Nutrient intake, weight, and Leu7Pro polymorphism in prepro-neuropeptide Y in children.

CONTEXT: The important role of neuropeptide Y (NPY) in the regulation of food intake and energy balance has been firmly documented in rodents, but human data are sparse. The recently identified functional Leu7Pro polymorphism in the signal peptide region of the prepro-NPY is a useful tool for the investigation of the role of NPY in men. Pro7 substitution has been associated with the following: plasma NPY concentration, the risk factors of cardiovascular disease, birth weight of children, serum triglyceride concentration, and the function of vascular endothelium. OBJECTIVE: The objective of this study was to analyze the connection between Leu7Pro polymorphism and relative weight, nutrient intakes, and serum lipids in early childhood. We closely followed 647 healthy Finnish children participating in the Special Turku Risk Factor Intervention Project through their first 9 yr of life. RESULTS: Leu7Pro polymorphism showed no relation to intakes of energy, macronutrients, or the relative weight in either gender. However, Pro7 substitution was associated with serum triglyceride concentration in boys at the ages of 5, 7, and 9 yr. CONCLUSION: The functional Leu7Pro polymorphism is not likely to be involved in the regulation of adiposity or major nutrient preferences in childhood. In boys, the Pro7 variant may have impact on serum triglyceride concentration.

Serum leptin concentration poorly reflects growth and energy and nutrient intake in young children.

OBJECTIVE: We studied whether the serum leptin concentration at age 2 years predicts changes in relative body weight by age 8 and whether the serum leptin concentration is associated with intake of energy and nutrients at age 5. METHODS: A total of 156 8-year-old participants of the Special Turku Coronary Risk Factor Intervention Project were chosen to represent children whose relative weight decreased, was stable, or increased during the preceding 6 years. Their serum leptin concentrations were measured in samples collected when they were 2 years. Serum leptin was also measured in 100 5-year-old children in the Special Turku Coronary Risk Factor Intervention Project whose energy and nutrient intakes were analyzed using 4-day food records. RESULTS: The boys whose relative weight decreased (n = 25), was stable (n = 28), or increased (n = 26) between 2 and 8 years of age had similar serum leptin concentrations at the age of 2 years. The girls whose relative weight decreased (n = 27) had higher serum leptin concentrations at 2 years than the girls whose relative weight remained stable (n = 26) but only when the leptin values were not adjusted for body mass index. The serum leptin concentration was higher in 5-year-old girls than in 5-year-old boys even when adjusted for body mass index. Serum leptin correlated with relative weight in girls and boys (r = 0.65 and r = 0.45, respectively). Serum leptin concentration adjusted for relative weight correlated poorly with intakes of energy, fat, saturated fat, carbohydrates, sucrose, and protein. CONCLUSIONS: Serum leptin concentrations at age 2 poorly predicted changes in relative body weight during the following 6 years and poorly reflected the intake of energy or major nutrients at age 5.

Effects of diet on the neurologic development of children at 5 years of age: the STRIP project.

OBJECTIVES: To evaluate the effects of diet, serum cholesterol concentrations, and apolipoprotein E phenotype on neurodevelopment of 5-year-old children. STUDY DESIGN: Prospective, 4.4-year cohort study in 496 children. Fat-modified diet was introduced to intervention families of 7-month-old infants. Control children consumed an unrestricted diet. Nutrient intakes, serum cholesterol, and neurodevelopment were studied. The groups were combined in univariate and stepwise multivariate logistic regression analyses. RESULTS: In 13-month-old boys (girls), energy intake was 996 (938) kcal, fat intake 26.6 (26.4) percent of energy (E%), and protein intake 17.2 (17.4) E%. In 5-year-old boys (girls), the intakes were 1484 (1364) kcal, 32.1 (31.9) E%, and 15.5 (15.9) E%, respectively. The intakes of total fat and saturated fat and serum cholesterol were not associated with neurodevelopment. In boys, high intake of protein at 5 years, high intakes of protein at 4 years and cholesterol at 2 years, and high intake of polyunsaturated fatty acids at 3 years predicted favorable outcomes in the tests of speech and language skills, gross motor function and perception, and visual motor skills, respectively. Apolipoprotein E phenotype did not influence the test performance. CONCLUSIONS: Moderate restriction of dietary fat has no unfavorable effects on neurodevelopment in early childhood. However, the quality of fat and the relative intake of protein may influence neurodevelopment of the boys.

Impact of dietary intervention, sex, and apolipoprotein E phenotype on tracking of serum lipids and apolipoproteins in 1- to 5-year-old children: the Special Turku Coronary Risk Factor Intervention Project (STRIP).

The effects of dietary intervention, sex, and apolipoprotein E phenotype on tracking of serum lipid values in young children have remained poorly characterized. We investigated these associations in 1062 infants who were randomized into control and intervention groups (n=522 and n=540, respectively) at age 7 months; the intervention group received counseling aimed at maintaining a low-saturated fat, low-cholesterol diet. In 519 children in the control (n=254) and intervention (n=265) groups, serum lipid values were studied annually between 13 months and 5 years of age. In all children, tracking was strongest for the ratio of high density lipoprotein (HDL) cholesterol to total cholesterol; when a 13-month-old child belonged to the lowest quartile of the distribution, the odds ratio for belonging to the same quartile at older ages was 39.0 (95% CI 23.1 to 66.0). Dietary intervention did not influence the tracking of serum lipids. Tracking of HDL cholesterol was stronger in the boys than in the girls (P=0.018). Tracking of non-HDL cholesterol and apolipoprotein B in the children with phenotypes E2/3 or E3/3 was stronger than that in the other children (P=0.031 and P=0.014, respectively). In conclusion, the apolipoprotein E phenotype strongly influences tracking of non-HDL cholesterol and apolipoprotein B values in early childhood, whereas dietary intervention had no effect on tracking of any of the lipids. A child's sex influenced tracking only of HDL cholesterol, with boys showing stronger tracking.

Recognition of familial dyslipidemias in 5-year-old children using the lipid phenotypes of parents. The STRIP project.

Adult dyslipidemias may reveal familial and, therefore, offspring dyslipidemias. We evaluated the prevalences of the adult-offspring dyslipidemias in 441 general population families composed of both parents and one 5-year-old child. Family members were classified using the 90th or 10th percentiles for hypercholesterolemia (IIA), hypertriglyceridemia (IV), combined hyperlipidemia (IIB), and low high density lipoprotein cholesterol concentration without hyperlipidemia (hypoHDL). In familial combined hyperlipidemia (FCHL), the IIB-phenotype was in one generation and one of the three hyperlipidemias in the other generation. Finally, the parental dyslipidemia phenotypes and elevated lipids (>80th percentile) that reveal offspring dyslipidemia were selected by stepwise logistic regression. Either the IIA-, IV- or hypoHDL phenotype was found in both generations in 2.8, 2.0 and 1.4% of the families, respectively. FCHL was seen in 1.8% of the families, which confirms the earlier views. The predictive values of the elevated parental cholesterol, type IV or hypoHDL parents to find type IIA, IV and hypoHDL children were low for systematic screening: 16, 13 and 15%, respectively. However, 44% of the children of IIB parents expressed hyperlipidemia (odds ratio 4.7, P=0.006). The IIB phenotype of the parent is a good predictor of the child's hyperlipidemia, and when encountered, it indicates that the lipids of the child should be studied. This would be as important as selective screening of familial hypercholesterolemia.

Cardiovascular disease risk factors in young children in the STRIP baby project.

Introducing nutritional principles of preventive cardiology to the care of young children may improve permanently adherence to a low-saturated-fat, low-cholesterol diet later in life. This approach has not been readily adapted because of worries of the possible effects of such a diet on the growth and development of children. In the STRIP baby project, 1062 infants were randomized at 7 months of age into an intervention group (n = 540) or a control group (n = 522). The counselling of the intervention children aimed at a fat intake of 30% of energy after the age of 1 year and to a 1:1:1 ratio in saturated:monounsaturated:polyunsaturated fat intake. Dietary intake, growth and serum lipid concentrations were monitored in the children regularly through the first years of life. The intake of total fat, saturated fat and cholesterol were lower and the intake of polyunsaturated fat and the ratio of polyunsaturated to saturated fat (P/S) in the diet were higher in the intervention children than in the controls. During the first 3 years of the trial, the serum cholesterol concentration was 3-6% lower in the intervention children than in the controls (95% CI for the mean difference between groups from -0.27 to-0.12 mmol/L). No differences in the growth of the children were observed between the groups. We conclude that repeated individualized counselling aiming at reduced consumption of saturated fat combined with regular follow-up is effective and does not restrict the growth of children.