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April 21, 2026Epidemiology Biostatistics and Public HealthOpen Access

Re-analysis of the DISC Study: Advanced Statistical Approaches to Understanding Dietary Interventions in Pediatric Cardiovascular Health

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Why the study?

Building on advances in longitudinal modeling, investigators re-analyzed DISC data using linear and spline mixed-effects models to reassess intervention effects, evaluate subgroup differences, and examine the impact of compliance on fat intake.

Does a cholesterol-lowering dietary intervention reduce LDL-C and improve dietary fat intake in children aged 8-10 years with elevated LDL-C?

Population

Children in the DISC trial

Comparison

Dietary intervention group vs usual care group

Design

Secondary analysis of a randomized trial

Key result

The cholesterol-lowering dietary intervention significantly accelerated the decline in LDL-cholesterol over time compared to usual care (p=0.027), with an estimated difference of 5 mg/dL by month 84.

Authors

ASAnahita SaeediBBBruce BartonRBRaji Balasubramanian

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Overview

Affirms dietary intervention for pediatric CV risk reduction; reinforces DISC findings using linear and spline mixed-effects models.

Key Points

  • This research aims to re-assess the effects of a dietary intervention on cardiovascular risk factors in children using advanced statistical methods.
  • Conducted a secondary analysis of the randomized DISC trial.
  • Utilized linear and B-spline mixed-effects models to assess LDL-C and nutrient intake.
  • Evaluated compliance through session attendance and adherence to dietary goals.
  • Intervention group showed a significant reduction in LDL-C compared to usual care.
  • Identified non-linear trends in LDL-C and dietary fat over time.
  • Higher attendance at sessions linked to better fat intake, with a weaker effect in girls.

Study Design

Type

RCT (n=663)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does a cholesterol-lowering dietary intervention reduce LDL-C and improve dietary fat intake in children aged 8-10 years with elevated LDL-C?

P
Population
663 children aged 8-10 years with elevated LDL-C (fasting LDL-C between the 80th and 98th percentiles for age and sex).
I
Intervention
Dietary intervention promoting adherence to a diet providing 28% of energy from total fat, less than 8% from saturated fat, up to 9% from polyunsaturated fat, and less than 75 mg/1000 kcal of cholesterol per day, delivered via structured group sessions and individual counseling.
C
Comparator
Usual care (parents or guardians informed of their child's elevated LDL-C and provided publicly available heart-healthy eating materials only).
O
Outcome
LDL-cholesterol (LDL-C) trajectories over time.surrogate

Main Result

p-value: p=0.027

A family-based dietary intervention initiated in childhood produces meaningful and sustained reductions in LDL-C and dietary fat intake, with parental involvement significantly enhancing these benefits.

Limitations

  • Limited to originally collected variables, constraining the ability to account for unmeasured confounders
  • Dietary intake was based on self-reported data, which is subject to recall bias and misreporting among children
  • Limited to the variables and measurements originally collected, which constrained the ability to account for unmeasured confounders or refine certain outcome assessments
  • Dietary intake was based on self-reported data, which is subject to recall bias and misreporting

Cite This Study

Saeedi et al. (2026) conducted an RCT in Elevated low-density lipoprotein cholesterol (LDL-C) (n=663). Cholesterol-lowering dietary intervention vs. Usual care was evaluated on LDL-cholesterol (LDL-C) trajectory over time (p=0.027). The cholesterol-lowering dietary intervention significantly accelerated the decline in LDL-cholesterol over time compared to usual care (p=0.027), with an estimated difference of 5 mg/dL by month 84.

synapsesocial.com/papers/69e7132bcb99343efc98cf55https://doi.org/10.54103/2282-0930/30207
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