Prospective, randomized, infancy-onset trial of the effects of a low-saturated-fat, low-cholesterol diet on serum lipids and lipoproteins before school age - The Special Turku coronary Risk factor Intervention Project (STRIP)

Background-We showed previously that repeated dietary counseling during the first 3 years of life reduces the concentration of serum nonfasting choles terol. We have now extended the study to children 5 years of age and analyz ed fasting blood samples, enabling LDL cholesterol calculations for the fir st time. Methods and Results-Families of 7-month-old infants (n=1062) were randomize d to a control group (n=522) or an intervention group (n=540) that received individualized dietary counseling with the aims of a fat intake of 30% to 35% of daily energy, a saturated/monounsaturated/polyunsaturated fatty acid ratio of 1:1: 1, and a cholesterol intake of <200 mg/d, Nutrient intakes w ere studied biannually, nonfasting serum lipid values were studied annually . and fasting values were studied at 5 years of age. The intervention child ren always had lower intakes of saturated fat and cholesterol than the cont rol children. The intervention boys had 0.39 mmol/L (P<0.0001) lower mean s erum cholesterol values than the control boys between 13 and 60 months of a ge, but among girls, the difference was of marginal significance (0.15 mmol /L, P=0.052). Five-year-old intervention boys had 9% lower mean serum LDL c holesterol concentrations than the control boys (P=0.0002; 95% CI, -0.39 to -0.12 mmol/L), whereas no difference was observed in girls. In both sexes, serum triglyceride concentrations were similar in the 2 groups. Conclusions-The restriction of saturated fat and cholesterol intake by repe ated, individualized dietary counseling since infancy resulted in lower ser um total and LDL cholesterol concentrations at 5 years of age. However, the effect was significant only in boys.