HEAT Dietary Assessment Tool Useful for Children With Dyslipidemia

A 10-point assessment tool may be effective for assessing Cardiovascular Health Integrated Lifestyle Diet (CHILD-2) dietary compliance in children and adolescents with dyslipidemia, according to study results presented at the National Lipid Association (NLA) Scientific Sessions 2023, held in Atlanta, Georgia, between June 1 and June 4, 2023.

The prospective, cross-sectional study evaluated use of the Healthy Eating Assessment Tool (HEAT) in meeting dietary fat and cholesterol restriction cut points of CHILD-2 and its association with adiposity and lipid variable markers. The study enrolled patients aged 2 to 18 years from a pediatric dyslipidemia clinic over 2 years.

The researchers assessed the association between individual HEAT scores and HEAT score categories (poor, 0-4.5; fair, 5-6.5; good, 7-8.5; and excellent, 9-10; analysis of variance) and factors such as nutritional analysis findings of 7-day food records, body mass index (BMI) z-score, waist-to-height ratio, and lipid variables.

Participants who had the highest HEAT scores (good, 43%; excellent, 64%) met the CHILD-2 cut point of less than 25% total fat calories (P =.03), with a nonsignificant trend (P =.08) for saturated fat to less than 8% of total daily calories (excellent, 64%).

Having a lower HEAT score was associated with an increased BMI z-score (r = -0.31, P <.01) and waist-to-height ratio (r = -0.31, P <.01).

No association was observed between HEAT score and any lipid variable after adjustment for age, sex, amount of moderate to vigorous physical activity, hours of screen time, use of lipid-lowering medications, BMI z-score, and waist-to-height ratio.

“HEAT score associations with meeting CHILD-2 fat targets were modest, with more consistent associations with markers of adiposity, and no independent association with lipid levels,” wrote the study authors. “While fat-restricted diets are safe, they are not particularly effective for treatment of dyslipidemia or for weight management alone. The HEAT may be a more useful and simplified way of assessing and tracking broader dietary goals in clinical practice.”