PROSPECTIVE RANDOMIZED TRIAL OF LOW-SATURATED-FAT, LOW-CHOLESTEROL DIET DURING THE FIRST 3 YEARS OF LIFE - THE STRIP BABY PROJECT

Background The long-term consequences of modified fat rake in early ch ildhood are poorly known. The randomized prospective STRIP baby projec t evaluates the effects of repeated dietary counseling on nutrient int akes and serum lipid values in children 7 months to 3 years old. Metho ds and Results One thousand sixty-two infants were randomized to inter vention and control groups at 7 months of age. The families of the 540 intervention children were counseled to reduce the child's intake of saturated fat and cholesterol but to ensure adequate energy intake. Fi ve hundred twenty-two control children consumed an unrestricted diet. Food records were kept. and serum lipids were measured at 5- to 12-mon th intervals. Intakes of saturated fat, fat as proportion of energy (E %), and cholesterol were lower in the intervention children than in co ntrol children at 13.24, and 36 months of age. Fat intake by the inter vention children decreased from 29+/-5 E% at 8 months of age to 26+/-6 E% at 13 months and then increased to 30+/-5 E% at 24 months and to 3 1+/-5 E% at 36 months. The control children consumed 29+/-4 E%, 28+/-5 E%, 33+/-5 E%, and 33+/-5 E% of fat at 8, 13, 24, and 36 months, resp ectively. The ratio of dietary polyunsaturated to saturated fats of th e intervention children was consistently higher than that of the contr ol children (P<.0001). Base-line adjusted mean serum cholesterol conce ntration was lower in the intervention children than control children between 13 and 36 months (P<.0001: 95% confidence interval of the diff erence between the group means, -0.27 to -0.12 mmol/L). The effect was significant only in boys (95% confidence interval, -0.39 to -0.20 mmo l/L in boys; -0.21 to 0.01 mmol/L in girls). Conclusions Repeated indi vidualized dietary counseling markedly reduces the increase in serum c holesterol concentration that occurs in control children during the fi rst years of life.