Lagström H, Jokinen E, Seppänen R, Rönnemaa T, Viikari J, Välimäki I, Venetoklis J, Myyrinmaa A, Niinikoski H, Lapinleimu H, Simell O
Cardiorespiratory Research Unit, University of Turku, Finland.
Arch Pediatr Adolesc Med. 1997 Feb;151(2):181-8. doi: 10.1001/archpedi.1997.02170390071013.
To evaluate the impact of individualized and repeatedly given dietary counseling on fat intake and nutrient intake of children aged 8 months to 4 years.
Prospective randomized clinical trial.
Children (N = 1062) from 1054 families were randomized to an intervention (n = 540) or a control (n = 522) group when each child participant was 6 months old.
The children in the intervention group were counseled to reduce their intake of saturated fat and cholesterol but to ensure their adequate energy intake. Dietary issues were discussed with the families of the children in the control group only briefly according to the current practice of well-baby clinics.
Food consumption was evaluated by using 3- and 4-day food records that were kept at 5- to 12-month intervals, and nutrient intakes were analyzed with a Micro Nutrica computer program (Social Insurance Institution, Turku, Finland).
The intake of fat (29% of the energy intake) and cholesterol (70 mg) showed no differences between the groups of children at 8 months of age. The fat intake in the children in the intervention group was then continuously 2% of the energy intake below that of the children in the control group (P < .001). After the age of 13 months, the cholesterol intake of the children in the control group exceeded that of the children in the intervention group by 20 mg (P < .001). The children in the intervention group consumed 3% (of the energy intake) less saturated (P < .001) and 1% (of the energy intake) more polyunsaturated fats (P < .001) than did the children in the control group at age 13 months and older. The carbohydrate intake was slightly higher in the children in the intervention group than in the children in the control group. Intakes of vitamins, minerals, and trace elements showed no differences between the 2 groups.
The intakes of fat by the children in the intervention and control groups were markedly below values that were recommended for the first 2 years of life. Despite the low intake of fat, the intake of other nutrients fulfilled current recommendations, except for vitamin D and iron. Individualized dietary counseling that led to clear changes in the type of fat intake had a minimal effect on vitamin or mineral intakes.
评估个性化且反复进行的饮食咨询对8个月至4岁儿童脂肪摄入量和营养素摄入量的影响。
前瞻性随机临床试验。
来自1054个家庭的1062名儿童在每个儿童参与者6个月大时被随机分为干预组(n = 540)或对照组(n = 522)。
建议干预组儿童减少饱和脂肪和胆固醇的摄入量,但要确保充足的能量摄入。对照组儿童的家庭仅根据健康婴儿诊所的现行做法简要讨论饮食问题。
使用间隔5至12个月记录的3天和4天食物记录评估食物消耗情况,并使用Micro Nutrica计算机程序(芬兰图尔库社会保险机构)分析营养素摄入量。
8个月大时,两组儿童的脂肪摄入量(占能量摄入量的29%)和胆固醇摄入量(70毫克)无差异。此后,干预组儿童的脂肪摄入量持续比对照组儿童低能量摄入量的2%(P <.001)。13个月龄后,对照组儿童的胆固醇摄入量比干预组儿童高20毫克(P <.001)。13个月及以上时,干预组儿童摄入的饱和脂肪比对照组儿童少能量摄入量的3%(P <.001),多不饱和脂肪比对照组儿童多能量摄入量的1%(P <.001)。干预组儿童的碳水化合物摄入量略高于对照组儿童。两组儿童的维生素、矿物质和微量元素摄入量无差异。
干预组和对照组儿童的脂肪摄入量均明显低于生命最初2年的推荐值。尽管脂肪摄入量较低,但除维生素D和铁外,其他营养素的摄入量符合当前推荐标准。导致脂肪摄入类型明显改变的个性化饮食咨询对维生素或矿物质摄入量的影响极小。