The effect of nutritional intervention on the lipid profile and dietary intake of adolescents with juvenile systemic lupus erythematosus: a randomized, controlled trial

Objective This study sought to evaluate the effects of a nutritional intervention on the lipid metabolism biomarkers associated with cardiovascular risk, and their variation over time, in juvenile systemic lupus erythematosus (JSLE) patients. This study also investigated the relationships between these biomarkers and dietary intake, nutritional status, disease variables, and medication used. Methods A total of 31 10- to 19-year-old female adolescents with JSLE for at least six months were analyzed. The participants were randomly allocated to two groups: nutritional intervention or control. The intervention group received verbal and printed nutritional instructions once per month over nine months. Before and after the intervention, the participants underwent assessments of anthropometrydietary intakephysical activitysocioeconomic statustotal cholesterol and fractionstriglyceridesapolipoprotein A (Apo A-I)apolipoprotein B (Apo B)paraoxonase (PON) activity (a) and amount (q)myeloperoxidase (MPO)and small, dense LDL-c (sdLDL) particles. Results After nine months, we found significant reductions in the calorie, carbohydrate, total fat, saturated fat, and trans fat intakes in the intervention compared with the control group over time. The PONa/HDL-c ratio increased by 3.18 U/ml/mg/dl in the intervention group and by 0.63 U/ml/mg/dl in the control group (p=0.037). Unlike the intervention group, the sdLDL levels of the control group worsened over time (p=0.018). Conclusion The present study detected a reduction in calorie and fat intake, which indicates an improvement of HDL-c function and possible protection against cardiovascular risk for the intervention group.Sao Paulo Research Foundation (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP)Brazilian Federal Agency for Support and Evaluation of Graduate Education (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - CAPES)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Univ Fed Sao Paulo, Dept Pediat, Rua Borges Lagoa 802, BR-04038001 Sao Paulo, SP, BrazilSch Med ABC, Lab Clin Anal, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Sao Paulo, SP, BrazilFac Med ABC, Sch Med ABC, Dept Morphol & Physiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Pediat, Rua Borges Lagoa 802, BR-04038001 Sao Paulo, SP, BrazilFAPESP: 2012/08529-8CNPq: 303752/2015-7Web of Scienc