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Childhood dietary intervention prevented metabolic syndrome in adolescence
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Ongoing dietary counseling aimed at reducing saturated fats during infancy and early childhood was effective against the development of metabolic syndrome in adolescence.
Researchers for the Special Turku Coronary Risk Factor Intervention Project conducted a longitudinal, prospective, randomized atherosclerosis-prevention trial that included the families of 1,062 healthy infants seen at clinics in Turku, Finland, from February 1990 to June 1992.
The researchers randomly assigned infants at age 6 months to an intervention group (n=540), which included biannual or more frequent individualized dietary counseling until age 20 years, or a control group (n=522). The intervention was focused on supplanting saturated fat with unsaturated fat, but did not seek to achieve a decrease in overall fat intake. Children assigned the intervention also receiving counseling on reducing salt intake and increasing consumption of whole grains, fruits, vegetables, fiber and healthy carbohydrates. The nutritional counseling was provided to parents until the child was aged 7 years, after which time counseling was gradually given directly to the child. Children in the control group were given basic health education offered a Finnish well-baby clinics and school health care.
All aspects of metabolic syndrome, including BP, waist circumference, weight, height, triglycerides, glucose and LDL cholesterol, were measured in children from age 15 to 20 years. The Modified International Diabetes Foundation criteria for metabolic syndrome were primarily used.
At the study visit between age 15 and 20 years, the prevalence of metabolic syndrome ranged from 6% to 7.5% in the intervention group compared with 10% to 14% in the control group. The intervention group had a significantly reduced long-term relative risk for metabolic syndrome compared with the control group (RR = 0.59; 95% CI, 0.4-0.88).
Analysis of individual components of metabolic syndrome demonstrated that the intervention was associated with lower risk for high BP in boys and girls (RR = 0.83; 95% CI, 0.70-0.99) and lower risk for high triglycerides in boys (RR = 0.71; 95% CI, 0.52-0.98). While patients in the intervention group experienced a decrease in elevated waist circumference, it was not significant (RR = 0.78, 95% CI, 0.59-1.03).
“Despite the firm evidence from observational studies that elevated cardiometabolic risk status begins in childhood, no long-term intervention trials exist that would have specifically tested the hypothesis that reduction of risk factor exposure in childhood decreases the risk of cardiometabolic outcomes in adulthood,” the researchers wrote. “Future follow-ups in the Special Turku Coronary Risk Factor Intervention Project participants will show whether the intervention effect persists into later adulthood and is reflected in cardiometabolic morbidity.”
Disclosure: The researchers report no relevant financial disclosures.
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