Growth until 3 years of age in a prospective, randomized trial of a diet with reduced saturated fat and cholesterol

Abstract

Objective: Modification of fat intake in childhood may decrease children's future risk for atherosclerosis. Excessive changes in fat intake have been linked with possible growth failure. This study evaluates the effects of a low-saturated fat diet on growth during the first 3 years of life.

Design: Half of 1062 healthy infants were randomized at 7 months of age to the intervention group (n = 540) to receive at 1- to 6-month intervals individualized dietary counseling aimed at reducing their exposure to atherosclerosis risk factors. Five hundred twenty-two children served as control children. Growth and serum lipids were measured regularly, and nutrient intakes were analyzed using 3- to 4-day food records at 5- to 12-month intervals.

Results: The intervention children consistently consumed slightly less energy than did the control children. The mean fat intake of children in both groups was lower than expected, especially during the first 2 years of life (29.0 [SD, 4.7] percentage of energy intake [E%] and 28.8 [4.1] E% in the intervention and control children, respectively, at 8 months, formula-fed children only). At 13, 24, and 36 months, fat intake in the intervention and control children accounted for 26.2 (6.0) and 27.9 (4.9) E%, 29.9 (5.0) and 32.8 (4.8) E%, and 30.8 (4.9) and 33.2 (4.6) E%, respectively. From 13 to 36 months, the baseline adjusted mean serum cholesterol concentration was lower in the intervention children than the control children (95% confidence interval for the difference between means, -0.27 to -0.12 mmol/L). The true mean of the height of the boys in the intervention group during the trial was at most 0.34 cm more or 0.57 cm less (95% confidence interval), and the weight was at most 0.19 kg more or 0.22 kg less than that of the control boys. The respective values for girls were at most 0.77 cm more or 0.16 cm less and at most 0.42 kg more or 0.04 kg less. The numbers of slim children were similar in both groups.

Conclusions: Fat intake by young children is markedly lower than assumed. A supervised low-saturated fat, low-cholesterol diet has no influence on growth during the first 3 years of life.