EFFECT OF DIETARY-FAT ON CARDIOVASCULAR RISK-FACTORS IN INFANCY

Objective. To determine the effects of feeding regimens of varying fat composition on dietary intake and serum lipid and lipoprotein concent rations in older infants. Design, setting, and participants. One hundr ed four healthy infants aged 4 to 6 months were enrolled from private pediatric practices or public health clinics and were randomly assigne d to one of four feeding groups until 12 months of age. Interventions. Infants received whole cow milk or a standard infant formula (48% to 49% of energy as fat from butterfat or a soy-coconut oil blend, respec tively) or one of two nearly identical investigational lower fat follo w-up formulas (36% kcal from a fat blend of palm olein, corn, and saff lower oils) as their primary food source in addition to table foods. M ain outcome measures. Nutrient intakes during the study period were ch aracterized qualitatively and quantitatively. Serum lipids, lipoprotei n concentrations, and anthropometrics were determined at baseline and at 12 months of age (study completion). Results. Total energy intake w as equivalent among feeding groups. Infants fed cow milk had higher me an daily intakes of total fat, saturated fat, monounsaturated fat, and cholesterol. Linoleic acid intake by infants fed cow milk, including that from table foods, was insufficient to meet current recommendation s. Mean serum total cholesterol was significantly higher in the infant s fed cow milk at age 12 months, whereas mean low density lipoprotein and apolipoprotein B were lower in the infants fed the follow-up formu las. Infants consuming the infant formula or whole cow milk demonstrat ed greater increases in mean serum total cholesterol, low density lipo protein, and apolipoprotein B by 12 months of age compared with infant s ingesting follow-up formula. Ponderal, linear, and head circumferenc e growth was equivalent among feeding groups. Conclusions. (1) Older i nfants fed lower fat formula have adequate total energy intake and nor mal growth. (2) The fat composition of the diets fed to the infants in fluenced serum lipid and lipoprotein profiles. (3) The fat composition of cow milk is inferior compared with commercial formulas. (4) The op timal fat blend for older infants including the consequences of the st andard practice of adding high percentage of coconut oil to infant for mulas should be defined further.