Impact of lifestyle training on serum lipids of children and adolescents with dyslipidemia

A quasi-experimental study

Authors

  • Fatemeh Taheri MD, Pediatrician, Professor, Cardiovascular Diseases Research Center, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

Keywords:

Dyslipidemia, Childhood, Lifestyle

Abstract

Background: Dyslipidemia is one of the most important risk factors for cardiovascular diseases. It can cause a rise in the incidence of these diseases in adulthood. Lifestyle modification is a determinant factor for incidence, prognosis and complications of cardiovascular diseases. Objective: The aim of the study was to evaluate the effect of lifestyle modification on serum lipids of children and adolescents with dyslipidemia. Methods: This quasi-experimental study (before - and after design) was conducted on all dyslipidemia children and adolescents with dyslipidemia referred to the cardiovascular diseases research center of Birjand University of Medical Sciences (Iran) in 2015. Participants underwent 6 sessions of training, appropriate to their age, including fat definition and healthy lifestyle. Before the study and 6 months after trainings, in the same circumstances, subjects were examined for level of blood lipids and blood pressure. Data were analyzed using paired-samples t-test, Pearson correlation coefficient, and independent-samples t-test. P-value of less than 0.05 was considered statistically significant. Results: This study was performed on 50 children with dyslipidemia, of whom 52% were female and 48% were male. The mean age of participants was 12.77±1.84 years. The study showed a significant difference between the mean of cholesterol (p<0.001) and LDL (p=0.008) before and after the study. Comparing the changes made in the mean of variables such as FBS, Cholesterol, TG, HDL and LDL as a result of gender-based lifestyle modification, no significant difference between the two sexes was seen (p>0.05). Pearson correlation coefficient showed no significant relationship between the mean of these variables in children as a result of lifestyle modification and their age (p>0.05). Conclusion: Lifestyle modification relying on exercise and physical activity, nutrition and sufficient sleep and rest can be effective as a non-pharmacological supplement in reducing blood lipids and dyslipidemia. Lifestyle modification training is essential for both children and their parents after diagnosis of dyslipidemia as a part of the Therapeutic plan.  

References

Dholpuria R, Raja S, Gupta BK, Chahar CK, Panwar RB, Gupta R, et al. Atherosclerotic risk factors in

adolescents. Indian J Pediatr. 2007; 74(9): 823-6. PMID: 17901667.

Antman EM, Selwyn AP, Braunwald E. Ischemic heart disease. In: Fauci AS, Braunwald E, Kasper D,

Longo L, Hauser S L, Jameson J. L, Lascalza, J (editors). Harrison's Principle of Internal Medicine. 17th

ed. New York, NY: McGraw-Hill. 2008; 1514-20.

Couch SC, Cross AT, Kida K, Ros E, Plaza I, Shea S, et al. Rapid westernization of children's blood

cholesterol in 3 countries: evidence for nutrient- gene interactions? Am J Clin Nutr. 2000; 72 (suppl 5):

s-74s. doi: 10.1093/ajcn/72.5.1266s. PMID: 11063468.

Barquera S, Pedroza-Tobias A, Medina C, Hernandez-Barrera L, Bibbins-Domingo K, Lozano R, et al.

Global Overview of the epidemiology of Atherosclerotic Cardiovascular Disease. Archives of Medical

Research. 2015; 46(5): 328-38. doi: 10.1016/j.arcmed.2015.06.006. PMID: 26135634.

Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan SH, Marshal T, Thomas G N, Iranipour R. Incidence

of Cardiovascular Diseases in an Iranian Population: The Isfahan Cohort Study. Arch Iran Med. 2013;

(3): 138-44. doi: 013163/AIM.004. PMID: 23432164.

Ganz P, Ganz W. Coronary blood flow and mycardial ischemia. In: Braunwald E, Zipes DP, Libby P (eds).

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia; WB Saunders.

; l105-6.

Daniels SR, Greer FR, Bhatia JJ, Schneider MB, Silverstein J, Stettler N, et al. Lipid screening and

cardiovascular health in childhood. Pediatrics. 2008; 122(1): 198-208. doi: 10.1542/peds.2008-1349.

PMID: 18596007.

Zapata LB, Bryant CA, McDermott RJ, Hcfelfinger JA. Dietary and physical activity behaviors of middle

school youth: the youth physical activity and nutrition survey. J Sch Health. 2008; 78(1): 9-18; quiz 65-7.

doi: 10.1111/j.1746-1561.2007.00260.x. PMID: 18177295.

Rey-Lopez JP, Vicente-Rodriguez G, Biosca M, Moreno LA. Sedentary behaviour and obesity

development in children and adolescents. Nutr Metab Cardiovasc Dis. 2008; 18(3): 242-51. doi:

1016/j.numecd.2007. 07.008. PMID: 18083016.

Guedes D, Guedes J, Barbosa D, Oliveira, JD. Niveis de pratica de atividade fisica habitual em

adolescentes. Rev Bras Med Esporte. 2001; 7(6): 187-99. doi: 10.1590/S1517-86922001000600002.

Bellize M.C, Graham W, Horgan F, Guillaume M, William H. Dietz. Prevalence of childhood and

adolescent overweight and obesity in Asian and European countries. In: Chunming Chen, Dietz W.H (edt).

Obesity in childhood and adolescence. Lippincott Williams & Wilkins, Philadelphia, 2002; 23-32.

Skybo TA, Ryan- Wenger N. A school-based intervention to teach third grade children about the

prevention of heart disease. Pediat Nurs. 2002; 28(3): 223-9, 235. PMID: 1208764.

Rackley CE, Schlant RC. Dyslipidiosis, other risk factor and prevention of coronary artery disease. In:

Wayne RA, Schlant RC (eds). The Textbook of Heart Disease. 9th ed. New York; McGrow-Hill. 1997; Pp:

l213-21.

Radomyska B. Screening programme for hyper lipidemia in children and adolescents. Prophylactic -aspects

of atherosclerosis. Med Wieku Rozwoj. 2001; 5(1): 27-34. PMID: 11276501.

Kelishadi R. Childhood overweight, obesity and the metabolic syndrome in Developing countries.

Epidemiol Rev. 2007; 29: 62-76. doi: 10.1093/epirev/mxm003. PMID: 17478440.

Klishadi R, HashemiPour M, Zadegan NS, Kahbazi M, Sadry G, Amani A, et al. Dietary fat intake and

lipid profiles of Iranian adolescents: Isfahan healthy heart program-heart health promotion from childhood.

Prev Med. 2004; 39(4): 760-66. doi: 10.12691/jfnr-2-6-10. PMID: 15351543.

Azizi F, Rahmani M, Madjid M, Allahverdian S, Ghanbili J, Ghanbarian A, et al. Serum lipid levels in an

Iranian population of children and adolescents: Tehran lipid and glucose study. Eur J Epidemiol. 2001;

(3): 281-88. PMID: 11680549.

Dholpuria R, Raja S, Gupta BK, Chahar CK, Panwar RB, Gupta R, et al. Atherosclerotic risk factors in

adolescents. Indian J Pediatr. 2007; 74(9): 823-6. PMID: 17901667.

Antal M, Regoly-Merei A, Mesko E, Nagy K M, Barna M, Biro L, et al. Incidence of risk factors in parents

with acute myocardial infarction at young age and in their children. Orv Hetil. 2004; 145(49): 2477-83.

PMID: 15633735.

Oksan D, Turner L, Hasanoglu A. Cholesterol screening in school children: is family history reliable to

choose the ones to screen. Acta Pediatrica. 2007; 96(12): 1794-8. doi: 10.1111/j.1651-2227.2007.00554.x.

Robert M, Kligman B, Staton MD, Joseph ST. Disorders of lipoprotein metabolism and transport. l91h.

united states. Sunders Ni. 2011: 80-88.

Austin MA, Hutter CM, Zimmem RL, Humphries SE. Familial hypercholesterolemia and coronary heart

disease: a huge association review. Am J Epidemiol. 2004; 160(5): 421-429. doi: 10.1093/aje/kwh237.

PMID: 15321838.

Bhatnagar D, Soran H, Durrington PN. Hypercholesterolaemia and its management. BMJ 2008; 337: 503- 8. doi: 10.1136/bmj.a993. PMID: 18719012.

Brunzell JD, William R. Hypertriglyceridemia in children. N Engl J Med. 2007; 357: 1009-17. doi:

1056/NEJMcp070061.

Jalali F, Haji Ahmadi M, Hosseimpour M, Angari MZ, Asadi E. Knowledge, attitude and practice (KAP) of

people living in Babol about clinical symptoms and risk factors of coronary artery diseases (CAD). Journal

of Babol University of Medical Sciences. 2004; 6(1): 43-9. In Persian.

Kelishadi R, Hashemipour M, Sheikh-Heidar A, Ghatreh-Samani S H. Changes in Serum lipid profile of

obese or overweight children and adolescents following a lifestyle modification course. ARYA

Atherosclerosis Journal. 2012, 8(3): 143-7. In Persian. PMID: 23359278, PMCID: PMC3557010.

Knip M, Nuufinen Q. Long- term effects of weight reduction on serum lipids and plasma insulin in 0bese

children. Am J Clin Nutr. 1993; 57(4): 490-3. doi: 10.1093/ajcn/57.4.490.

Wadden TA, Anderson DA, Foster GD. Two-year changes in lipids and lipoproteins associated with the

maintenance of a 5% to 10% reduction in initial weight: some findings and some questions. Obes Res.

; 7(2): 170-8. doi: 10.1002/j.1550-8528.1999.tb00699.x. PMID: 10102254.

Lim JS. The current state of dyslipidemia in Korean children and adolescents and its management in

clinical practice. Ann Pediatr Endocrinol Metab. 2013; 18(1): 1-8. doi: 10.6065/apem.2013.18.1.1. PMID:

, PMCID: PMC4027065.

Avila- Rodriguez A, Avila- Rodriguez EH, Araujo- Contreras JM, Rivas-Avila E, Lee RE, Rodriguez- Ortega LJ, et al. Relationship between Dyslipidemia and Physical Activity in Mexican Children.

International Journal of Exercise science. 2012; 6(2).

Zardast M, Namakin, K, Chahkandi T, Taheri F, Kazemi T, Bijari B. Prevalence of Metabolic Syndrome in

Elementary School Children in East of Iran. J Cardiovasc Thorac Res. 2015; 7(4): 158-163. doi:

15171/jcvtr.2015.34. PMID: 26702345, PMCID: PMC4685282.

Rômulo Araújo Fernandes, Diego Giulliano Destro Christofaro, Juliano Casonatto, Jamile Sanches

Codogno, Eduardo Quieroti Rodrigues, Mauro Leandro Cardoso, et al. Prevalence of dyslipidemia in

individuals physically active during childhood, adolescence and adult age. Arq Bras Cardiol. 2011; 97(4):

-23. doi: 10.1590/S0066-782X2011005000083. PMID: 21830000.

Bazzano LA, Serdula MK, Liu S. Dietary intake of fruits and vegetables and risk of cardiovascular disease.

Curr Atheroscler Rep. 2003; 5(6): 492-9. PMID: 14525683.

de Alcantara Neto OD, Silva Rde C, Assis AM, Pinto Ede J. Factors associated with dyslipidemia in

children and adolescents enrolled in public schools of Salvador Bahia, Alcantara Neto. Rev Bras

Epidemiol. 2012; 15(2): 335-45. PMID: 22782099.

Basta M, Chrousos GP, Vela-Bueno A, Vgontzas An. Chronic Insomnia and Stress System. Sleep Med

Clin. 2007; 2(2): 279-291. doi: 10.1016/j.jsmc.2007.04.002. PMID: 18071579, PMCID: PMC2128619.

Silverstein J, Haller M. Coronary artery disease in youth: present markers, future hope? J Pediatr. 2010;

( 4): 523-4. doi: 10.1016/j.jpeds.2010.07.010. PMID: 20728091.

Ramezani M, Azizi F. Prevalence of Hyperlipidemia in 3-19 years old children and adolescent of Tehran in

Iranian Journal of Endocrinology and Metabolism. 2005; 7(3): 249-53.

Ribas SA, Santana da Silva LC. Anthropometric indices: predictors of dyslipidemia in children and

adolescents from north of Brazil. Nutr Hosp. 2012; 27(4): 1228-35. doi: 10.3305/nh.2012.27.4.5798.

PMID: 23165566.

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Published

2022-02-12