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ARTICLE |

Reducing Dietary Intake of Fat and Cholesterol in Children FREE

Thomas B. Newman, MD, MPH; Stephen B. Hulley, MD, MPH
JAMA. 1995;274(18):1424-1424. doi:10.1001/jama.1995.03530180017011
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To the Editor.  —We do not share the conclusion of the authors of the DISC study1 that the "results indicate that children who require dietary change to lower their LDL-C levels may safely and successfully do so under supervision" (emphasis added).First, although the DISC found no adverse effects on growth, blood chemistry, or psychosocial health, it is not possible, with a 3-year study of only about 300 children per group, to say that the intervention is "safe." Although the diet clearly is not grossly hazardous, the real issue is whether there are uncommon, delayed, or subtle harmful effects that exceed the benefits. Given the small magnitude of the benefits, this question remains unanswered. Harms could be far greater than benefits and could still not be found in this study.Second, we disagree that the change of 0.08 mmol/L (3.23 mg/dL) in LDL-C achieved with intensive diet treatment (compared

REFERENCES

The Writing Group for the DISC Collaborative Research Group.  Efficacy and safety of lowering dietary intake of fat and cholesterol in children with elevated low-density lipoprotein cholesterol: the Dietary Intervention Study in Children (DISC). JAMA . 1995;;273:1429-1435.
Luepker RV.  Reducing blood cholesterol levels in children: what have we learned from the DISC study? JAMA . 1995;;273:1461-1462.
Newman TB, Browner WS, Hulley SB.  The case against childhood cholesterol screening. JAMA . 1990;;264:3039-3043.
Law MR, Wald NJ, Thompson SG.  By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ . 1994;;308:367-372.
Newman TB, Garber AM, Holtzman NA, Hulley SB.  Problems with the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Arch Pediatr Adolesc Med . 1995;;149:241-247.

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The Writing Group for the DISC Collaborative Research Group.  Efficacy and safety of lowering dietary intake of fat and cholesterol in children with elevated low-density lipoprotein cholesterol: the Dietary Intervention Study in Children (DISC). JAMA . 1995;;273:1429-1435.
Luepker RV.  Reducing blood cholesterol levels in children: what have we learned from the DISC study? JAMA . 1995;;273:1461-1462.
Newman TB, Browner WS, Hulley SB.  The case against childhood cholesterol screening. JAMA . 1990;;264:3039-3043.
Law MR, Wald NJ, Thompson SG.  By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ . 1994;;308:367-372.
Newman TB, Garber AM, Holtzman NA, Hulley SB.  Problems with the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Arch Pediatr Adolesc Med . 1995;;149:241-247.
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