TABLE 3

RCTs of Diet and/or Exercise for Children and Adolescents Without Monogenic Dyslipidemia

Author (Year)Intervention(s)PopulationDuration of TrialSignificant Changes vs Control
NAgeTCHDLLDLTGQuality Rating
Diet
    DISC Collaborative Research Group170 (1995)Family-oriented behavioral intervention to promote dietary adherence vs usual care6638–10 y3 y↓ (year 1 only)Good
    Gold et al195 (1991)Oat bran–supplemented cereal within AHA Step 1 diet vs cereal within Step 1 diet and no oat bran49 with TC >185 mg/dL10 y (mean)4 wkNRPoor
    Kuehl et al189 (1993)Four 90-min family-oriented nutrition sessions vs one 90-min session295 with TC >1852–15 y16 wkPoor
    Obarzanek et al169 (2001)Counseling intervention (same as DISC above) vs usual care6638–10 y4 y (7 y total follow-up)○ 5 and 7 y○ 5 and 7 y○ 5 and 7 y○ 5 and 7 yGood
    Shannon et al173 (1994)PCAT: 10 talking-book lessons and follow-up paper and pencil games for children with a manual for parents vs 45- to 60-min counseling session with parent, child, and registered dietitian and take-home print materials for both261 with elevated LDL4–10 y3-mo follow-upNRNRNRGood
    Stallings et al190 (1993)PCAT: 10 sessions total, 1 per week completed in home by child and parents vs usual care44 with LDL 90th–99th percentile4–10 y6 moNRNRNRPoor
    Williams et al193 (1995)Fiber cereal with 3.2 g of soluble fiber per serving (dose = 1 box of cereal per d for 3 wk, then 2 boxes per d), with children aged 2–5 y consuming only 1 box per d throughout study, compared to placebo cereal with 0.5 g of fiber58 with TC >170 mg/dL and LDL >110 mg/dL2–11 y12 wkPoor
Exercise
    Boreham et al194 (2000)7-wk stair-climbing program vs no change in activity25 sedentary females18–22 y7 wkaNRNRPoor
    Ferguson et al182 (1999)Exercise program 5 d/wk, 40 min/d (children were paid $1 per session and given prizes for maintaining a heart rate >150 beats per min) vs no exercise program81 obese children9.5 y (mean)4 moFair
    Kang et al188 (2002)Physical activity training with lifestyle intervention 5 d/wk vs lifestyle intervention alone80 obese children13–16 y8 moPoor
    Linder et al196 (1983)Physical conditioning program vs usual activities50 healthy boys11–17 y8 wkFair
    Savage et al197 (1986)Walking/jogging/running 3 d/wk (1.6 km per session) high intensity (heart rate = 75% of V̇o2max) vs low intensity (heart rate = 40% of V̇o2max)663 boys8–9 y (mean)11 wkNRNRFair
    Stergioulas et al191 (1998)Four 60-min sessions per wk vs no specific training program58 sedentary boys10–14 y2 moNRNRNRPoor
Diet and Exercise
    Becque et al174 (1988)(1) Diet and behavior change: met with dietician and behavior therapist 1 d/wk; (2) exercise plus diet and behavior change: same as above, with exercise program 50 min for 3 d/wk; and (3) no change in activity or diet36 overweight adolescents13 y (mean)20 wkFair
    Epstein et al163 (1989)Diet of 3800–5000 kJ/d monitored by a nutritionist; information on diet, exercise, stimulus control, reinforcement, modeling, and contingency contracting presented to parents and their children in 8 weekly sessions followed by 4 monthly sessions56 obese (>20% of ideal weight) children8–12 y6 moNRPoor
    Walter et al176 (1985)“Know Your Body” curriculum yearly, taught 2 h/wk by usual classroom teacher, vs standard curriculum11154th-graders1 yNRNRFair
  • ↑ indicates significant increase; ↓, significant decrease; ○, no significant change; DISC, Dietary Intervention Study in Children; PCAT, Parent-Child Auto Tutorial Program; NR, not reported; TG, triglycerides.

  • a This trial reported significant pre-experimental differences between groups in HDL levels (P < .05).