STRIP
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Nutrient intakes and cholesterol values of the parents in a prospective randomized child-targeted coronary heart disease risk factor intervention trial--the STRIP project.

Journal European journal of clinical nutrition
Year 1999
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This article is included in 1 Systematic review Systematic reviews (1 reference)

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OBJECTIVE: To analyze food consumption, nutrient intakes and serum cholesterol concentrations of the parents in a child-targeted CHD intervention trial, during which the age of children increased from 7 months to 5 y. DESIGN AND SUBJECTS: The children were randomized to an intervention group (n = 540) or a control group (n = 522) at six months of age. The intervention families were counseled at 3-6 month intervals to reduce their child's intake of saturated fat and cholesterol. Dietary issues were discussed with the control families only briefly. The parents' food consumption was analyzed by 24 h dietary recall at the child's age of 7 and 13 months and at 2, 3, 4, and 5 y. Nutrient intakes were calculated using the Micro-Nutrica program. RESULTS: The mothers and fathers of the intervention children used less butter, more margarine and more skim milk than those of the control children (P < 0.001 for all measurements). After the onset of counseling, the intervention mothers consumed continuously less fat (1.4 E% less at the child's age of 5 y), less saturated fat (1.5 E% less at the child's age of 5 y) and more polyunsaturated fat (0.5 E% more at the child's age of 5 y) than the control mothers (P = 0.008, P < 0.001 and P < 0.001 for trend, respectively). After the child's age of 13 months the intervention fathers also had a continuously lower fat intake (2.4 E% less at the child's age of 5 y) and consumed less saturated fat (1.5 E% less at the child's age of 5 y) than the control fathers (P < 0.001 for trend for both measurements). The serum cholesterol concentration of the intervention mothers was consistently lower than that of the control mothers during the intervention (at child's age of 5 y 4.86 and 5.09 mmol/L, respectively; P for trend = 0.03), while the values of the intervention and control fathers showed no differences. CONCLUSIONS: Continuous dietary intervention begun in infancy and focused on modification of the child's diet according to the current principles of preventive cardiology, was accompanied by a moderate decrease in the intake of total and saturated fat in the parents, but serum cholesterol concentration diminished consistently only in the mothers of the intervention children.

Primary study

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A randomized intervention since infancy to reduce intake of saturated fat: calorie (energy) and nutrient intakes up to the age of 10 years in the Special Turku Coronary Risk Factor Intervention Project.

Journal Archives of pediatrics & adolescent medicine
Year 2004
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This article is included in 5 Systematic reviews Systematic reviews (5 references)

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OBJECTIVE: To evaluate the longitudinal impact of dietary counseling on children's nutrient intake. DESIGN: A prospective, randomized, clinical trial. PARTICIPANTS: Children were recruited to the study between December 1, 1989, and May 30, 1992. At the age of 7 months, children were randomized to the intervention group (n = 540) or the control group (n = 522) and were followed up until the age of 10 years. Intervention Families in the intervention group have, since randomization, received regularly individualized counseling about how to modify the quality and quantity of fat in the child's diet, the goal being an unsaturated-saturated fat ratio of 2:1. MAIN OUTCOME MEASURES: Nutrient intakes between the ages of 4 and 10 years based on annual 4-day food records. RESULTS: The fat intake of the intervention children was constantly around 30% of the calorie (energy) intake, while that of the control children was 2 to 3 calorie percentage units higher (P<.001). The intervention children received 2 to 3 calorie percentage units less saturated fats and 0.5 to 1.0 calorie percentage unit more polyunsaturated fats than the control children (P<.001 for both). However, neither group reached the 2:1 goal set for the unsaturated-saturated fatty acid ratio. The vitamin and mineral intakes of the intervention and control children closely resembled each other despite the marked differences in fat intake. CONCLUSION: Individualized, biannually given, fat intake-focused dietary counseling that began at the child's age of 8 months continued to influence favorably the diet of 4- to 10-year-old intervention children without disadvantageous dietary effects, but the 2:1 goal for unsaturated-saturated fat ratio was not reached.

Primary study

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Longitudinal trends in consumption of vegetables and fruit in Finnish children in an atherosclerosis prevention study (STRIP).

Journal European journal of clinical nutrition
Year 2006
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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OBJECTIVE: To assess prospectively the consumption of fruit and vegetables and its' correlation to the parental consumption in boys and girls taking part in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study). HYPOTHESIS: Nutrition counselling focused on cardiovascular health effects vegetable and fruit consumption. DESIGN: A prospective, randomised, clinical trial. SUBJECTS: Children were recruited to the STRIP study between 1989 and 1992. At the age of 7 months, children were randomised to the intervention (n = 540) or the control group (n = 522) and were followed up until the age of 11 years. INTERVENTION: Families in the intervention group have, since randomisation, received biannual individualised dietary counselling aimed at reduction of cardiovascular risk factors, especially saturated fat intake. Food records were used to assess fruit and vegetable consumption of children and parents. RESULTS: The percentage of total energy intake provided by fruit and vegetables decreased when the children grew older (P for age <0.001). The 1- to 10-year-old intervention boys consumed more vegetables (mean difference 3.18 g/day; CI 1.48-4.86; P < 0.001) and fruit (mean difference 10.1 g/day; CI 5.28-14.94; P < 0.001) than did the control. Mother's consumption correlated with the consumption of their daughters and sons, whereas father's consumption correlated only with the consumption of their sons. CONCLUSIONS: Finnish children taking part in the atherosclerosis prevention study had a remarkably low fruit and vegetable consumption, which furthermore decreased with age. The children's consumption correlated with the parental consumption, except between boys and mothers. A slight intervention effect was present only among boys.

Primary study

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Development of overweight in an atherosclerosis prevention trial starting in early childhood. The STRIP study.

Journal International journal of obesity (2005)
Year 2006
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This article is included in 5 Systematic reviews Systematic reviews (5 references)

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CONTEXT: Recent data indicate a marked increase in the prevalence of obesity among school-aged children. Thus, efficacious programmes that prevent overweight development in children are urgently needed. OBJECTIVE: To evaluate the impact of repeatedly given, individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life. DESIGN AND PARTICIPANTS: This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP), which is a prospective, randomised trial aimed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis. At the child's age of 7 months, 1062 children were assigned to an intervention group (n=540) or to a control group (n=522). The intervention children received individualised counselling focused on healthy diet and physical activity biannually. Height and weight of the children were measured at least once a year. MAIN OUTCOME MEASURE: Prevalence of overweight and obesity among the intervention and control children by sex and age. Children were classified as overweight or obese if their weight for height was >20% or > or =40% above the mean weight for height of healthy Finnish children, respectively. RESULTS: After the age of 2 years, there were continuously fewer overweight girls in the intervention group than in the control group. At the age of 10 years, 10.2% of the intervention girls and 18.8% of the control girls were overweight (P=0.0439), whereas 11.6% of the intervention boys and 12.1% of the control boys were overweight (P approximately 1.00). Only three children in the intervention group were obese at some age point, whereas 14 control children were classified as obese at some age point. CONCLUSION: Individualised dietary and lifestyle counselling given twice a year since infancy decreases prevalence of overweight in school-aged girls even without any primary energy restrictions.

Primary study

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Impact of repeated dietary counseling between infancy and 14 years of age on dietary intakes and serum lipids and lipoproteins: the STRIP study.

Journal Circulation
Year 2007
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This article is included in 3 Systematic reviews Systematic reviews (3 references)

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BACKGROUND: Atherosclerosis development might be delayed or prevented by dietary measures. The aims of the present study were to evaluate the effect of low-saturated-fat, low-cholesterol dietary counseling on fat intakes, growth, serum cholesterol values, and pubertal development in children and adolescents. METHODS AND RESULTS: In the randomized prospective Special Turku Coronary Risk Factor Intervention Project (STRIP), a low-saturated-fat, low-cholesterol diet was introduced to intervention infants (n=540) at 7 months of age, and control children (n=522) received an unrestricted diet. Dietary intakes, serum cholesterol values, somatic growth, and development were followed up throughout childhood and adolescence. Saturated fat intakes, serum total cholesterol, and low-density lipoprotein cholesterol values were lower (P<0.001) in the intervention than in control children during the 14 years, whereas high-density lipoprotein cholesterol values in the 2 study groups showed no difference. Boys had lower total and low-density lipoprotein cholesterol concentrations than girls throughout childhood (P<0.001), and the intervention effect on serum cholesterol concentration was larger in boys than girls. The 2 study groups showed no difference in growth, body mass index, pubertal development, or age at menarche (median, 13.0 and 12.8 years in the intervention and control girls, respectively; P=0.52). The cholesterol values decreased as puberty progressed. Mean concentrations of total and high-density lipoprotein cholesterol decreased from approximately 4.5 and approximately 1.4 mmol/L, respectively, in Tanner stage 1 (prepubertal) boys to approximately 3.9 and approximately 1.1 mmol/L in Tanner stage 4 (late pubertal) boys. CONCLUSIONS: Repeated dietary counseling remains effective in decreasing saturated fat and cholesterol intake and serum cholesterol values at least until 14 years of age. Puberty markedly influences serum cholesterol concentrations.

Primary study

Unclassified

Growth patterns and obesity development in overweight or normal-weight 13-year-old adolescents: The STRIP study

Journal Pediatrics
Year 2008
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This article is included in 1 Systematic review Systematic reviews (1 reference)

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OBJECTIVE. Our goal was to study childhood growth patterns and development of overweight in children who were overweight or normal weight at 13 years of age. PARTICIPANTS AND METHODS. This study is part of a prospective atherosclerosis-prevention trial Special Turku Coronary Risk Factor Intervention Project for Children). At 7 months of age, 1062 children were randomly assigned to an intervention group (n = 540) receiving biannual fat-oriented dietary counseling or to a control group (n = 522). Height and weight of the children and their parents were monitored annually. Our study group comprised those children who participated in the 13-year study visit (n = 541). At 13 years of age, the child was classified as overweight (n = 84) if his or her BMI exceeded the international age- and gender-specific overweight criteria. RESULTS.In overweight girls, the annual weight gain increased from 2.8 kg during the third and fourth year of life to 7.5 kg during the 12th year of life, whereas the annual weight gain of the girls who were normal weight ranged from 2.1 to 4.8 kg during the same period. The annual weight gain was similar of overweight boys and in their normal-weight peers until the age of 5 years, but after that it increased from 3.5 to 7.9 kg in overweight and from 2.6 to 5.5 kg in normal-weight boys. The BMI of the girls and boys who were overweight at the age of 13 exceeded the international cutoff point for overweight from the age of 5 and 8 years onward, respectively. The mean BMIs of the mothers and fathers of the overweight children were higher than those of the parents of the normal-weight children. The STRIP intervention had no effect on the examined growth parameters or on parental BMI. CONCLUSIONS. The children who were overweight at 13 years of age gained more weight than their normal-weight peers by the age of 2 or 3 years onward. The girls became overweight by the age of 5 years, whereas the boys only after 8 years of age. Parental BMI and steep weight gain in early childhood indicate markedly increased risk for becoming overweight. Copyright © 2008 by the American Academy of Pediatrics.

Primary study

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Dietary and lifestyle counselling reduces the clustering of overweight-related cardiometabolic risk factors in adolescents

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Journal Acta paediatrica (Oslo, Norway : 1992)
Year 2010
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This article is included in 1 Systematic review Systematic reviews (1 reference)

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Aim: The aim of this study was to evaluate the impact of individualised dietary and lifestyle counselling, primarily aimed to decrease serum low-density lipoprotein cholesterol, on the clustering of overweight-related cardiometabolic risk factors in children. Design and participants: The 7-month-old study children were randomized either to counselling (n = 540) or control group (n = 522). Main outcome measures: The 5- to 15-year-old participants who fulfilled the international criteria were classified as overweight. Being in the highest [lowest for high-density lipoprotein (HDL) cholesterol] age- and gender-specific quintile of body mass index (BMI), blood pressure, serum triglycerides, HDL cholesterol or glucose was considered a risk factor. A cluster was defined as having high BMI and ≥2 other risk factors. Results: The counselling did not reduce the prevalence of overweight in 5- to 15-year-old participants. From age 7 onwards, the proportion of children with ≥2 risk factors was lower in the intervention than in the control group (p = 0.005). At the age of 15 years, 13.0% of girls and 10.8% of boys in the intervention group and 17.5% of girls and 18.8% of boys in the control group had the risk factor cluster (p = 0.046 for main effect of the study group). Having even one risk factor at the age of 5 years predicted the clustering of risk factors at the age of 15 years (OR: 3.8, p < 0.001). Conclusion: Repeated, individualized dietary and lifestyle counselling may reduce the clustering of overweight-related cardiometabolic risk factors in adolescents even though the counselling is not intense enough to prevent overweight. © 2009 Foundation Acta Pædiatrica.