Abstract
PurposeWe studied the effects of a physical activity and dietary intervention on plasma lipids in a general population of children. We also investigated how lifestyle changes contributed to the intervention effects.MethodsWe carried out a 2-year controlled, non-randomized lifestyle intervention study among 504 mainly prepubertal children aged 6–9 years at baseline. We assigned 306 children to the intervention group and 198 children to the control group. We assessed plasma concentrations of total, LDL, HDL, and VLDL cholesterol, triglycerides, HDL triglycerides, and VLDL triglycerides. We evaluated the consumption of foods using 4-day food records and physical activity using a movement and heart rate sensor. We analyzed data using linear mixed-effect models adjusted for age at baseline, sex, and pubertal stage at both time points. Furthermore, specific lifestyle variables were entered in these models.ResultsPlasma LDL cholesterol decreased in the intervention group but did not change in the control group ( − 0.05 vs. 0.00 mmol/L, regression coefficient (β) = − 0.0385, p = 0.040 for group*time interaction). This effect was mainly explained by the changes in the consumption of high-fat vegetable oil-based spreads (β = − 0.0203, + 47% change in β) and butter-based spreads (β = − 0.0294, + 30% change in β), moderate-to-vigorous physical activity (β = − 0.0268, + 30% change in β), light physical activity (β = − 0.0274, + 29% change in β) and sedentary time (β = − 0.0270, + 30% change in β). The intervention had no effect on other plasma lipids.ConclusionLifestyle intervention resulted a small decrease in plasma LDL cholesterol concentration in children. The effect was explained by changes in quality and quantity of dietary fat and physical activity.Clinical Trial Registry NumberNCT01803776, ClinicalTrials.gov
Highlights
Pathophysiological processes underlying the development of cardiovascular diseases are known to begin already in childhood [1]
LDL low-density lipoprotein, HDL high-density lipoprotein, VLDL very-low-density lipoprotein explained less of the effects of the intervention on plasma LDL cholesterol concentration (Table 3). This 2-year controlled lifestyle intervention study demonstrated that the individualized and family-based physical activity and dietary intervention resulted a small decrease in fasting plasma LDL cholesterol concentration in a population sample of mainly prepubertal children
Some previous physical activity or dietary interventions have been observed to be beneficial for the reduction of plasma lipids and lipoproteins in children with obesity [5] or hypercholesterolemia [6]; whereas, other lifestyle interventions have shown little or no effects on plasma lipid concentrations [5, 7, 8]
Summary
Pathophysiological processes underlying the development of cardiovascular diseases are known to begin already in childhood [1]. The development of cardiovascular diseases could potentially be prevented by sufficient quantity and intensity of physical activity and a healthy diet in early childhood onwards [4]. A meta-analysis observed that physical activity interventions decreased plasma triglycerides by 12% [5]. A dietary intervention study showed a decrease in plasma LDL cholesterol both at 1-year timepoint ( − 4.8 mg/dL) and 3-year timepoint ( − 3.3 mg/dL) in children with hypercholesterolemia [6]. Other lifestyle intervention studies have shown little or no effects on plasma concentrations of lipids in children [5, 7, 8]. It is important to study which lifestyle changes explain the intervention effects on plasma concentrations of lipids. There are few studies on the effects of physical activity interventions [5] and dietary interventions [9], and no studies on the effects of combined physical activity and dietary interventions on plasma lipid concentrations in general populations of children
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