Abstract 884: Effects of a Low-Fat Diet and Nutritional Supplements on Inflammatory Markers of Atherosclerosis in Hyperlipidemic Children: The EARLY Trial
Background: Evidence suggests that inflammation plays a major role in the pathogenesis of atherosclerosis. Inflammatory markers reflecting endothelial function such as soluble intercellular adhesion molecule-1 (sICAM-1), soluble CD40 ligand (sCD40L) and high-sensitivity C-reactive protein (hsCRP) are predictive of future cardiovascular risk. The aim of this study was to determine the effects of the National Cholesterol Education Program Step II (NCEP-II) diet and nutritional supplements on markers of vascular inflammation in hyperlipidemic children.
Methods and Results: In a randomized, double-blind placebo-controlled trial, 53 children (ages 7–19) with familial hypercholesterolemia or familial combined hyperlipidemia consumed the NCEP-II diet for 6 wks and were then given: a combination of vitamins C ( 500mg/day) and E (400 IU/day) (Vits); docosahexaenoic acid (DHA, 1.2g/day); L-arginine (L-Arg, 6g/day); or a cocoa beverage (100mg/day, 200mg flavanols) for 6 wks. This was followed by a washout phase (6 wks) and a placebo phase (6 wks) while continuing the NCEP-II diet. Plasma concentrations of hsCRP were determined by particle-enhanced immunonephelometery; sICAM-1 and sCD40L concentrations by standard enzyme-linked immunosorbant assay. Baseline median concentrations of sICAM-1 (147ng/ml, interquartile range 115–178), sCD40L (1.1ng/ml, 1.0 –2.3) and hsCRP (.10mg/dl, .03–.33) were not significantly affected by the NCEP-II diet. After 6 wks of supplementation with Vits, DHA, L-Arg or Cocoa, concentrations of sICAM-1, sCD40L and hsCRP were not significantly changed compared to baseline (Table⇓). There was no weight loss associated with the diet or supplements.
Conclusion: We found no evidence that the NCEP-II diet and nutritional supplements modified circulating concentrations of selected markers of endothelial function and inflammation in hyperlipidemic children.