HEAT Dietary Assessment Tool Useful for Children With Dyslipidemia

In pediatric patients with dyslipidemia the 10-point HEAT assessment tool may be useful for determining dietary compliance

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.”


Wong JP, DiLauro S, Collins T, Chahal N, McCrindle BW. The Healthy Eating Assessment Tool (HEAT): a simplified 10-point assessment of CHILD-2 dietary compliance for children and adolescents with dyslipidemia. Abstract presented at: National Lipid Association (NLA) Scientific Sessions 2023; June 1-4, 2023; Atlanta, GA. Abstract #159