CHANGING EATING PATTERNS TO MEET LOW FAT GOALS: DISC

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(Adapted from the applicant's abstract) The Dietary Intervention Study in Children (DISC) is an NHLBI-funded clinical trial designed to test the efficacy and safety of a dietary intervention to reduce serum cholesterol levels in 8-10 year-old pre-pubertal children with elevated LDL cholesterol levels. Children were randomized to intervention with a diet that was 28% of energy from total fat, less than 8% from saturated fat, up to 9% from polyunsaturated fat and less than 75mg/4200kJ cholesterol per day or usual care. Three 24-hour recalls were collected by nutritionists trained and certified in the Nutrient Data System of the Nutrition Coordinating Center. Foods were ranked by saturated fat and cholesterol content and classified as GO! and WHOA! foods to help with shopping and making appropriate choices when eating out. Families were educated regarding the types of foods that could be selected to help achieve the study goals, but a variety of individual adaptions occurred. After three years, the intervention group lowered mean dietary intake of total and saturated fat from a mean of 34% at baseline to 28.6%, and serum LDL-C was significantly lower than usual care by 0.09mmol/L (3.3mg/dL, p=.02). These data illustrate adaptation of dietary behavior to achieve the goal nutrient levels, but quantifying the specific changes in eating patterns, food choices and preparation techniques requires further programming and data analyses than what has been already accomplished in this study. Proposed are additional food group analyses to quantify and compare specific food choices adopted within and between groups. By utilizing the GO! vs. WHOA! system, the dietary data collected from over 6,000 recalls will be configured to identify lower vs. higher fat food choices across the overall eating pattern. This will permit better understanding about the self-selected dietary changes that were made in DISC among those children who adhered to the diet, document the level of nutrient adequacy achieved among this cohort and provide potential insights for future translational studies on reduced fat eating in this age group.