Treatment of type IIa hyperlipidemia in childhood by a simplified American Heart Association diet and fiber supplementation
M. Glassman, A. Spark, S. Berezin, S. Schwarz, M. Medow and L. J. Newman
Department of Pediatrics, New York Medical College, Valhalla 10595.
Thirty-six children identified as having primary type IIa
hypercholesterolemia were treated with a diet restricting the intake of
saturated fat to 10% of total energy and supplemented with soluble fiber
for 8.1 +/- 2.4 (mean +/- SEM) months. In 14 of 36 patients first treated
with the American Heart Association "Step-One" diet for 8.0 +/- 1.1 months,
total cholesterol level dropped from 257.9 +/- 15.8 mg/dL to 240.6 +/- 10.9
mg/dL; the low-density lipoprotein cholesterol level dropped from 191.8 +/-
17.4 mg/dL to 175.0 +/- 11.7 mg/dL; the high-density lipoprotein
cholesterol level dropped from 42.8 +/- 1.94 mg/dL to 41.6 +/- 1.68 mg/dL;
and triglyceride concentration rose from 115.9 +/- 13.7 mg/dL to 128.1 +/-
14.1 mg/dL. The 36 patients treated with saturated fat-restrictive diets
and supplemental soluble fiber diets had a reduction of total cholesterol
levels from 249.2 +/- 7.66 mg/dL to 207.1 +/- 6.31 mg/dL and a low-density
lipoprotein cholesterol level reduction from 184.7 +/- 7.55 mg/dL to 142.6
+/- 6.7 mg/dL, a reduction of 18% and 23%, respectively. There was no
significant change in high-density lipoprotein cholesterol levels (46.4 +/-
1.9 mg/dL vs 44.3 +/- 2.1 mg/dL) or in triglyceride concentrations (94.2
+/- 7.43 mg/dL vs 102.2 +/- 8.45 mg/dL). In addition, the reduction in
serum lipoprotein concentrations resulting from this program was
significantly greater than the concentrations resulting from the American
Heart Association diet alone. The different responses to these regimens
suggest that a simplified diet and soluble fiber supplementation is well
tolerated and reduces total and low-density lipoprotein cholesterol levels
more effectively than the standard American Heart Association diet in
children.
