Achievement of the Targets of the 20-Year Infancy-Onset Dietary Intervention-Association with Metabolic Profile from Childhood to Adulthood.

The Special Turku Coronary Risk Factor Intervention Project (STRIP) is a prospective infancy-onset randomized dietary intervention trial targeting dietary fat quality and cholesterol intake, and favoring consumption of vegetables, fruit, and whole-grains. Diet (food records) and circulating metabolites were studied at six time points between the ages of 9-19 years (n = 549-338). Dietary targets for this study were defined as (1) the ratio of saturated fat (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) < 1:2, (2) intake of SAFA < 10% of total energy intake, (3) fiber intake ≥ 80th age-specific percentile, and (4) sucrose intake ≤ 20th age-specific percentile. Metabolic biomarkers were quantified by high-throughput nuclear magnetic resonance metabolomics. Better adherence to the dietary targets, regardless of study group allocation, was assoiated with higher serum proportion of PUFAs, lower serum proportion of SAFAs, and a higher degree of unsaturation of fatty acids. Achieving ≥ 1 dietary target resulted in higher low-density lipoprotein (LDL) particle size, lower circulating LDL subclass lipid concentrations, and lower circulating lipid concentrations in medium and small high-density lipoprotein subclasses compared to meeting 0 targets. Attaining more dietary targets (≥2) was associated with a tendency to lower lipid concentrations of intermediate-density lipoprotein and very low-density lipoprotein subclasses. Thus, adherence to dietary targets is favorably associated with multiple circulating fatty acids and lipoprotein subclass lipid concentrations, indicative of better cardio-metabolic health.

Longitudinal effect of 20-year infancy-onset dietary intervention on food consumption and nutrient intake: the randomized controlled STRIP study.

BACKGROUND/OBJECTIVES: Coronary heart disease begins in childhood and warrants prevention strategies such as dietary modification. The objective was to determine the effect of the Special Turku Coronary Risk Factor Intervention Project (STRIP) dietary intervention on food consumption and nutrient intake over 20-year intervention period. SUBJECTS/METHODS: The STRIP is a prospective, randomized trial conducted between 1990 and 2011. Enrolled 6-month-old infants (n = 1062) were randomized to an intervention group (n = 540) receiving dietary counseling biannually from age 7 months to 20 years or control group (n = 522) not receiving any intervention. Food and nutrient intake was assessed annually using 4-day food records. A food-based diet score was calculated. RESULTS: The intervention led to (1) higher consumption of low-fat unsweetened dairy (ß = 177.76, 95% CI 157.36-198.16 g/day), vegetable-oil based fats (ß = 6.00, 5.37-6.63 g/day), fish (ß = 2.45, 1.44-3.45 g/day), fiber-rich grain products (ß = 5.53, 3.17-7.89 g/day), fruits/berries (ß = 9.93, 4.44-15.43 g/day), vegetables (ß = 11.95, 7.74-16.16 g/day); (2) lower consumption of desserts (ß = - 4.10, 95% CI - 6.50 to - 1.70 g/day); (3) lower intake of sucrose (ß = - 1.61, 95% CI - 2.88 to - 0.35 g/day), and higher intake of fiber (ß = 0.83, 0.55-1.11 g/day), folate (ß = 11.14, 95% CI 8.23-14.05 µg/day), vitamin D (ß = 0.52, 0.39-0.64 µg/day), C (ß = 8.08, 4.79-11.38 mg/day), E (ß = 0.93, 0.81-1.05 mg/day), iron (ß = 0.31, 0.18-0.44 mg/day), zinc (ß = 0.29, 0.17-0.40 mg/day), magnesium (ß = 12.17, 9.02-15.33 mg/day), sodium (ß = 55.00, 24.40-85.60 mg/day), potassium (ß = 157.11, 107.24-206.98 mg/day). No effect was found on nut/seed, red/processed meat, sugar-sweetened beverage, salty snack consumption, or vitamin A and calcium intake. Intervention effect was more pronounced in boys. CONCLUSIONS: The STRIP intervention improved children's diet quality over 20 years, indicating that beneficial dietary changes can be introduced and sustained in youth.