Plant-Based No Added Fat or American Heart Association Diets, Impact on Cardiovascular Risk in Obese Hypercholesterolemic Children and Their Parents

OBJECTIVE: To perform a randomized trial to determine if there is cardiovascular disease (CVD) risk reduction from a plant-based no added fat diet (PB) and the American Heart Association Diet (AHA) in children. STUDY DESIGN: Four-week (4/20/2013-5/18/2013) prospective randomized trial in a large Midwestern hospital system’s predominantly middle class outpatient pediatric practices. Thirty children (9–18 years old) parent pairs with a last recorded child BMI >95(th) percentile and child cholesterol >169 mg/dL were randomized to PB or AHA with weekly 2-hour classes of nutrition education. RESULTS: Children on PB had nine and children on AHA had four statistically significant (P<0.05) beneficial changes from baseline (mean decreases): BMI Z-score(PB) (−0.14), systolic blood pressure(PB) (−6.43 mm Hg), total cholesterol(PB) (−22.5 mg/dL), low density lipoprotein(PB) (−13.14 mg/dL), hsCRP(PB) (−2.09 mg/L), insulin(PB) (−5.42uU/ml), myeloperoxidase(PB/AHA) (−75.34/69.23 pmol/L), mid-arm circumference(PB/AHA) (−2.02/−1.55 cm), weight(PB/AHA) (−3.05/ −1.14kg) and waist circumference(AHA) (−2.96 cm). Adults on PB and AHA had seven and two respectively statistically significant (P<0.05) beneficial changes. The significant change favoring AHA was a 1% difference in children’s waist circumference. Difficulty shopping for food for the PB was the only statistically significant acceptability barrier. CONCLUSIONS: PB and the AHA in both children and adults demonstrated potentially beneficial changes from baseline in risk factors for CVD. Future larger, long-term randomized trials with easily accessible PB foods will further define the role of the PB in preventing CVD.