Embargoed for May 3, 1999
Presenter/Contact: Leena Rask-Nissil≈, MD
Neurological Development of 5-Year-Old Children in a Prospective Randomized Trial of a Low-Saturated-Fat, Low-Cholesterol Diet since Infancy: The STRIP Project
Repeated child-targeted dietary counseling during the first five years of life diminishes the age-associated increase in serum cholesterol concentration and is compatible with normal neurological development.
The Special Turku coronary Risk factor Intervention Project (STRIP) is a prospective randomized trial aimed at decreasing exposure of the intervention children to known environmental risk factors. The STRIP project was launched in 1990 in the city of Turku, Finland, recruiting families with five-month-old infants to the trial; 56.5 % of the eligible cohort decided to participate. 1062 seven-month-old infants were randomized to an intervention group and a control group. The intervention group received repeated, individualized dietary counseling, targeted to restrict the intake of saturated fat so that only one third of the total fat intake is saturated, one third monounsaturated and one third polyunsaturated. The recommendation for total fat intake was 30 - 35 % of daily energy for children under three years and 30 % of daily energy thereafter. In practice, the families were advised to continue breastfeeding or to use formula as the milk source until the infant was 1 year old and skimme
In both groups, the parents recorded the food consumption of their child in a food record for 3 - 4 days twice a year. Venous blood samples were drawn at the ages of 7, 13 and 24 months and yearly thereafter. At the age of five years, 496 children underwent a developmental assessment comprising tests of speech and language, gross motor performance, perception and visual motor skills.
The intakes of fat, saturated fat and cholesterol of the intervention children were markedly below the respective values of the control children, and serum cholesterol concentration was continuously 3 % to 5 % lower in the intervention children than in the control children. Neurological development of the intervention children was at least as good as that of the control children, as the relative risk of the intervention children to fail in the developmental assessment was similar than that of the control children. Children, whose fat intake was low (always < 30 E%), managed as well in the developmental assessment than children, whose fat intake was moderate or high (always > 30 E%).
Coronary heart disease (CHD) is an endpoint in a lifelong process. Elevated serum cholesterol values in early adult life associate with high risk of CHD later in life, and modification of dietary fat intake in early childhood might prevent or delay the development of CHD. Thus, it would be reasonable to introduce a healthy diet already during the first years of life, when eating habits are formed.
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Leena Rask-Nissil≈1, Eero Jokinen2, Pirjo Terho3, Helena Lapinleimu4, Tapani R√nnemaa5, Jorma Viikari5, Ilkka V≈lim≈ki4 and Olli Simell4.
1Cardiorespiratory Research Unit, University of Turku, Turku, Finland; 2Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland; 3Department of Child and Adolescent Health Care, City of Turku, Turku, Finland; 4Department of Pediatrics, University of Turku, Turku, Finland and Department of Medicine, University of Turku, Turku, Finland.
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