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November 8, 1995

Reducing Dietary Intake of Fat and Cholesterol in Children

Author Affiliations

University of California, San Francisco

JAMA. 1995;274(18):1424. doi:10.1001/jama.1995.03530180017011

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

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