Hyperlipidemias: Van Horn L

Gidding SS, Dennison BA, Birch LL, Daniels SR, Gillman MW, Gilman MW, Lichtenstein AH, Rattay KT, Steinberger J, Stettler N, Van Horn L, Anonymous00030, Anonymous00031. · No affiliation provided · Circulation. · Pubmed #16186441 links to  free full text

Abstract: Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children's cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age.

Van Horn L, Obarzanek E, Friedman LA, Gernhofer N, Barton B. · Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, 1102, Chicago, IL 60611-4402, USA. · Pediatrics. · Pubmed #15930237 links to  free full text

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.

Van Horn L, Liu K, Gerber J, Garside D, Schiffer L, Gernhofer N, Greenland P. · Department of Preventive Medicine, Northwestern University Medical School, Chicago, IL 60611, USA. · J Am Diet Assoc. · Pubmed #11716313 No free full text.

Abstract: OBJECTIVES: To study possible synergistic effects of oats and soy on reducing total and low-density lipoprotein cholesterol (LDL-C) concentrations in human beings and the efficacy and feasibility of including these adjustments to a National Cholesterol Education Program Step I diet. SUBJECT/SETTING: One hundred twenty-seven postmenopausal women with moderate hypercholesterolemia were recruited from a large Midwestern workforce and senior centers in the surrounding community. Intervention and clinical visits were conducted in these same facilities. DESIGN: After a 3-week lead-in period on the Step I diet, participants were randomly assigned to 1 of 4 dietary treatments for an additional 6 weeks: an oats/milk group, a wheat/soy group, an oats/soy group, and a wheat/milk group. Clinical measurements included blood draws, body weight and height, blood pressure, and medical history data. Three-day food records were collected at baseline and Weeks 3 and 9 of the intervention. Randomization was stratified based on the status of hormone replacement therapy and was blocked with sizes 4 or 8 for group assignment. RESULTS: After 3 weeks on the Step I diet, total cholesterol, LDL-C, and triglyceride levels; total fat and saturated fat intake, dietary cholesterol intake, Keys score, and body mass index were all reduced. Following an additional 6 weeks on the Step I diet plus intervention, total cholesterol and LDL-C were further reduced for both the oats/soy group and oats/milk group. There were no significant further changes in total cholesterol, LDL-C, or high-density lipoprotein cholesterol levels in the wheat/soy and wheat/milk groups. Body mass index remained stable in all groups from Week 3 to Week 9. APPLICATIONS: Nonpharmacologic dietary interventions like the Step I diet are feasible in a community setting and can produce rapid and significant lipid-lowering benefits. Daily consumption of 2 servings of oats can contribute to further lipid alterations in this population although soy intake at this dose may not. Palatability and convenience are important considerations in achieving dietary adherence.

Lauer RM, Obarzanek E, Hunsberger SA, Van Horn L, Hartmuller VW, Barton BA, Stevens VJ, Kwiterovich PO, Franklin FA, Kimm SY, Lasser NL, Simons-Morton DG. · University of Iowa Hospitals and Clinics, Department of Pediatrics, Iowa City, IA 52242, USA. · Am J Clin Nutr. · Pubmed #11063475 links to  free full text

Abstract: BACKGROUND: Few studies have shown the efficacy and safety of lower-fat diets in children. OBJECTIVE: Our objective was to assess the efficacy and safety of lowering dietary intake of total fat, saturated fat, and cholesterol to decrease LDL-cholesterol concentrations in children. DESIGN: A 6-center, randomized controlled clinical trial was carried out in 663 children aged 8-10 y with LDL-cholesterol concentrations greater than the 80th and less than the 98th percentiles for age and sex. The children were randomly assigned to either an intervention group or a usual care group. Behavioral intervention promoted adherence to a diet providing 28% of energy from total fat, <8% from saturated fat, </=9% from polyunsaturated fat, and <0.018 mg cholesterol*kJ(-)(1)*d(-)(1) (not to exceed 150 mg/d). The primary efficacy measure was mean LDL cholesterol and the safety measures were mean height and serum ferritin concentration at 3 y. RESULTS: At 3 y, dietary total fat, saturated fat, and cholesterol were lower in the intervention group than in the usual care group (all P: < 0. 001). LDL cholesterol decreased in the intervention and usual care groups by 0.40 mmol/L (15.4 mg/dL) and 0.31 mmol/L (11.9 mg/dL), respectively. With adjustment for baseline concentration, sex, and missing data, the mean difference between groups was -0.08 mmol/L (95% CI: -0.15, -0.01), or -3.23 mg/dL (95% CI: -5.6, -0.5) (P: = 0. 016). There were no significant differences between groups in adjusted mean height or serum ferritin. CONCLUSION: Dietary changes are effective in achieving modest lowering of LDL cholesterol over 3 y while maintaining adequate growth, iron stores, nutritional adequacy, and psychological well-being during the critical growth period of adolescence.

McCoin M, Sikand G, Johnson EQ, Kris-Etherton PM, Burke F, Carson JA, Champagne CM, Karmally W, Van Horn L. · University of California, Berkeley, CA 94720, USA. · J Am Diet Assoc. · Pubmed #18237570 No free full text.

This publication has no abstract.

Friedman LA, Snetselaar L, Stumbo P, Van Horn L, Singh B, Barton BA. · Maryland Medical Research Institute, 600 Wyndhurst Ave, Baltimore, MD 21210, USA. · J Am Diet Assoc. · Pubmed #17383264 No free full text.

Abstract: OBJECTIVE: To compare treatment, sex, and visit differences in beverage choice and calcium intake in the Dietary Intervention Study in Children, to compare the relationship of other beverages to milk consumption, and document whether or not the dietary intervention affected choice of beverage and milk type over time. DESIGN: Data from the Dietary Intervention Study in Children, a randomized, controlled, multicenter, clinical trial with five sets of three 24-hour recalls. SUBJECTS: Six hundred fifty-three children from six clinics started the study at age 8 to 10 years. Participants had serum low-density lipoprotein cholesterol levels between the 80th and 98th percentiles of age, and were followed for a median of 7.3 years. INTERVENTION: Children were randomized to a total fat- and saturated fat-modified dietary intervention or usual care. MAIN OUTCOME MEASURES: Volume and percent of total energy from soft drinks, fruit-flavored drinks, fruit juice, and milk, calcium intake in milligrams and per 1,000 kcal, and percent reduced-fat and skim milk consumed. STATISTICAL ANALYSES: General Estimating Equations methodology was used to adjust for treatment, sex, and visit differences. RESULTS: The intervention group consumed more reduced-fat or skim milk than the usual care group. The intervention group also reported a greater increase in calcium per 1,000 kcal than those in the usual care group due to nonbeverage sources. Consumption of soft drinks increased over the course of the study, whereas total milk consumption decreased sharply. CONCLUSIONS: With nutrition education, children can make changes in the type of milk consumed, and in the quantity of dietary calcium consumed.