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Children's adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC).
Pediatrics. 2005 Jun; 115(6):1723-33.Ped

Abstract

BACKGROUND

Prevention of cardiovascular disease through diet and lifestyle change is strongly advocated in adults and is initiated preferably during childhood. The Dietary Intervention Study in Children (DISC) was a multicenter, collaborative, randomized trial in 663 preadolescent children (363 boys and 301 girls) with elevated low-density lipoprotein cholesterol, designed to test the efficacy and safety of a dietary intervention to lower saturated-fat and cholesterol intake while also advocating a healthy eating pattern. DISC results have been published extensively. This ancillary study reports new data regarding changes in eating patterns among this cohort.

OBJECTIVE

We set out to compare children's self-selected eating patterns and approaches to achieving adherence to the DISC fat-reduced diet intervention with children in the usual-care group.

METHODS

An ancillary study was conducted to develop a detailed food-grouping system and report new analyses on dietary adherence to the recommended eating pattern. Every food in the nutrient database was ranked by its saturated-fat and cholesterol content and classified within its relevant food group as a "go" (less atherogenic) or "whoa" (more atherogenic) food.

RESULTS

At baseline, go foods contributed approximately 57% of total energy intake and 12.4% to 13.1% total fat energy intake in both groups. At 3 years, go foods contributed 67.4% and 13.7% of total and fat energy intake, respectively, in the intervention group versus 56.8% and 12.8% in the usual-care group. Differences between the 2 treatment groups were significant for changes in consumption of dairy foods, desserts, and fats/oils, with the intervention group reporting a 0.2- to 0.3-serving-per-day greater increase in go foods than the usual-care group. The intervention group also reported a 0.2- to 0.8-serving-per-day greater decrease in whoa foods than the usual-care group for breads/grains, dairy, fats/oils, meat/fish/poultry, snacks, and vegetables. Overall, snack foods, desserts, and pizza contributed approximately one third of total daily energy intake in both groups at 3 years.

CONCLUSIONS

Children in the intervention group reported consuming more servings per day of go grains, dairy, meats, and vegetable foods compared with children in the usual-care group, but intake of fruits and vegetables was low in both groups. Discovering that snacks, desserts, and pizza actively contribute so heavily to the diets of this age group, even among children who were part of this intervention, offers valuable insights regarding the need for more aggressive, innovative, and realistic approaches for additional dietary counseling.

Authors+Show Affiliations

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, 1102, Chicago, IL 60611-4402, USA. lvanhorn@northwetern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15930237

Citation

Van Horn, Linda, et al. "Children's Adaptations to a Fat-reduced Diet: the Dietary Intervention Study in Children (DISC)." Pediatrics, vol. 115, no. 6, 2005, pp. 1723-33.
Van Horn L, Obarzanek E, Friedman LA, et al. Children's adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC). Pediatrics. 2005;115(6):1723-33.
Van Horn, L., Obarzanek, E., Friedman, L. A., Gernhofer, N., & Barton, B. (2005). Children's adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC). Pediatrics, 115(6), 1723-33.
Van Horn L, et al. Children's Adaptations to a Fat-reduced Diet: the Dietary Intervention Study in Children (DISC). Pediatrics. 2005;115(6):1723-33. PubMed PMID: 15930237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Children's adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC). AU - Van Horn,Linda, AU - Obarzanek,Eva, AU - Friedman,Lisa Aronson, AU - Gernhofer,Niki, AU - Barton,Bruce, PY - 2005/6/3/pubmed PY - 2005/11/11/medline PY - 2005/6/3/entrez SP - 1723 EP - 33 JF - Pediatrics JO - Pediatrics VL - 115 IS - 6 N2 - BACKGROUND: Prevention of cardiovascular disease through diet and lifestyle change is strongly advocated in adults and is initiated preferably during childhood. The Dietary Intervention Study in Children (DISC) was a multicenter, collaborative, randomized trial in 663 preadolescent children (363 boys and 301 girls) with elevated low-density lipoprotein cholesterol, designed to test the efficacy and safety of a dietary intervention to lower saturated-fat and cholesterol intake while also advocating a healthy eating pattern. DISC results have been published extensively. This ancillary study reports new data regarding changes in eating patterns among this cohort. OBJECTIVE: We set out to compare children's self-selected eating patterns and approaches to achieving adherence to the DISC fat-reduced diet intervention with children in the usual-care group. METHODS: An ancillary study was conducted to develop a detailed food-grouping system and report new analyses on dietary adherence to the recommended eating pattern. Every food in the nutrient database was ranked by its saturated-fat and cholesterol content and classified within its relevant food group as a "go" (less atherogenic) or "whoa" (more atherogenic) food. RESULTS: At baseline, go foods contributed approximately 57% of total energy intake and 12.4% to 13.1% total fat energy intake in both groups. At 3 years, go foods contributed 67.4% and 13.7% of total and fat energy intake, respectively, in the intervention group versus 56.8% and 12.8% in the usual-care group. Differences between the 2 treatment groups were significant for changes in consumption of dairy foods, desserts, and fats/oils, with the intervention group reporting a 0.2- to 0.3-serving-per-day greater increase in go foods than the usual-care group. The intervention group also reported a 0.2- to 0.8-serving-per-day greater decrease in whoa foods than the usual-care group for breads/grains, dairy, fats/oils, meat/fish/poultry, snacks, and vegetables. Overall, snack foods, desserts, and pizza contributed approximately one third of total daily energy intake in both groups at 3 years. CONCLUSIONS: Children in the intervention group reported consuming more servings per day of go grains, dairy, meats, and vegetable foods compared with children in the usual-care group, but intake of fruits and vegetables was low in both groups. Discovering that snacks, desserts, and pizza actively contribute so heavily to the diets of this age group, even among children who were part of this intervention, offers valuable insights regarding the need for more aggressive, innovative, and realistic approaches for additional dietary counseling. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15930237/Children's_adaptations_to_a_fat_reduced_diet:_the_Dietary_Intervention_Study_in_Children__DISC__ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15930237 DB - PRIME DP - Unbound Medicine ER -