Effect of response to a low-fat diet among adolescent males on their adult blood cholesterol levels

Background. While primary prevention of adult cardiovascular diseases should begin early, there are problems in identifying children at increased risk of future disease. Methods. We did a follow-up study in 1991-1992 of 100 male former students at a boarding high school who had blood cholesterol measured in 1970-1971 both prior to and following a school-wide, reduced-fat dietary intervention. We compared adult cholesterol levels of the 50 subjects whose cholesterol decreased ≤16.5% (the median decrease) following the 1970- 1971 intervention (Diet-Sensitive) with the 50 whose response was <16.5% (Non-Diet-Sensitive). Results. Blood cholesterol of adults who were Diet- Sensitive in 1970-1971 was 4.2 mg/dl lower than their baseline values in adolescence, while adults classified as Non-Diet-Sensitive as adolescents showed a 15.9 mg/dl increase in cholesterol over 21 years. Adjusting for baseline adolescent values, Non-Diet-Sensitive subjects were 4.8 (95% CI 1.4, 15.9) times as likely as Diet-Sensitive subjects to have adult cholesterol ≤200 mg/dl. Also, Diet-Sensitive adults on a low-fat diet had adult blood cholesterol levels >20 mg/dl lower than Non-Diet-Sensitive adults on a similar diet (180.1 vs 292.1 mg/dl, respectively). Conclusions. Degree of response to a low-fat, low-cholesterol diet during adolescence may identify male subjects who will have differing patterns of cholesterol change over time.