18 February 2000
Kids who have to eat their way to health
by Kate Melville
One in 500 people have a common inherited disease called heterozygous familial hypercholesterolemia (FH). Kids with the FH gene can't get rid of low-density lipoprotein(LDL), the "bad" cholesterol, strongly linked to heart disease. Two-thirds of men born with one FH gene develop heart disease by 40 if they do not receive treatment. For those unlucky enough to inherit two FH genes, cholesterol levels can become so high that the arteries begin to get blocked in the womb, and heart attacks are likely before reaching 20! However FH sufferers, particularly kids, can now eat a special margarine which significantly reduces blood cholesterol levels. This dietary approach make sense because atherosclerosis, the disease process that underlies heart disease, begins in childhood for FH sufferers and should be treated as early as possible. There are other treatments but these involve drugs whose side effects make it unlikely that children will comply with the regimen over the longer term.
The study that developed the margarine was led by Alpo F. Vuorio, M.D., Ph.D., a post-doctoral fellow at the Finnish Academy's Department of Medicine, University of Helsinki, Finland. Vuorio's team investigated 19 families from North Karelia who carried the FH gene, including four adults and 24 children with the gene and 16 relatives who did not have it.
This group then ate a special margarine containing stanol esters, (derived from pine pulp) for 12 weeks. At the conclusion of the trial, LDL cholesterol levels had fallen by up to 11% in the adults, 18% in the children and 12% in the family members without FH. According to Vuorio, "Finnish North Karelia represents a high-risk coronary heart disease area, probably due to a combination of unfavorable dietary habits and cholesterol-raising genes. This situation led us to conduct the first evaluation of a family therapy to lower cholesterol. We found that even family members who do not have FH decreased their LDL cholesterol levels by about 12% by eating this margarine".
Now while this may sound fantastic the reality is that out of the test group only one child's LDL cholesterol level fell back to the normal range. Nevertheless, the results are significant, as stanol ester margarine seem to be safe, effective and easy to use with children who tend to dislike complex drug therapies.
But this is not something for everyone, and so when spreading the news remind your audience that only people with elevated cholesterol should even consider trying cholesterol-lowering margarines and then only under the guidance of a doctor, i.e. NOT RECOMMENDED FOR CHILDREN OR ADULTS WITH NORMAL CHOLESTEROL LEVELS!