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


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

Year Published: 



The Journal of Pediatrics


Study Design: 

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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.

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.

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.

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.