Simell O, Niinikoski H, Rönnemaa T, Lapinleimu H, Routi T, Lagström H, Salo P, Jokinen E, Viikari J
Departments of Pediatrics and Medicine and the Cardiorespiratory Research Unit, University of Turku, Finland.
Am J Clin Nutr. 2000 Nov;72(5 Suppl):1316S-1331S. doi: 10.1093/ajcn/72.5.1316s.
Introducing nutritional and lifestyle principles to children in late infancy may permanently improve their adherence to a low-saturated fat, low-cholesterol diet, thus reducing of coronary risk factors, but worries about possible effects on growth and development have hampered such an approach.
The Special Turku Coronary Risk Factor Intervention Project for Babies (STRIP) aimed to decrease exposure to known environmental atherosclerosis risk factors in children 7-36 mo of age.
Repeated, individualized counseling aimed at promoting a fat intake of 30% of energy and a 1:1:1 ratio of saturated to monounsaturated to polyunsaturated fat intake was provided (n = 540 intervention children; 284 boys). Nutrition was discussed superficially with the families of the control children (n = 522; 266 boys) and food intake was recorded at 3-6-mo intervals by use of 3-4-d food diaries. Serum lipids were measured at 6-12-mo intervals and growth was monitored regularly.
Fat intake of the intervention (control) children provided 29.5% (29.4%) of energy at the age of 8 mo, 26.6% (28.5%) of energy at 13 mo, 30.5% (33.5%) of energy at 24 mo, and 31. 5% (33.5%) of energy at 36 mo. The intervention children consistently consumed less saturated fat than did the control children (P: <0.0001). Recommended intakes of other nutrients (except vitamin D and occasionally iron) were reached irrespective of the amount and type of dietary fat. Serum cholesterol, non-HDL cholesterol, and HDL-cholesterol concentrations were 3-6% lower in the intervention children than in the control children. The intervention had no effect on height, weight, or head circumference gain. Fat intake did not predict children's growth patterns.
Repeated, individualized counseling in early childhood aimed at reducing consumption of saturated fat and cholesterol was effective and feasible and did not restrict growth in circumstances in which children were regularly monitored.
在婴儿晚期向儿童介绍营养和生活方式原则可能会永久性地提高他们对低饱和脂肪、低胆固醇饮食的依从性，从而降低冠心病风险因素，但对生长发育可能产生的影响的担忧阻碍了这种方法的实施。
图尔库婴儿特殊冠心病风险因素干预项目（STRIP）旨在减少7至36个月大儿童接触已知的环境动脉粥样硬化风险因素。
提供反复的个性化咨询，旨在促进脂肪摄入量占能量的30%，饱和脂肪、单不饱和脂肪与多不饱和脂肪的摄入量比例为1:1:1（n = 540名干预儿童；284名男孩）。对对照儿童的家庭进行了表面的营养讨论（n = 522名；266名男孩），并通过使用3至4天的食物日记，每隔3至6个月记录一次食物摄入量。每隔6至12个月测量一次血脂，并定期监测生长情况。
干预组（对照组）儿童在8个月大时脂肪摄入量占能量的29.5%（29.4%），13个月大时占26.6%（28.5%），24个月大时占30.5%（33.5%），36个月大时占31.5%（33.5%）。干预组儿童始终比对照组儿童摄入更少的饱和脂肪（P：<0.0001）。无论膳食脂肪的量和类型如何，其他营养素（维生素D和偶尔的铁除外）的推荐摄入量均能达到。干预组儿童的血清胆固醇、非高密度脂蛋白胆固醇和高密度脂蛋白胆固醇浓度比对照组儿童低3%至6%。干预对身高、体重或头围增长没有影响。脂肪摄入量不能预测儿童的生长模式。
在幼儿期进行反复的个性化咨询，旨在减少饱和脂肪和胆固醇的摄入量是有效且可行的，并且在对儿童进行定期监测的情况下不会限制生长。
