PROSPECTIVE RANDOMIZED TRIAL IN 1062 INFANTS OF DIET LOW IN SATURATEDFAT AND CHOLESTEROL

Interventions to avoid atherosclerosis might be more successful if lau nched early in life when eating and lifestyle patterns are formed, but dietary interventions have been limited by fears of diet-induced grow th failure. We investigated the effects of a diet low in saturated fat and cholesterol on serum lipid concentrations and growth in 1062 heal thy 7-month-old infants in a randomised study. Every 1-3 months, famil ies in the intervention group received dietary advice aimed at adequat e energy supply, with low fat intake (30-35% energy, polyunsaturated/ monounsaturated/saturated fatty acid ratio 1/1/1, and cholesterol inta ke <200 mg daily). Infants in control families consumed an unrestricte d diet. 3-day food records were collected at ages 8 and 13 months. Gro wth was carefully monitored. Between 7 and 13 months serum cholesterol and non-high-density-lipoprotein cholesterol concentrations did not c hange significantly in the intervention group (mean change -0.03 [SD 0 .72] mmol/L and 0.01 [0.67] mmol/L) but increased substantially in the control group (0.24 [0.64] mmol/L and 0.23 [0.60] mmol/L; p for diffe rence in mean changes between groups <0 001). Daily intakes of energy and saturated fat were lower in the intervention than in the control g roup at 13 months (4065 [796] vs 4370 [748] kJ, p=0.033, and 9.3 [3.5] vs 14.5 [4.8] g, p<0.001, respectively), and intake of polyunsaturate d fat was higher (5.8 [2.2] vs 4.4 [1.4] g, p<0.001). Growth did not d iffer between the groups and was as expected for children at this age. Serum cholesterol concentrations fell significantly in parents of int ervention-group infants. The increases in serum cholesterol and non-hi gh-density-lipoprotein cholesterol concentration that occur in infants between the ages of 7 and 13 months can be avoided by individualised diets, with no effect on the children's growth.