Evaluation of Mediterranean Diet adherence and nutritional status in children with familial hypercholesterolemia

This study was conducted to evaluate the current nutritional status of children and adolescents with familial hypercholesterolemia and secondary hyperlipidemia, to question their compliance with the Mediterranean diet, and to examine the effect of this compliance on serum lipid profiles. 70 children and adolescents aged 5-18 years, 13 of whom were diagnosed with heterozygous Type IIa familial hypercholesterolemia and 57 with secondary hyperlipidemia by the Pediatric Metabolism and Nutrition Department of Hacettepe University İhsan Doğramacı Children's Hospital, participated in this study. Participants' general characteristics, dietary habits, 24-hour retrospective food consumption records, anthropometric measurements, and biochemical findings including lipid profiles were evaluated. The KIDMED index was used to question the participants' adherence to the Mediterranean diet. 51.4% of the participants were male, 48.6% were female and the mean age was 11.85 years. The mean BMI of participants with familial hypercholesterolemia was 21.79±3.61 kg/m2 and the mean BMI of participants with secondary hyperlipidemia was 21.39±4.86 kg/m2. Children and adolescents with familial hypercholesterolemia consumed more FFA, omega-3, vitamin E and fiber compared to the group with secondary hyperlipidemia (p<0.05). In participants with familial hypercholesterolemia, triglycerides and total cholesterol/HDL-C ratio increased with increasing saturated fat intake (p<0.05). In the same group, as fructose consumption increased, TC, LDL-C and Non-HDL-C levels increased, and as omega-3 consumption increased, LDL-C, TC and Non-HDL-C levels decreased (p<0.05). The KIDMED index ratios of the participants were calculated as 46.2% good, 30.8% moderate, 23.0% poor in the familial hypercholesterolemia group; 26.3% good, 38.6% moderate and 35.1% poor in the secondary hyperlipidemia group. Among the participants with familial hypercholesterolemia, those with good KIDMED scores had lower VLDL-C levels compared to those in the intermediate group (p<0.05). Among the participants with secondary hyperlipidemia, those with poor KIDMED scores had higher Non-HDL-C levels (p<0.05). In the regression analysis of the study, it was found that the risk of poor diet quality increased by 3.4% with a one unit increase in LDL values in all participants (OR=1.034). The study results suggest that the Mediterranean diet may be an effective nutritional model to improve serum lipid profile in children and adolescents with familial hypercholesterolemia and secondary hyperlipidemia.