A randomized intervention since infancy to reduce intake of saturated fat: calorie (energy) and nutrient intakes up to the age of 10 years in the Special Turku Coronary Risk Factor Intervention Project.

OBJECTIVE: To evaluate the longitudinal impact of dietary counseling on children's nutrient intake. DESIGN: A prospective, randomized, clinical trial. PARTICIPANTS: Children were recruited to the study between December 1, 1989, and May 30, 1992. At the age of 7 months, children were randomized to the intervention group (n = 540) or the control group (n = 522) and were followed up until the age of 10 years. Intervention Families in the intervention group have, since randomization, received regularly individualized counseling about how to modify the quality and quantity of fat in the child's diet, the goal being an unsaturated-saturated fat ratio of 2:1. MAIN OUTCOME MEASURES: Nutrient intakes between the ages of 4 and 10 years based on annual 4-day food records. RESULTS: The fat intake of the intervention children was constantly around 30% of the calorie (energy) intake, while that of the control children was 2 to 3 calorie percentage units higher (P<.001). The intervention children received 2 to 3 calorie percentage units less saturated fats and 0.5 to 1.0 calorie percentage unit more polyunsaturated fats than the control children (P<.001 for both). However, neither group reached the 2:1 goal set for the unsaturated-saturated fatty acid ratio. The vitamin and mineral intakes of the intervention and control children closely resembled each other despite the marked differences in fat intake. CONCLUSION: Individualized, biannually given, fat intake-focused dietary counseling that began at the child's age of 8 months continued to influence favorably the diet of 4- to 10-year-old intervention children without disadvantageous dietary effects, but the 2:1 goal for unsaturated-saturated fat ratio was not reached.

Dietary patterns and nutrient intakes of 7-year-old children taking part in an atherosclerosis prevention project in Finland.

OBJECTIVE: To evaluate the dietary patterns of 7-year-old children participating in an atherosclerosis prevention project and the relationship of those dietary patterns to nutrient intakes and serum cholesterol values. DESIGN: In the randomized, prospective Special Turku Coronary Risk Factor Intervention Project (STRIP) 1,062 children were randomly assigned to an intervention group (n=540; low-saturated fat, low-cholesterol diet) or to a control group (n=522; unrestricted diet) at 7 months of age. SUBJECTS/SETTINGS: The intervention families received, at 6-month intervals, individualized counseling that focused on the known environmental atherosclerosis risk factors and aimed at reducing children's saturated fat and cholesterol intake. Nutrition counseling was targeted at the child but, because of the young age of the children, was given to the parents. When children were 7 years old, food and nutrient intakes of 307 intervention and 323 control children were studied using 4-day food records. STATISTICAL ANALYSES PERFORMED: K-means cluster analysis was used to classify children into 4 groups on the basis of similarity of food intake. Differences in nutrient intakes and serum lipid concentrations between children in the 4 food intake clusters were evaluated using Tukey's multiple comparison test. RESULTS: Intervention children dominated the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster whereas the 1.5%-fat milk and butter cluster included mainly control children. Saturated fat intake was nearest to the recommendations, that is 11.7% and 11.9% of energy, in the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster, respectively. Children in the bread, skim milk, and margarine cluster had 20% to 27% higher fiber intakes (P<.001) whereas children in the sugar and sweets cluster had markedly higher sugar intakes than children in other clusters (P<.001). Serum cholesterol concentrations were lower in those clusters with high dietary ratios of polyunsaturated to saturated fat. CONCLUSION: Detailed and repeated dietary counseling of parents, starting when children are aged 7 months, that aims at decreasing children's exposure to known nutrition risk factors for coronary heart disease modifies children's food patterns and nutrient intakes toward expected values.