Diet therapy for hypercholesterolemia in children and adolescents. A follow-up
M. Sanchez-Bayle, A. Gonzalez-Requejo, J. Baeza, P. Arnaiz, S. Vila, J. Asensio and C. Ruiz-Jarabo
Hospital del Nino Jesus, Madrid, Spain.
OBJECTIVE: To determine the effectiveness and compliance of dietary
restriction in a group of children and adolescents with
hypercholesterolemia. RESEARCH DESIGN: Prospective clinical trial. SETTING:
Pediatric hospital in Madrid, Spain. PARTICIPANTS: Four hundred fifty-one
children and adolescents of both sexes aged 2 to 18 years diagnosed as
having hypercholesterolemia and treated with dietary restriction (American
Heart Association Step-One and Step-Two Diets). The follow-up period ranged
from 6 months to 2 years and was performed by one pediatrician. RESULTS:
Total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein
B-100 levels as well as the low-density lipoprotein
cholesterol/high-density lipoprotein cholesterol ratio decreased
significantly (P < .01) from the first month of dietary restriction,
whereas the high-density lipoprotein cholesterol level increased (P <
.01). The apolipoprotein A-I level increased significantly (P < .01)
only after 6 months of diet therapy. After 12 months of follow-up, 30.7%
(58/189) of patients did not follow the diet strictly. In this group,
significantly higher levels of total cholesterol, low-density lipoprotein
cholesterol, and apolipoprotein B-100 were found. CONCLUSIONS: Diet therapy
is effective in the treatment of hypercholesterolemia in children and
adolescents. Dietary restriction has a beneficial effect not only on total
cholesterol and low-density lipoprotein cholesterol levels but also on
apolipoprotein A-I and B-100 levels.
