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Effect of Dietary Counseling on a Comprehensive Metabolic Profile from Childhood to Adulthood.

Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Electronic address: mimleh@utu.fi. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland. Computational Medicine, Faculty of Medicine, University of Oulu & Biocenter Oulu, Oulu, Finland. Department of Public Health, University of Turku, Turku, Finland. Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland. National Institute for Health and Welfare, Turku, Finland. Computational Medicine, Faculty of Medicine, University of Oulu & Biocenter Oulu, Oulu, Finland; Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Systems Epidemiology, Baker Heart and Diabetes Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.

The Journal of pediatrics. 2018;:190-198.e3
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Abstract

OBJECTIVES To study the effects of repeated, infancy-onset dietary counseling on a detailed metabolic profile. Effects of dietary saturated fat replacement on circulating concentrations of metabolic biomarkers still remain unknown. STUDY DESIGN The Special Turku Coronary Risk Factor Intervention Project (STRIP) study is a longitudinal, randomized atherosclerosis prevention trial in which repeated dietary counseling aimed at reducing the proportion of saturated fat intake. Nuclear magnetic resonance metabolomics quantified circulating metabolites from serum samples assessed at age 9 (n = 554), 11 (n = 553), 13 (n = 508), 15 (n = 517), 17 (n = 457), and 19 (n = 417) years. RESULTS The intervention reduced dietary intake of saturated fat (mean difference in daily percentage of total energy intake: -2.1 [95% CI -1.9 to -2.3]) and increased intake of polyunsaturated fat (0.6 [0.5-0.7]). The dietary counseling intervention led to greater serum proportions of polyunsaturated fatty acids (P < .001), with greater proportions of both circulating omega-3 (P = .02) and omega-6 (P < .001) fatty acids. The proportion of saturated fatty acids in serum was lower for both boys and girls in the intervention group (P < .001), whereas the serum proportion of monounsaturated fat was lower for boys in the intervention group only (P < .001). The intervention also reduced circulating intermediate-density lipoprotein and low-density lipoprotein lipid concentrations (P < .01). Dietary intervention effects on nonlipid biomarkers were minor except from greater concentrations of glutamine in the intervention group. CONCLUSIONS Repeated dietary counseling from infancy to early adulthood yielded favorable effects on multiple circulating fatty acids and lipoprotein subclass lipids, particularly in boys. These molecular effects substantiate the beneficial role of saturated fat replacement on the metabolic risk profile. TRIAL REGISTRATION ClinicalTrials.gov: NCT00223600.

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Publication Type : Randomized Controlled Trial

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