Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty : The Dietary Intervention Study in Children (DISC)

• Published in: Circulation (New York, N.Y.) Vol. 96; no. 8; pp. 2526 - 2533
• Main Authors: KWITEROVICH, P. O, BARTON, B. A, LAUER, R, STEVENS, V, VAN HORN, L, GIDDING, S, SNETSELAAR, L, HARTMULLER, V. W, GREENLICK, M, FRANKLIN, F. JR, MCMAHON, R. P, OBARZANEK, E, HUNSBERGER, S, SIMONS-MORTON, D, KIMM, S. Y. S, FRIEDMAN, L. A, LASSER, N, ROBSON, A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 21.10.1997
• Subjects: Biological and medical sciences; Body Mass Index; Child; Cholesterol, Dietary - administration & dosage; Cholesterol, LDL - blood; Diet; Dietary Fats - administration & dosage; Disorders of blood lipids. Hyperlipoproteinemia; Humans; Hypercholesterolemia - diet therapy; Longitudinal Studies; Medical sciences; Metabolic diseases; Puberty - physiology; Sexual Maturation - physiology; Human; Lipoprotein LDL; Sexual maturation; Puberty; Diet; Sex; Metabolic diseases; Exploration; Lipids; Dyslipemia; Child
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.8.2526

The Dietary Intervention Study in Children (DISC) is a multicenter, randomized, controlled clinical trial designed to examine the efficacy and safety of a dietary intervention to reduce serum LDL cholesterol (LDL-C) in children with elevated LDL-C. The effects of dietary intake of fat and cholesterol and of sexual maturation and body mass index (BMI) on LDL-C were examined in a 3-year longitudinal study of 663 boys and girls (age 8 to 10 years at baseline) with elevated LDL-C levels. Multiple linear regression was used to predict LDL-C at 3 years. For boys, LDL-C decreased by 0.018 mmol/L for each 10 mg/4.2 MJ decrease in dietary cholesterol (P<.05). For girls, no single nutrient was significant in the model, but a treatment group effect was evident (P<.05). In both sexes, BMI at 3 years and LDL-C at baseline were significant and positive predictors of LDL-C levels. In boys, the average LDL-C level was 0.603 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.01). In girls, the average LDL-C level was 0.274 mmol/L lower at Tanner stage 4+ than at Tanner stage 1 (P<.05). In pubertal children, sexual maturation, BMI, dietary intervention (in girls), and dietary cholesterol (in boys) were significant in determining LDL-C. Sexual maturation was the factor associated with the greatest difference in LDL-C. Clinicians screening for dyslipidemia or following dyslipidemic children should be aware of the powerful effects of pubertal change on measurements of lipoproteins.