RESUMO
OBJECTIVE: To investigate cholesterol-lowering efficacy and safety of plant stanol ester margarine in healthy 6-year-old children already consuming a low-saturated-fat, low-cholesterol diet. STUDY DESIGN: Eighty-one intervention children from the STRIP project, a randomized prospective trial aimed at reducing exposure of young children to the known environmental atherosclerosis risk factors, were recruited to this double-blind crossover study at 6 years of age. In randomized order the families were advised to replace daily 20 g of the child's dietary fat intake with plant stanol ester margarine or control margarine for 3 months. The washout period lasted 6 weeks. Statistical analysis was performed according to intention-to-treat principle with analysis of variance for crossover design. RESULTS: The mean daily plant stanol ester margarine consumption was 18.2 g (1.5 g plant stanol). The well-tolerated plant stanol ester margarine reduced serum total and low-density lipoprotein cholesterol concentrations by 5.4% and 7.5%, respectively (P =.0001 for both). The serum high-density lipoprotein cholesterol and triglyceride concentrations and alpha-tocopherol to low-density lipoprotein cholesterol ratio remained unchanged. The serum beta-carotene to low-density lipoprotein cholesterol ratio decreased by 19% (P =.003). CONCLUSION: Plant stanol ester margarine significantly diminishes serum total and low-density lipoprotein cholesterol concentration without adverse clinical effects in healthy children who already consume a low-saturated-fat, low-cholesterol diet but decreases the serum beta-carotene to low-density lipoprotein cholesterol ratio.
Assuntos
Colesterol/sangue , Hipolipemiantes/administração & dosagem , Lipoproteínas LDL/sangue , Margarina , Sitosteroides/administração & dosagem , Criança , Pré-Escolar , Estudos Cross-Over , Gorduras na Dieta/administração & dosagem , Método Duplo-Cego , Finlândia , Humanos , Hipolipemiantes/efeitos adversos , Lactente , Lipoproteínas LDL/efeitos dos fármacos , Margarina/efeitos adversos , Estudos Prospectivos , Valores de Referência , Sitosteroides/efeitos adversos , Fatores de TempoRESUMO
OBJECTIVE: To evaluate the contribution of the type of milk on serum cholesterol ester fatty acids in infants receiving mixed feeding, we analyzed 3-day dietary records and serum cholesterol ester fatty acid composition of 397 seven-month-old infants. STUDY DESIGN: The infants received, in addition to solid food, only one type of milk: human milk (n = 218), a ready-to-use liquid formula (n = 139), a powdered formula (n = 33), or soy formula (n = 7). RESULTS: Mean fat intakes were low and varied from 28% to 31% of energy; the milks provided 43% to 64% of the fat. The mean polyunsaturated/saturated fat ratios of solid foods were from 0.52 to 0.63 and of milks from 0.20 to 0.45. Breast-fed infants' relative serum linoleic acid (18:2n-6) concentration was low (51.2%), whereas infants fed liquid formula had low serum oleic acid (18:1n-9) in accordance with low oleic acid content in that formula. The breast-fed infants had markedly higher serum concentrations of arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3) than the infants fed any of the formulas. CONCLUSION: The typical fatty acid patterns of breast- or formula-fed infants were still evident in 7-month-old infants who already received 60% to 70% of their energy from solid food. Marked differences were seen also in the relative concentrations of docosahexaenoic acid and arachidonic acid despite their small contribution in cholesterol esters.
Assuntos
Aleitamento Materno , Ácidos Graxos/sangue , Alimentos Infantis/análise , Leite Humano/química , Gorduras na Dieta/administração & dosagem , Gorduras/análise , Ácidos Graxos/análise , Feminino , Humanos , Lactente , MasculinoRESUMO
OBJECTIVE: To determine the influence of gender, apolipoprotein E phenotypes, and diet on the interindividual variances in serum lipid and lipoprotein concentrations in children at 7 and 13 months of age. STUDY DESIGN: Prospective randomized intervention trial. Half of 1062 families with 7-month-old infants received dietary and lifestyle counseling aimed at partially replacing saturated fat with mono- and polyunsaturated fat and reducing exposure to other known atherosclerosis risk factors. This study comprises all trial children who at 8 months of age received, in addition to solid food, only breast milk or only formula (N = 553). Forward stepwise multiple regression analysis was used in the evaluation of the contributions of gender, apolipoprotein E phenotype, and diet. RESULTS: Apolipoprotein E phenotypes, gender, and milk type provided independent information concerning serum lipid values at 7 and 13 months of age (three-way ANOVA, p < 0.01). At 7 months, milk type was the most significant predictor of total, non-high-density lipoprotein and high-density lipoprotein cholesterol and apolipoprotein B and A1 concentrations. At 13 months when the effects of gender (5%) and apolipoprotein E type (5%) were excluded, diet predicted only 2% of the variance in serum cholesterol concentration. The apolipoprotein E type predicted 8% of the variance in non-high-density lipoprotein cholesterol concentration and 7% of the variance in apolipoprotein B concentration (p < 0.001), together explaining only 3% of the variance in serum high-density lipoprotein cholesterol and apolipoprotein A1 concentrations. CONCLUSIONS: At 7 months of age diet is an important predictor of serum lipid and lipoprotein concentrations. At the age of 13 months the apolipoprotein E phenotype significantly predicts the concentrations of serum non-high-density lipoprotein cholesterol and apolipoprotein B. However, at both ages apolipoprotein E phenotype, gender, and diet together explain only from 1.4% to 15.5% of the variance in serum lipids and apolipoproteins, suggesting that other, presumably genetic, factors are major determinants.