Providing Food to Treat Adolescents at Risk for Cardiovascular Disease

OBJECTIVE: Diet modification is recommended to treat childhood cardiovascular (CV) risk factors; however, the optimal dietary strategy is unknown. METHODS: In a randomized trial the effect of a low-fat (LF) and a low-glycemic-load (LGL) reduced-calorie diet were examined in youth with overweight/obesity with CV risk factors. Using a novel intervention, we delivered LF or LGL meals and nutrition education to the home for 8 weeks (Intensive Phase), followed by 4-months Maintenance without food provision. Between-group differences in the change in insulin area-under-the-curve (InsAUC) by oral glucose tolerance test and other risk factors were analyzed. RESULTS: Overall, participants (n=27) showed substantial improvement during the Intensive Phase, including InsAUC (−59±18.2 µU/mL*120mins, p=0.004), total cholesterol (−9.9±3.6mg/dL, p=0.01), weight (−2.7±0.5kg, p<0.001), waist circumference (−3.1±0.8cm, p<0.001), HOMA-IR (−1.7±0.4, p<0.001), systolic BP (−5±1.4 mmHg, p=0.002) and CRP (−0.1±0.1mg/dL, p=0.04). There were minimal between-group differences; the LF group showed greater declines in HDL-C (p=0.005) and fasting glucose (p=0.01) compared to the LGL group. Improvements waned during Maintenance. CONCLUSIONS: Home delivery of LF or LGL diets resulted in rapid and clinically important improvements in CV risk factors that diminished without food delivery, and did not differ based on dietary intervention. If scalable, food provision may represent an alternative nutrition treatment strategy.