Longitudinal effect of 20-year infancy-onset dietary intervention on food consumption and nutrient intake: the randomized controlled STRIP study

Abstract

Background/objectives: Coronary heart disease begins in childhood and warrants prevention strategies such as dietary modification. The objective was to determine the effect of the Special Turku Coronary Risk Factor Intervention Project (STRIP) dietary intervention on food consumption and nutrient intake over 20-year intervention period.

Subjects/methods: The STRIP is a prospective, randomized trial conducted between 1990 and 2011. Enrolled 6-month-old infants (n = 1062) were randomized to an intervention group (n = 540) receiving dietary counseling biannually from age 7 months to 20 years or control group (n = 522) not receiving any intervention. Food and nutrient intake was assessed annually using 4-day food records. A food-based diet score was calculated.

Results: The intervention led to (1) higher consumption of low-fat unsweetened dairy (β = 177.76, 95% CI 157.36-198.16 g/day), vegetable-oil based fats (β = 6.00, 5.37-6.63 g/day), fish (β = 2.45, 1.44-3.45 g/day), fiber-rich grain products (β = 5.53, 3.17-7.89 g/day), fruits/berries (β = 9.93, 4.44-15.43 g/day), vegetables (β = 11.95, 7.74-16.16 g/day); (2) lower consumption of desserts (β = - 4.10, 95% CI - 6.50 to - 1.70 g/day); (3) lower intake of sucrose (β = - 1.61, 95% CI - 2.88 to - 0.35 g/day), and higher intake of fiber (β = 0.83, 0.55-1.11 g/day), folate (β = 11.14, 95% CI 8.23-14.05 μg/day), vitamin D (β = 0.52, 0.39-0.64 μg/day), C (β = 8.08, 4.79-11.38 mg/day), E (β = 0.93, 0.81-1.05 mg/day), iron (β = 0.31, 0.18-0.44 mg/day), zinc (β = 0.29, 0.17-0.40 mg/day), magnesium (β = 12.17, 9.02-15.33 mg/day), sodium (β = 55.00, 24.40-85.60 mg/day), potassium (β = 157.11, 107.24-206.98 mg/day). No effect was found on nut/seed, red/processed meat, sugar-sweetened beverage, salty snack consumption, or vitamin A and calcium intake. Intervention effect was more pronounced in boys.

Conclusions: The STRIP intervention improved children's diet quality over 20 years, indicating that beneficial dietary changes can be introduced and sustained in youth.