To the Editor.
—The recent DISC study demonstrated that in preadolescents with elevated LDL-C blood concentrations (80th to 98th percentile), an intensive combination of dietary restriction, nutritional counseling, and family-oriented behavioral intervention over 3 years resulted in a modest decrease in total cholesterol levels compared with a control group (-0.08 mmol/L [-3.23 mg/dL]). Nevertheless, based on these results, the authors suggested that the current 30:10 recommendations for children (30% of total energy as fat and 10% of energy as saturated fat) could be "advocated safely" for all children when children's growth and development were followed by health care personnel. The DISC study did not provide any evidence that children with LDL-C concentrations below the 80th percentile would benefit from a fat-restricted diet. Moreover, based on the modest effect on blood lipid levels despite an intensive (and expensive) intervention program in a population at risk, one might predict that a less
Zlotkin SH. Reducing Dietary Intake of Fat and Cholesterol in Children. JAMA. 1995;274(18):1423-1424. doi:10.1001/jama.1995.03530180017010