Medicine, Cleveland Clinic, Cleveland, OH.
authors: Mladen
authors: M
authors: Golubic
mesh_terms: D000293:Adolescent; D000328:Adult; D000572:American Heart Association; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000453:epidemiology / Q000209:etiology; D002648:Child; D018752:Diet, Fat-Restricted / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000178:diet therapy*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D010945:Plants, Edible; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology