Achievement of the Targets of the 20-Year Infancy-Onset Dietary Intervention-Association with Metabolic Profile from Childhood to Adulthood

Abstract

The Special Turku Coronary Risk Factor Intervention Project (STRIP) is a prospective infancy-onset randomized dietary intervention trial targeting dietary fat quality and cholesterol intake, and favoring consumption of vegetables, fruit, and whole-grains. Diet (food records) and circulating metabolites were studied at six time points between the ages of 9-19 years (n = 549-338). Dietary targets for this study were defined as (1) the ratio of saturated fat (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) < 1:2, (2) intake of SAFA < 10% of total energy intake, (3) fiber intake ≥ 80th age-specific percentile, and (4) sucrose intake ≤ 20th age-specific percentile. Metabolic biomarkers were quantified by high-throughput nuclear magnetic resonance metabolomics. Better adherence to the dietary targets, regardless of study group allocation, was assoiated with higher serum proportion of PUFAs, lower serum proportion of SAFAs, and a higher degree of unsaturation of fatty acids. Achieving ≥ 1 dietary target resulted in higher low-density lipoprotein (LDL) particle size, lower circulating LDL subclass lipid concentrations, and lower circulating lipid concentrations in medium and small high-density lipoprotein subclasses compared to meeting 0 targets. Attaining more dietary targets (≥2) was associated with a tendency to lower lipid concentrations of intermediate-density lipoprotein and very low-density lipoprotein subclasses. Thus, adherence to dietary targets is favorably associated with multiple circulating fatty acids and lipoprotein subclass lipid concentrations, indicative of better cardio-metabolic health.

Keywords: diet; metabolic profiling; metabolomics; primordial prevention; quality of diet.

Figure 1

Differences in circulating serum fatty acids between achieving the dietary targets compared to achieving none of the dietary targets. Effect estimates are standard deviation scaled differences between achieving zero dietary targets with respect to achieving ≥1 (red) or ≥2 (blue) of the targets. Error bars indicate 95% confidence intervals. Metabolic measures are from pooled analyses across the six time points; n-3 fatty acids/total FA denotes the ratio of omega-3 fatty acids to total fatty acids; PUFA, polyunsaturated fatty acids; MUFA, monounsaturated fatty acids; SAFA, saturated fatty acids; DHA, docosahexaenoic acid; LA, linoleic acid.

Figure 2

Differences in serum lipid measures between achieving the dietary targets compared to achieving none of the dietary targets. Effect estimates are standard deviation scaled differences between achieving zero dietary targets with respect to achieving ≥1 (red) or ≥2 (blue) of the targets. Error bars indicate 95% confidence intervals. Lipid measures are from pooled analyses across the six time points, and those with skewed distributions were log(x + 1)-transformed prior to analyses. C, cholesterol; HDL, high-density lipoprotein; LDL, low-density lipoprotein; VLDL, very low-density lipoprotein; IDL, intermediate-density lipoprotein.

Figure 3

Differences in circulating metabolites between achieving the dietary targets compared to achieving none of the dietary targets. Effect estimates are standard deviation scaled differences between achieving zero dietary targets with respect to achieving ≥1 (red) or ≥2 (blue) of the targets. Error bars indicate 95% confidence intervals. Metabolic measures are from pooled analyses across the six time points, and those with skewed distributions were log(x + 1)-transformed prior to the analyses.