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Low–Saturated Fat Dietary Counseling Starting in Infancy Improves Insulin Sensitivity in 9-Year-Old Healthy Children

The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study

¹ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
² Department of Medicine, University of Turku, Turku, Finland
³ Clinical Physiology, Turku, Finland
⁴ National Public Health Institute, Turku, Finland
⁵ Hospital for Children and Adolescents, Helsinki, Finland
⁶ Department of Pediatrics, University of Turku, Turku, Finland

Address correspondence and reprint requests to Tuuli Kaitosaari, MD, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland. E-mail: tuuli.kaitosaari{at}utu.fi

OBJECTIVE—Insulin resistance is promoted already in childhood by obesity and possibly by high–saturated fat intake. We examined the effect of infancy onset biannually given dietary counseling on markers of insulin resistance in healthy 9-year-old children.

RESEARCH DESIGN AND METHODS—Healthy 7-month-old infants (n = 1,062) were randomized to the intervention (n = 540) and control (n = 522) groups. Each year, two individualized counseling sessions were organized to each intervention family. The purpose of counseling was to minimize children’s exposure to known environmental atherosclerosis risk factors. Homeostasis model assessment of insulin resistance (HOMA-IR) index, serum lipids, blood pressure, and weight for height were determined in a random subgroup of 78 intervention children and 89 control children at the age of 9 years.

RESULTS—Intervention children consumed less total and saturated fat than the control children (P = 0.002 and < 0.0001, respectively). The HOMA-IR index was lower in intervention children than in control children (P = 0.020). There was a significant association between saturated fat intake and HOMA-IR. In multivariate analyses including saturated fat intake, study group, and other determinants of HOMA-IR (serum triglyceride concentration, weight for height, and systolic blood pressure), study group was, whereas saturated fat intake was not, significantly associated with HOMA-IR. This suggests that the beneficial effect of intervention on insulin sensitivity was largely, but not fully, explained by the decrease in saturated fat intake.

CONCLUSIONS—The long-term biannual dietary intervention decreases the intake of total and saturated fat and has a positive effect on insulin resistance index in 9-year-old children.

Abbreviations: apo, apolipoprotein • HOMA-IR, homeostasis model assessment of insulin resistance • PAI-1, plasminogen activator inhibitor type 1 • STRIP, Special Turku Coronary Risk Factor Intervention Project for Children

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