Providing food to treat adolescents at risk for cardiovascular disease.
OBJECTIVE
Diet modification is recommended to treat childhood cardiovascular (CV) risk factors; however, the optimal dietary strategy is unknown.


METHODS
In a randomized trial, the effect of a low-fat (LF) and a low-glycemic-load (LGL) reduced-calorie diet were examined in youth with overweight/obesity with CV risk factors. Using a novel intervention, we delivered LF or LGL meals and nutrition education to the home for 8 weeks (Intensive Phase), followed by 4 months Maintenance without food provision. Between-group differences in the change in insulin area under the curve (InsAUC) by oral glucose tolerance test and other risk factors were analyzed.


RESULTS
Overall, participants (n = 27) showed substantial improvement during the Intensive Phase, including InsAUC (-59 ± 18.2 µU/ml × 120 min, P = 0.004), total cholesterol (-9.9 ± 3.6 mg/dl, P = 0.01), weight (-2.7 ± 0.5 kg, P < 0.001), waist circumference (-3.1 ± 0.8 cm, P < 0.001), HOMA-IR (-1.7 ± 0.4, P < 0.001), systolic blood pressure (-5 ± 1.4 mm Hg, P = 0.002), and CRP (-0.1 ± 0.1 mg/dl, P = 0.04). There were minimal between-group differences; the LF group showed greater declines in HDL (P = 0.005) and fasting glucose (P = 0.01) compared to the LGL group. Improvements waned during Maintenance.


CONCLUSIONS
Home delivery of LF or LGL diets resulted in rapid and clinically important improvements in CV risk factors that diminished without food delivery and did not differ based on dietary intervention. If scalable, food provision may represent an alternative nutrition treatment strategy.
Department of Cardiology, FA607 Children's Hospital Boston, Boston, Massachusetts, USA.
Sarah D
SD
de Ferranti
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.
Carly E
CE
Milliren
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.
Erica Rose
ER
Denhoff
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.
Nicolle
N
Quinn
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.|Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Stavroula K
SK
Osganian
Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.|Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Henry A
HA
Feldman
New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.
Cara B
CB
Ebbeling
New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, USA.
David S
DS
Ludwig
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000209:etiology*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005502:Food; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000178:diet therapy*; D010865:Pilot Projects; D012307:Risk Factors; D016896:Treatment Outcome