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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children (DISC).
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Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children (DISC).

机译：低密度脂蛋白胆固醇升高的儿童降低胆固醇饮食的长期安全性和有效性：儿童饮食干预研究（DISC）的七年结果。

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OBJECTIVE: Diets reduced in fat and cholesterol are recommended for children over 2 years of age, yet long-term safety and efficacy are unknown. This study tests the long-term efficacy and safety of a cholesterol-lowering dietary intervention in children. METHODS: Six hundred sixty-three children 8 to 10 years of age with elevated low-density lipoprotein cholesterol (LDL-C) were randomized to a dietary intervention or usual care group, with a mean of 7.4 years' follow-up. The dietary behavioral intervention promoted adherence to a diet with 28% of energy from total fat, <8% from saturated fat, up to 9% from polyunsaturated fat, and <75 mg/1000 kcal cholesterol per day. Serum LDL-C, height, and serum ferritin were primary efficacy and safety outcomes. RESULTS: Reductions in dietary total fat, saturated fat, and cholesterol were greater in the intervention than in the usual care group throughout the intervention period. At 1 year, 3 years, and at the last visit, the intervention compared with the usual care group had 4.8 mg/dL (.13 mmol/L), 3.3 mg/dL (.09 mmol/L), and 2.0 mg/dL (.05 mmol/L) lower LDL-C, respectively. There were no differences at any data collection point in height or serum ferritin or any differences in an adverse direction in red blood cell folate, serum retinol and zinc, sexual maturation, or body mass index. CONCLUSION: Dietary fat modification can be achieved and safely sustained in actively growing children with elevated LDL-C, and elevated LDL-C levels can be improved significantly up to 3 years. Changes in the usual care group's diet suggest that pediatric practices and societal and environmental forces are having positive public health effects on dietary behavior during adolescence.
机译：目的：建议2岁以上的儿童饮食减少脂肪和胆固醇，但长期安全性和疗效尚不清楚。这项研究测试了降低胆固醇的饮食干预对儿童的长期疗效和安全性。方法：将63例8至10岁的低密度脂蛋白胆固醇（LDL-C）升高的儿童随机分为饮食干预组或常规护理组，平均随访7.4年。饮食行为干预通过每天总脂肪中的28％能量，<8％的饱和脂肪，高达9％的多不饱和脂肪和<75 mg / 1000 kcal胆固醇的能量促进饮食的坚持。血清LDL-C，身高和血清铁蛋白是主要疗效和安全性结果。结果：在整个干预期间，干预组的饮食中总脂肪，饱和脂肪和胆固醇的减少幅度均高于常规护理组。在第1年，第3年和最后一次就诊时，与常规护理组相比，干预措施分别为4.8 mg / dL（.13 mmol / L），3.3 mg / dL（.09 mmol / L）和2.0 mg / d dL（.05 mmol / L）分别降低LDL-C。在身高或血清铁蛋白的任何数据收集点上，在红细胞叶酸，血清视黄醇和锌，性成熟或体重指数方面，在任何不利方向上都没有差异。结论：LDL-C升高的活跃成长儿童可以实现并安全地维持饮食中的脂肪改性，而LDL-C水平的升高可以在3年内得到显着改善。常规护理人群饮食的变化表明，儿科实践以及社会和环境力量正在对青春期的饮食行为产生积极的公共卫生影响。

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