Räsänen Minna, Lehtinen Jan-Christian, Niinikoski Harri, Keskinen Soili, Ruottinen Soile, Salminen Mari, Rönnemaa Tapani, Viikari Jorma, Simell Olli
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
J Am Diet Assoc. 2002 Apr;102(4):518-24. doi: 10.1016/s0002-8223(02)90118-5.
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.
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.
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.
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.
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.
评估参与动脉粥样硬化预防项目的7岁儿童的饮食模式，以及这些饮食模式与营养摄入和血清胆固醇值之间的关系。
在随机、前瞻性的特殊图尔库冠心病危险因素干预项目（STRIP）中，1062名儿童在7个月大时被随机分配到干预组（n = 540；低饱和脂肪、低胆固醇饮食）或对照组（n = 522；无限制饮食）。
研究对象/研究背景：干预家庭每隔6个月接受一次个性化咨询，咨询重点是已知的环境动脉粥样硬化危险因素，旨在降低儿童的饱和脂肪和胆固醇摄入量。营养咨询针对儿童，但由于儿童年龄较小，实际上是向家长提供。当儿童7岁时，使用4天食物记录对307名干预组儿童和323名对照组儿童的食物和营养摄入情况进行了研究。
采用K均值聚类分析，根据食物摄入量的相似性将儿童分为4组。使用Tukey多重比较检验评估4个食物摄入聚类中儿童的营养摄入和血清脂质浓度差异。
干预组儿童主要集中在面包、脱脂牛奶和人造黄油聚类以及谷物、大米和面食聚类中，而含1.5%脂肪的牛奶和黄油聚类主要包括对照组儿童。在面包、脱脂牛奶和人造黄油聚类以及谷物、大米和面食聚类中，饱和脂肪摄入量最接近推荐值，分别为能量的11.7%和11.9%。面包、脱脂牛奶和人造黄油聚类中的儿童膳食纤维摄入量高20%至27%（P <.001），而糖和甜食聚类中的儿童糖摄入量明显高于其他聚类中的儿童（P <.001）。多不饱和脂肪与饱和脂肪饮食比例高的聚类中，血清胆固醇浓度较低。
从儿童7个月大开始，对家长进行详细且反复的饮食咨询，旨在减少儿童接触已知的冠心病营养危险因素，可使儿童的食物模式和营养摄入朝着预期值改变。
