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November 8, 1995

Reducing Dietary Intake of Fat and Cholesterol in Children-Reply

Author Affiliations

DISC Collaborative Research Group Baltimore, Md

JAMA. 1995;274(18):1424-1425. doi:10.1001/jama.1995.03530180017012

In Reply.  —The correspondents appear to agree that the relationship between diet and heart disease is causal and reducing dietary fat will reduce heart disease risk in adults, but they question whether dietary recommendations are appropriate for children and whether the "small" magnitude of the dietary effect found in DISC is of importance.On a population level, it has been estimated that a mean change of -0.09 mmol/L (-3.3 mg/dL), or a net 2.5% reduction in LDL-C, is associated with a 5% to 7.5% reduction in CHD risk.1 Such small changes translate into large numbers for highly prevalent conditions such as elevated LDL-C and high incident conditions like CHD. Also, the net change of 0.08 mmol/L (3.23 mg/dL) represents an average. Included in this average are the results of intervention children who were not adherent to the DISC diet as well as the results of nonintervention children who changed

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