RESUMO
OBJECTIVES: To evaluate the effects of diet, serum cholesterol concentrations, and apolipoprotein E phenotype on neurodevelopment of 5-year-old children. STUDY DESIGN: Prospective, 4.4-year cohort study in 496 children. Fat-modified diet was introduced to intervention families of 7-month-old infants. Control children consumed an unrestricted diet. Nutrient intakes, serum cholesterol, and neurodevelopment were studied. The groups were combined in univariate and stepwise multivariate logistic regression analyses. RESULTS: In 13-month-old boys (girls), energy intake was 996 (938) kcal, fat intake 26.6 (26.4) percent of energy (E%), and protein intake 17.2 (17.4) E%. In 5-year-old boys (girls), the intakes were 1484 (1364) kcal, 32.1 (31.9) E%, and 15.5 (15.9) E%, respectively. The intakes of total fat and saturated fat and serum cholesterol were not associated with neurodevelopment. In boys, high intake of protein at 5 years, high intakes of protein at 4 years and cholesterol at 2 years, and high intake of polyunsaturated fatty acids at 3 years predicted favorable outcomes in the tests of speech and language skills, gross motor function and perception, and visual motor skills, respectively. Apolipoprotein E phenotype did not influence the test performance. CONCLUSIONS: Moderate restriction of dietary fat has no unfavorable effects on neurodevelopment in early childhood. However, the quality of fat and the relative intake of protein may influence neurodevelopment of the boys.