Published online before print December 5, 2005, doi: 10.1161/CIRCULATIONAHA.105.583195
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(Circulation. 2005;112:3786-3794.)
© 2005 American Heart Association, Inc.
Pediatric Cardiology |
Endothelial Function in Healthy 11-Year-Old Children After Dietary Intervention With Onset in Infancy
The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP)
From the Departments of Clinical Physiology (O.T.R.), Medicine (T.R., J.S.A.V.), Research Centre of Applied and Preventive Cardiovascular Medicine (M.J.J, T.K, I.V., K.K., H.L.), and Pediatrics (H.N., O.S.), University of Turku, Turku, Finland, and Hospital for Children and Adolescents (E.J.), University of Helsinki, Helsinki, Finland.
Correspondence to Olli T. Raitakari, MD, PhD, Department of Clinical Physiology, University of Turku, PO Box 52, FIN-20521 Turku, Finland. E-mail olli.raitakari{at}utu.fi
Received April 6, 2005; de novo received August 16, 2005; revision received September 27, 2005; accepted October 7, 2005.
Background— Early childhood introduction of nutritional habits aimed at atherosclerosis prevention reduces children’s serum total cholesterol concentration, but its effect on vascular endothelial function is unknown.
Methods and Results— Between 1990 and 1992, we randomized healthy 7-month-old infants (n=1062) to intervention (low-saturated-fat diet) and control (unrestricted diet) groups. At the age of 11 years, endothelium-dependent (flow-mediated) and endothelium-independent (nitrate-mediated) vasodilatory responses of the brachial artery were measured with high-resolution ultrasound in 179 intervention and 190 control children. The effect of intervention on endothelial function was significant in boys (P=0.0034) but not in girls (P=0.69). The maximum endothelium-dependent dilation response (mean±SD) was 9.62±3.53% and 8.36±3.85% in intervention boys and control boys and 8.84±4.00% and 8.44±3.60% in intervention girls and control girls, respectively. Intervention had no effect on nitrate-mediated dilation. The difference in endothelial function in boys remained significant after adjustment for current serum total or LDL cholesterol but became nonsignificant after adjustment for mean cholesterol measured under 3 years of age (adjusted means: 9.46% [CI 8.68% to 10.24%] versus 8.54% [CI 7.75% to 9.32%], P=0.11).
Conclusions— A low-saturated-fat diet introduced in infancy and maintained during the first decade of life is associated with enhanced endothelial function in boys. The effect is explained in part by the diet-induced reduction in serum cholesterol concentration.
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