Giving families of infants and children individualized dietary counseling twice a year reduced the children's intake of fat and improved their insulin sensitivity by age 9 in a long-term randomized study.
The ongoing Special Turku Coronary Risk Factor Intervention Project for Children, a Finnish study, randomized healthy 7-month-old infants in 1990 to an intervention group (540 infants) or a control group (522 infants). The control group received the basic health education provided at well-baby clinics.
A physician and a dietitian provided individualized dietary counseling to the intervention group. Twice a year, families recorded what the child consumed for 4 consecutive days (including a weekend) within 3 weeks of the follow-up visit. The dietitian reviewed the list and suggested any changes needed to pursue a healthy diet low in saturated fat and cholesterol.
Clinicians recommend that children aged 3 and older get 55%–60% of energy from carbohydrates, 10%–15% from protein, and 30% from fat (with 10% or less as saturated fat), reported Dr. Tuuli Kaitosaari of the University of Turku (Finland) and associates.
When the children reached age 7, the investigators took detailed laboratory measurements of a subset of 200 children seen consecutively for follow-up visits; of these, 167 also had blood samples taken at their 9-year follow-up visit. The 9-year-olds (78 in the intervention group and 89 in the control group) make up the current study population.
The children in the intervention group consumed significantly less total fat and less saturated fat than those in the control group. Scores on the homeostasis model assessment of insulin resistance (HOMA-IR) index at age 9 were lower in the intervention children, indicating better insulin sensitivity compared with controls (Diabetes Care 2006;29:781–5).
Multivariate analyses indicated that “our finding of decreased HOMA-IR in intervention children is to a large extent due to their lower saturated fat intake,” Dr. Kaitosaari and associates said. Other factors that did not get measured in the study, such as exercise habits, also may partly explain the intervention's effect in lowering HOMA-IR scores, he added.