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Neurological development of 5-year-old children receiving a low-saturated fat, low-cholesterol diet since infancy: A
L Rask-Nissilä1, E Jokinen, P Terho
1Cardiorespiratory Research Unit, University of Turku, Kiinamyllynkatu 10, FIN-20,520 Turku, Finland. leena.rask-nissila@utu.fi
Insights
Early childhood dietary counseling for parents significantly reduced children's serum cholesterol levels by age 5. This nutritional intervention supported normal neurological development, indicating its safety and efficacy for long-term health.
Area of Science:
- Pediatrics
- Nutritional Science
- Cardiovascular Health
Background:
- Atherosclerosis prevention strategies initiated in early childhood are crucial for long-term health.
- The impact of early nutritional interventions on neurological development remains an area requiring further investigation.
Purpose of the Study:
- To evaluate the influence of parental counseling on children's fat and cholesterol intake.
- To assess the effects of this dietary intervention on neurodevelopment up to age 5.
Main Methods:
- A randomized controlled trial involving 1062 infants and their parents.
- Intervention group received counseling on limiting fat and cholesterol intake; control group received standard health education.
- Neurodevelopmental testing was conducted at age 5.
Main Results:
- Children in the intervention group had significantly lower intakes of total fat, saturated fat, and cholesterol.
- Serum cholesterol concentrations were 3-5% lower in the intervention group compared to controls at age 5.
- Neurological development outcomes were comparable between the intervention and control groups.
Conclusions:
- Child-targeted dietary counseling for parents effectively reduces serum cholesterol in young children.
- This nutritional approach is compatible with normal neurological development, supporting its use in pediatric care.
Context:
Early childhood introduction of nutritional habits aimed at atherosclerosis prevention is compatible with normal growth, but its effect on neurological development is unknown.
Objective:
To analyze how parental counseling aimed at keeping children's diets low in saturated fat and cholesterol influences neurodevelopment during the first 5 years of life.
Design:
Randomized controlled trial conducted between February 1990 and November 1996.
Setting:
Outpatient clinic of a university department in Turku, Finland.
Participants:
A total of 1062 seven-month-old infants and their parents, recruited at well-baby clinics between 1990 and 1992. At age 5 years, 496 children still living in the city of Turku were available to participate in neurodevelopmental testing.
Intervention:
Participants were randomly assigned to receive individualized counseling aimed at limiting the child's fat intake to 30% to 35% of daily energy, with a saturated:monounsaturated:polyunsaturated fatty acid ratio of 1:1:1 and a cholesterol intake of less than 200 mg/d (n = 540) or usual health education (control group, n = 522).
Main Outcome Measures:
Nutrient intake, serum lipid concentrations, and neurological development at 5 years, among children in the intervention vs control groups.
Results:
Absolute and relative intakes of fat, saturated fatty acids, and cholesterol among children in the intervention group were markedly less than the respective values of control children. Mean (SD) percentages of daily energy at age 5 years for the intervention vs control groups were as follows: for total fat, 30.6% (4.5%) vs 33.4% (4.4%) (P<. 001); and for saturated fat, 11.7% (2.3%) vs 14.5% (2.4%) (P<.001). Mean intakes of cholesterol were 164.2 mg (60.1 mg) and 192.5 mg (71. 9 mg) (P<.001) for the intervention and control groups, respectively. Serum cholesterol concentrations were continuously 3% to 5% lower in children in the intervention group than in children in the control group. At age 5 years, mean (SD) serum cholesterol concentration of the intervention group was 4.27 (0.63) mmol/L (165 [24] mg/dL) and of the control group, 4.41 (0.74) mmol/L (170 [29] mg/dL) (P =.04). Neurological development of children in the intervention group was at least as good as that of children in the control group. Relative risks for children in the intervention group to fail tests of speech and language skills, gross motor functioning plus perception, and visual motor skills were 0.95 (90% confidence interval [CI], 0.60-1.49), 0.95 (90% CI, 0.58-1.55), and 0.65 (90% CI, 0.39-1.08), respectively (P =.85,.86, and.16, respectively, vs control children).
Conclusion:
Our data indicate that repeated child-targeted dietary counseling of parents during the first 5 years of a child's life lessens age-associated increases in children's serum cholesterol and is compatible with normal neurological development. JAMA. 2000;284:993-1000
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