(Circulation. 2000;102:1477.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Prospective, Randomized, Infancy-Onset Trial of the Effects of a Low-Saturated-Fat, Low-Cholesterol Diet on Serum Lipids and Lipoproteins Before School Age
The Special Turku Coronary Risk Factor Intervention Project (STRIP)
From the Cardiorespiratory Research Unit (L.R.-N., A.T.), Departments of Pediatrics (H.N., O.S.), Medicine (T.R., J.V.), and Biostatistics (J.T.), University of Turku, Turku, Finland; Hospital for Children and Adolescents (E.J.), Helsinki, Finland; and Research and Development Unit of Social Insurance Institution (R.S.), Turku, Finland.
Correspondence to Dr Leena Rask-Nissilä, Cardiorespiratory Research Unit, University of Turku, Kiinamyllynkatu 10, FIN-20 520 Turku, Finland. E-mail leena.rask-nissila{at}utu.fi
Background—We showed previously that repeated dietary counseling during the first 3 years of life reduces the concentration of serum nonfasting cholesterol. We have now extended the study to children 5 years of age and analyzed fasting blood samples, enabling LDL cholesterol calculations for the first time.
Methods and Results—Families of 7-month-old infants (n=1062) were randomized to a control group (n=522) or an intervention group (n=540) that received individualized dietary counseling with the aims of a fat intake of 30% to 35% of daily energy, a saturated/monounsaturated/polyunsaturated fatty acid ratio of 1:1:1, and a cholesterol intake of <200 mg/d. Nutrient intakes were studied biannually, nonfasting serum lipid values were studied annually, and fasting values were studied at 5 years of age. The intervention children always had lower intakes of saturated fat and cholesterol than the control children. The intervention boys had 0.39 mmol/L (P<0.0001) lower mean serum cholesterol values than the control boys between 13 and 60 months of age, but among girls, the difference was of marginal significance (0.15 mmol/L, P=0.052). Five-year-old intervention boys had 9% lower mean serum LDL cholesterol concentrations than the control boys (P=0.0002; 95% CI, -0.39 to -0.12 mmol/L), whereas no difference was observed in girls. In both sexes, serum triglyceride concentrations were similar in the 2 groups.
Conclusions—The restriction of saturated fat and cholesterol intake by repeated, individualized dietary counseling since infancy resulted in lower serum total and LDL cholesterol concentrations at 5 years of age. However, the effect was significant only in boys.
Key Words: atherosclerosis • cholesterol • diet • pediatrics • prevention
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