Regulation of growth of 7- to 36-month-old children by energy and fat intake in the prospective, randomized STRIP baby trial

Abstract

Objective: To study the fat and energy intakes of children between 7 and 36 months of age with different growth patterns.

Methods: In the Special Turku coronary Risk factor Intervention Project for Babies, children were randomized to intervention (n = 540) and control groups (n = 522) at age 7 months. The intervention was aimed at replacing part of the saturated fat intake with monounsaturated and polyunsaturated fat to reduce children's exposure to high serum cholesterol values. The control children consumed a free diet. Children followed for >2 years (n = 848) were included in the analysis. Five groups of children representing different extreme growth patterns during the first 3 years of life were formed, and their energy and fat intakes were analyzed. Relative weight was defined as deviation of weight in percentages from the mean weight of healthy children of same height and sex, and relative height as deviation of height in SD units from the mean height of healthy children of same age and sex.

Results: Relative fat intakes (as percent of energy intake) were similar in children showing highly different height gain patterns. The thin (mean relative weight </= 5%) children consumed more fat (mean, 30% energy [ E%] [SD 7] at 13 months and 33 [4] E% at 24 months) than children with normal growth (27 [5] E% at 13 months and 31 [5] E% at 24 months). The energy intake of the tall (mean relative height >/= 95%) and the obese (mean relative weight >/= 95%) were highest, but weight-based energy intake of the tall (at 2 years, 82 [13] kcal/kg) and the obese (79 [17] kcal/kg) were lower than that of children with normal growth (89 [16] kcal/kg). The thin children consumed relatively more energy than the children with normal growth (at 2 years, 94 [13] kcal/kg and 89 [16] kcal/kg, respectively). Parental height and body mass index and the child's absolute and relative energy intakes predicted the best children's growth patterns. Children with consistently low fat intake grew equally to the children with higher fat intake.

Conclusions: Moderate supervised restriction of fat intake to values 25 to 30 E% is compatible with normal growth.