Effect of Repeated Dietary Counseling on Serum Lipoproteins From Infancy to Adulthood

BACKGROUND AND OBJECTIVE: As atherosclerosis is a lifelong process, prevention of exposure to its risk factors should start at an early age. Our aim was to study the influences of repeated low saturated fat dietary counseling on dietary intakes and lipoprotein measures from infancy to adulthood. METHODS: Dietary intakes (food records) and serum lipid profile were studied annually from 7 months to 19 years of age in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project), comprising 540 children in the intervention group and 522 children in the control group. Serum total and high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured and used to estimate very low-density lipoprotein-TG, intermediate-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and HDL2-C, as well as apolipoproteins A-1 and B. RESULTS: Compared with controls, the intervention children had a lower saturated fat intake (mean daily difference [95% confidence interval] between groups: -2.1 [-2.3, -1.9] percentage of total energy intake in boys; -1.9 [-2.1, -1.7] percentage of total energy intake in girls, both P < 001) and LDL-C concentration (difference [95% confidence interval] between groups: -0.18 [-0.26, -0.10] mmol/L, P < .001 in boys; -0.10 [-0.19, -0.01] mmol/L, P = .037 in girls), whereas HDL-C and apolipoprotein A-1 did not differ between the study groups. In boys, total cholesterol and intermediate-density lipoprotein cholesterol, very low-density lipoprotein-TG, apolipoprotein B, and TG concentrations were also lower in the intervention than in the control group, whereas no differences were found in girls. CONCLUSIONS: Repeated dietary counseling is effective in decreasing saturated fat intake and serum LDL-C values from infancy until 19 years of age in both genders. In boys, significant intervention effects are evident in various lipoprotein measures, indicating a more favorable lipid profile in the counseling group. Pediatrics 2012; 129: e704-e713