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Effect of a Rapeseed Oil Substituting Diet on Serum Lipids and Lipoproteins in Children and Adolescents with Familial Hypercholesterolemia

Department of Pediatrics, University of Vienna, Vienna, AUSTRIA

Address reprint requests to: K. Widhalm, MD, Department of Pediatrics, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, AUSTRIA

Objective:Familial hypercholesterolemia (FH) is a predominantly inherited disorder, which contributes to a defect of the LDL-cholesterol receptor. For adults with familial hypercholesterolemia (FH), it is known that a supplementary diet of monounsaturated fatty acids reduces elevated levels of total cholesterol and LDL-cholesterol and may further increase HDL-cholesterol. In particular the reduced intake of dietary fat reduces total serum cholesterol and LDL-cholesterol in the range of 10% to 15% and inhibits LDL-oxidation. Once the diagnosis of familial hypercholesterolemia is made in early childhood a supplementary diet with rapeseed oil should be started as early as possible to prevent development of atherosclerosis and subsequent complications. So far there are no reports of a lipid lowering diet enriched with rapeseed oil in children and adolescents.

Methods:Seventeen children and young adolescents (male = 6, female = 11, ages 4 to 19 years) diagnosed with FH were enrolled in this study. They received dietary training and a classical low fat/low cholesterol diet enriched with rapeseed oil over five months. In the first two months they received orally mean 15 g/day (8–23 g/day), for the remaining three months mean 22 g/day (15–30 g/day) rapeseed oil. The calculation of the three-days dietary protocols showed the following characteristics: 29.5% calories from fat, 14.3% calories from protein and 54.6% calories from carbohydrates. The subjects had six sessions of dietary counseling, and serum lipids levels and lipoprotein(a) were estimated; each month’s diet adherence was controlled by a dietitian and discussed with the patients and their families during this five-month study.

Result:During five months of 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 was well accepted; in most families a sustained change was reported.

Conclusions:Our results indicate that 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 classical cholesterol reduction diets (step I). However, an additional pronounced effect on lowering of triglycerides and VLDL-cholesterol can be observed.

Key words: familial hypercholesterolemia, rapeseed oil, monounsaturated fatty acids, cholesterol, triglycerides, children, LDL-cholesterol, HDL-cholesterol

Abbreviations: FH = familial hypercholesterolemia • HDL-C = high-density lipoprotein-cholesterol • LDL-C = low-density lipoprotein-cholesterol • VLDL-C = very low-density lipoprotein-cholesterol • TC = total cholesterol • TG = triglycerides • Lp(a) = lipoprotein (a) • BMI = body mass index

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