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(Circulation. 2007;116:1032-1040.)
© 2007 American Heart Association, Inc.

Pediatric Cardiology

Impact of Repeated Dietary Counseling Between Infancy and 14 Years of Age on Dietary Intakes and Serum Lipids and Lipoproteins

The STRIP Study

Harri Niinikoski, MD, PhD; Hanna Lagström, PhD; Eero Jokinen, MD, PhD; Marja Siltala, MS; Tapani Rönnemaa, MD, PhD; Jorma Viikari, MD, PhD; Olli T. Raitakari, MD, PhD; Antti Jula, MD, PhD; Jukka Marniemi, PhD; Kirsti Näntö-Salonen, MD, PhD; Olli Simell, MD, PhD

From the Departments of Pediatrics (H.N., K.N.-S., O.S.), Medicine (T.R., J.V.), and Clinical Physiology (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (H.L., M.S.), University of Turku, Turku; National Public Health Institute, Turku (A.J., J.M.); and Department of Paediatrics, University of Helsinki, Helsinki (E.J.), Finland.

Reprint requests to Harri Niinikoski, MD, PhD, Department of Pediatrics, University of Turku, Kiinamyllynkatu 4–8, 20520 Turku, Finland. E-mail harri.niinikoski{at}tyks.fi

Received February 27, 2007; accepted June 15, 2007.

Background— Atherosclerosis development might be delayed or prevented by dietary measures. The aims of the present study were to evaluate the effect of low-saturated-fat, low-cholesterol dietary counseling on fat intakes, growth, serum cholesterol values, and pubertal development in children and adolescents.

Methods and Results— In the randomized prospective Special Turku Coronary Risk Factor Intervention Project (STRIP), a low-saturated-fat, low-cholesterol diet was introduced to intervention infants (n=540) at 7 months of age, and control children (n=522) received an unrestricted diet. Dietary intakes, serum cholesterol values, somatic growth, and development were followed up throughout childhood and adolescence. Saturated fat intakes, serum total cholesterol, and low-density lipoprotein cholesterol values were lower (P<0.001) in the intervention than in control children during the 14 years, whereas high-density lipoprotein cholesterol values in the 2 study groups showed no difference. Boys had lower total and low-density lipoprotein cholesterol concentrations than girls throughout childhood (P<0.001), and the intervention effect on serum cholesterol concentration was larger in boys than girls. The 2 study groups showed no difference in growth, body mass index, pubertal development, or age at menarche (median, 13.0 and 12.8 years in the intervention and control girls, respectively; P=0.52). The cholesterol values decreased as puberty progressed. Mean concentrations of total and high-density lipoprotein cholesterol decreased from 4.5 and 1.4 mmol/L, respectively, in Tanner stage 1 (prepubertal) boys to 3.9 and 1.1 mmol/L in Tanner stage 4 (late pubertal) boys.

Conclusions— Repeated dietary counseling remains effective in decreasing saturated fat and cholesterol intake and serum cholesterol values at least until 14 years of age. Puberty markedly influences serum cholesterol concentrations.

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Impact of Repeated Dietary Counseling Between Infancy and 14 Years of Age on Dietary Intakes and Serum Lipids and Lipoproteins: The STRIP Study

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