Effects of reduced dietary fat intake on lipid and vitamin E status in 12–14 year-old children and adolescents during a weight reduction program

Background: High energy intake is usually associated with high fat intake and, consequently, reduction of energy intake is inevitably associated with reduced fat intake. In children and adolescents a balanced diet meeting age- and sex-specific macro- and micronutrient requirements is recommended even during weight reduction programs to ensure that there is no negative impact on growth and development. Study purpose: In the MODUL (Mitmachen ohne Diät – ultraleicht) Study we focused on the effects of a weight reduction program on lipid and fat-soluble vitamin status. Methods: Twenty-five children and adolescents 12–14yrs of age with BMI >97 th age- and sex-specific percentile participated in a 6-month follow-up study. The effects of dietary intervention were studied on blood tests before and at 5 time points during the program. Five-day prospective dietary records were completed before and diet diaries kept throughout the inter-vention period. Results: Reduction of dietary fat intake from 91±25g/d (37±5.3 energy%) to 40±13g/d (29±2.8 energy%) was associated with a significant reduction of vitamin E intake (11±5.1mg/d versus 6.6±1.7mg/d). There was a significant reduction in plasma total cholesterol and LDL cholesterol, as well as triglyceride and ApoB concentrations, while HDL cholesterol concentrations did not change. Plasma alpha-tocopherol concentrations dropped significantly, as did, interestingly, also ratios of alpha-tocopherol to cholesterol, while similar changes were not observed for gamma-tocopherol. Plasma alpha-tocopherol concentrations decreased to concentrations that were borderline or even indicative of biochemical vitamin E deficiency, i.e. below the age-specific mean minus 2 SD. A 4-week supplementation of 100mg/d of alpha-tocopherol completely restored vitamin E status. Conclusions: Reduction of dietary fat intake is associated with reduced vitamin E intake that eventually leads to impaired vitamin E status, which can be easily restored with low doses of vitamin E even in the presence of continued reduced dietary fat intake.