Plant-Based, No-Added-Fat or American Heart Association Diets: Impact on Cardiovascular Risk in Obese Children with Hypercholesterolemia and Their Parents

Author(s): 

Macknin M, Kong T, Weier A, Worley S, Tang AS, Alkhouri N, and Golubic M

Journal: 

The Journal of Pediatrics

Year Published: 

2015

Category: 

Study Design: 

Link to Full Article Free Online: 

Abstract: 

OBJECTIVE:
To perform a randomized trial to determine whether there is cardiovascular disease (CVD) risk reduction from a plant-based (PB), no-added-fat diet and the American Heart Association (AHA) diet in children.

STUDY DESIGN:
A 4-week (April 20, 2013 to May 18, 2013), prospective randomized trial was undertaken in a large, Midwestern hospital system's predominantly middle class outpatient pediatric practices. Thirty children (9-18 years of age) parent pairs with a last recorded child body mass index >95th percentile and child cholesterol >169 mg/dL were randomized to PB or AHA with weekly 2-hour classes of nutrition education.

RESULTS:
Children on PB had 9 and children on AHA had 4 statistically significant (P < .05) beneficial changes from baseline (mean decreases): body mass index z-scorePB (-0.14), systolic blood pressurePB (-6.43 mm Hg), total cholesterolPB (-22.5 mg/dL), low-density lipoproteinPB (-13.14 mg/dL), high-sensitivity C-reactive proteinPB (-2.09 mg/L), insulinPB (-5.42 uU/mL), myeloperoxidasePB/AHA (-75.34/69.23 pmol/L), mid-arm circumferencePB/AHA (-2.02/-1.55 cm), weightPB/AHA (-3.05/-1.14 kg), and waist circumferenceAHA (-2.96 cm). Adults on PB and AHA had 7 and 2, respectively, statistically significant (P < .05) beneficial changes. The significant change favoring AHA was a 1% difference in children's waist circumference. Difficulty shopping for food for the PB was the only statistically significant acceptability barrier.

CONCLUSIONS:
PB and the AHA in both children and adults demonstrated potentially beneficial changes from baseline in risk factors for CVD. Future larger, long-term randomized trials with easily accessible PB foods will further define the role of the PB in preventing CVD.