Dietary intervention in a hypercholesterolemic school-aged population from northern Spain

A ''before and after'' intervention study, over a five year period, was done in order to find the degree of compliance to dietary recommendations and their effects on serum lipids in a hypercholesterolemic school-aged population. 383 children between 6 and 13 years of age, were identified with hypercholesterolemia (total serum levels above 4.8 mmol/l), in a previous randomized mass screening of 1095 individuals. Some dietary guidelines aimed at decreasing fat consumption and increasing fiber and carbohydrate ingestion were given to the families, and 226 of the children participated in the follow-up. Changes of address and/or school-center was the main cause of non-participation. The follow-up examination consisted in the evaluation of serum lipids and actual diet. Cholesterol serum levels decreased from a mean value of 5.4 mmol/l to 4.8 mmol/l. 59.3 % of the sample had reached serum cholesterol levels below the risk threshold. Fat ingestion diminished significantly (40.3 % of calories to 36.7 %, p < 0.001), saturated fatty acids decreased from 15.3 % of calories to 13.5 % (p < 0.001), monounsaturated fatty acids decreased from 17.1 % to 15.4 % (p < 0.001) and polyunsaturated fatty acids remained unchanged. Carbohydrate consumption increased from 45 % of the calories to 47.38 % (p < 0.001). Dietary changes were greater in individuals out of risk than those who still had high cholesterol levels. These data indicate a good family compliance to the recommendations and that changes in food habits seem to be effective in controlling hyperlipidemia. Dietary changes are better accepted by younger children.