Kuehl K S, Cockerham J T, Hitchings M, Slater D, Nixon G, Rifai N
Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007.
Prev Med. 1993 Mar;22(2):154-66. doi: 10.1006/pmed.1993.1013.
Based on recent recommendations, the number of hypercholesterolemic children who would require dietary therapy could overwhelm current preventive pediatric cardiology resources. No previous studies have established the efficacy of such therapy in the pediatrician's office. The purpose of this study was to evaluate two programs of office-based therapy.
We randomly assigned 295 children with hypercholesterolemia (> 185 mg/dl) two interventions: one single or four multiple 90-min sessions of family-oriented nutritional education, based in pediatric practices. We examined total cholesterol, 3-day food records, height and weight, and in the multisession group high-density lipoprotein cholesterol and triglycerides at the beginning and at intervals of 8.5-9 and 21 to 33 weeks (single-session and multisession groups, respectively).
Total cholesterol was lowered equally in both treatment groups over the course of the study. This was accompanied by dietary changes: a decrease in calories derived from total and saturated fats, and increased intake of fiber, protein, and carbohydrate. However, more single-session patients withdrew from the program during the study.
The two interventions were equally effective in lowering total and low-density lipoprotein cholesterol and in reducing intake of total and saturated fat. However, the higher completion rate of the multisession group suggests that this approach may be the more effective.
根据最近的建议，需要饮食治疗的高胆固醇血症儿童数量可能会超出当前预防性儿科心脏病学资源的承受能力。以前没有研究确定这种治疗在儿科医生办公室的疗效。本研究的目的是评估两种基于办公室的治疗方案。
我们将295名高胆固醇血症儿童（>185mg/dl）随机分为两种干预措施：一种是在儿科诊所进行单次或四次每次90分钟的以家庭为导向的营养教育课程。我们在开始时以及8.5 - 9周和21至33周的间隔时间（分别为单节课程组和多节课程组）检查总胆固醇、3天食物记录、身高和体重，以及在多节课程组中检查高密度脂蛋白胆固醇和甘油三酯。
在研究过程中，两个治疗组的总胆固醇降低程度相同。这伴随着饮食变化：来自总脂肪和饱和脂肪的热量减少，纤维、蛋白质和碳水化合物的摄入量增加。然而，在研究期间，更多单节课程的患者退出了该项目。
两种干预措施在降低总胆固醇和低密度脂蛋白胆固醇以及减少总脂肪和饱和脂肪摄入方面同样有效。然而，多节课程组较高的完成率表明这种方法可能更有效。
