Journal Name:
Journal of Am College of Nutrition
Article Title:
Effect of a rapeseed oil substituting diet on serum lipids & lipoproteins in children and adolescents with familial hypercholesterolemia
Date Written:
2002
Volume:
21
Number:
2
Page:
103
Author(s):
Gulesserian, T.; Widhalm, K.
Article:
Familial hypercholesterolemia (FH) is predominantly an inherited disorder, which contributes to a defect of the LDL-cholesterol receptor. FH is one of the most frequent metabolic disorders with an incidence of approximately 1:500 in the general population. The underlying cause is an LDL receptor defect whereby LDL cannot be taken up and catabolized by the cells. Myocardial infarction already may occur at the mean age of 45 to 48 years in males and 55 to 58 in females. A diet high in monounsaturated fatty acids reduces elevated levels of total cholesterol and LDL-cholesterol and may increase HDL-cholesterol. It is recommended that once the diagnosis of FH is made in early childhood a diet high in canola (rapeseed oil) should be started as early as possible to prevent development of atherosclerosis and subsequent complications. The objective of this trial was to investigate how adolescents and families with FH would respond to a lipid lowering diet enriched with canola (rapeseed) oil and effects on serum lipids.
In this study, seventeen children and young adolescents (male = 6, female = 11, ages 4 to 19 years) diagnosed with FH received a low fat/low cholesterol diet enriched with rapeseed oil over five months. The three-day dietary protocols showed the following characteristics: 29.5% calories from fat, 14.3% calories from protein and 54.6% calories from carbohydrates. During five months of thhe rapeseed oil diet, serum triglycerides decreased by 29% (119.2 ? 62.8 mg/dL vs. 84.9 mean ? 39.7 mg/dL), VLDL-cholesterol by 27% (23 ? 12 mg/dL vs. 17 ? 8 mg/dL), total cholesterol by 10% (233 ? 35 mg/dL vs. 213 ? 36 mg/dL), LDL-cholesterol by 7% (151 ? 31 mg/dL vs. 142 ? 31 mg/dL). HDL-cholesterol (59 ? 15 mg/dL vs. 57 ? 11 mg/dL) and Lp(a) (29.8 ? 36.3 mg/dL vs. 32.6 ? 40.7 mg/dL) were not changed significantly.
The diet used in this study was well accepted, and in all families a sustained change was reported. Canola/Rapeseed oil is accepted because it is odorless, tasteless, easily available, not expensive and can be used for any cooking style. In children and adolescents with FH, a lipid-lowering diet with rapeseed oil has a similar effect on total serum cholesterol and LDL-cholesterol compared to a classical cholesterol reduction diet (step I). However, with the canola (rapeseed) oil, an additional pronounced effect on lowering of triglycerides and VLDL-cholesterol was observed. An early and long-term treatment of hypercholesterolemia should have a positive effect in prevention of vascular disease later in the patients' lives. This research shows that the treatment of familial hypercholesterolemia in children and adolescents with a low fat/low cholesterol diet combined with canola (rapeseed) oil is effective and in most of them well accepted and safe, so that medical treatment is affordable later in the childhood., ,
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