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November 8, 1995

Reducing Dietary Intake of Fat and Cholesterol in Children-Reply

Author Affiliations

University of Minnesota Minneapolis

JAMA. 1995;274(18):1425. doi:10.1001/jama.1995.03530180017013

In Reply.  —Dr Olson, Dr Zlotkin, and Drs Newman and Hulley agree about the importance of blood cholesterol in atherosclerosis; however, they suggest it is a problem of adults, not a problem in children. Specifically, they question the magnitude of cholesterol lowering and costs of the DISC intervention,1 the unknown safety among those not included in the trial, the association of fatty streaks observed in youth with more advanced lesions, and the relevance of diet among youth to adult eating patterns.While there are published data available to respond to each of these challenges, I will focus on their central implications: the current US diet for children is fine, there is no need to be concerned about cholesterol among youth, and we can wait until they become adults and approach the clinical disease threshold. In essence, they suggest that there is no role for cardiovascular disease prevention in a

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