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Apolipoprotein E polymorphism and serum lipids in a randomized, prospective trial of an infant diet with reduced
H Lapinleimu1, J Viikari, T Rönnemaa
1Cardiorespiratory Research Unit, University of Turku, Finland.
Insights
Apolipoprotein E (apoE) phenotype influences infant serum cholesterol. A low-fat, low-cholesterol diet in infancy prevents age-related lipid increases, regardless of apoE phenotype.
Area of Science:
- Nutritional Science
- Genetics
- Pediatrics
Background:
- Inherited apolipoprotein E (apoE) phenotype may influence dietary atherosclerosis prevention efficacy.
- This study investigates apoE phenotypes' impact on serum lipid changes during a 6-month infant diet intervention.
Purpose of the Study:
- To analyze the effects of apoE phenotypes on serum lipid concentrations in infants.
- To assess the effectiveness of a low-saturated-fat, low-cholesterol diet in infancy.
- To determine if dietary intervention effects are independent of apoE phenotype.
Main Methods:
- 1062 healthy infants randomized into intervention and control groups at 7 months.
- Intervention group received dietary counseling at 7, 8, and 10 months.
- Serum lipids measured at 7 and 13 months; apoE phenotype determined for 846 infants.
Main Results:
- Higher serum cholesterol in apoE4-positive infants at 7 months.
- Dietary intervention prevented age-associated increases in serum cholesterol and non-HDL cholesterol.
- Lipid changes from dietary intervention were independent of apoE phenotype.
Conclusions:
- ApoE phenotype significantly impacts infant serum cholesterol by 7 months.
- A reduced saturated fat and cholesterol diet effectively prevents lipid increases in infancy.
- Dietary intervention benefits are consistent across different apoE phenotypes.
Background:
The inherited apolipoprotein E (apoE) phenotype may determine effectiveness of dietary atherosclerosis prevention. This study analyzes the effects of apoE phenotypes on changes in serum lipid concentrations in a 6-month prospective, randomized trial of a low-saturated-fat, low-cholesterol diet in infancy.
Patients And Methods:
One thousand sixty-two healthy infants were randomized to intervention and control groups at the age of 7 months. Counseling was provided to the intervention families when the children's ages were 7, 8, and 10 months. Dietary goals were the child's intake of energy ad libitum, fat at 30% to 35% of energy, cholesterol at less than 200 mg/d, and saturated, monounsaturated, and polyunsaturated fatty acids at a 1:1:1 ratio. Control families consumed an unrestricted diet. The apoE phenotype of 846 of the infants was determined; serum lipid and lipoprotein concentrations were measured at 7 and 13 months of age; and nutrient intakes were analyzed using 3-day food records at 8 and 13 months of age.
Results:
At 7 months of age, serum cholesterol concentration was higher in apoE4-positive infants (E2/E4, E3/E4, and homozygous E4) than in apoE4-negative infants (159 +/- 31 mg/dL [4.10 +/- 0.81 mmol/L] vs 150 +/- 29 mg/dL [3.89 +/- 0.74 mmol/L]). The high-density lipoprotein cholesterol concentration was slightly lower in apoE4-positive infants than in apoE4-negative infants (34 +/- 8 mg/dL [0.88 +/- 0.20 mmol/L] vs 35 +/- 7 mg/dL [0.91 +/- 0.19 mmol/L]). Between 7 and 13 months of age, the serum cholesterol concentration in infants in the intervention group was unchanged, apoB concentration increased slightly, and apoA1 concentration decreased. In the control infants, serum cholesterol concentration increased 9 +/- 25 mg/dL (0.24 +/- 0.65 mmol/L), apoB concentration increased markedly, and apoA1 concentration was stable. Changes in serum lipid and apo concentrations that resulted from the dietary intervention were independent of the apoE phenotype.
Conclusions:
The apoE phenotype influenced serum cholesterol concentration markedly by 7 months of age. Between the ages of 7 and 13 months, a reduced saturated fat and cholesterol diet effectively prevented the age-associated increases in serum cholesterol and non-high-density cholesterol concentrations that were obvious in the control infants. The effects of the diet occurred in the infants independently of the apoE phenotype.