Published February 17, 2012
Kids who got regular diet counseling starting very early on ended up eating slightly less saturated fat and had lower "bad" cholesterol levels as teens, in a new study from Finland.
High cholesterol in kids and teens has been linked to build-up in the arteries in adulthood, a known risk for heart disease. But whether intervening in childhood helps prevent heart attacks and other cardiovascular ailments down the line isn't clear.
"In general, we know that lower ("bad" cholesterol) is better," said Dr. Stephen Daniels, a pediatric cardiologist at the University of Colorado School of Medicine and Children's Hospital Colorado in Aurora.
"If you look at it that way, I think you would have to suggest that these are beneficial changes," Daniels, who wasn't involved in the new study, told Reuters Health. "But quantifying the effect that they might have on actual outcomes I think is hard to do."
The U.S. Preventive Services Task Force, a government-backed panel, says there isn't enough evidence to recommend for or against regular diet counseling in kids and adults -- or routine cholesterol testing in youth.
Other groups, including the National Heart, Lung, and Blood Institute, say that diet counseling can help kids and families stick to nutrition guidelines and reduce cardiovascular risks.
For the current study, researchers led by Dr. Harri Niinikoski from the University of Turku recruited more than 1,000 parents at well-baby clinics in their city. Starting when infants were seven months old, half of the kids and their parents had diet counseling with a nutritionist during routine visits every three to six months.
From age seven through 19, kids had more counseling sessions without their parents. Nutritionists used kids' food records, kept for a few days twice a year, to make recommendations with a goal of lowering saturated fat and cholesterol in their diets.
The other participants, serving as a comparison, were given basic health education once or twice a year.
By the time they were teenagers, both boys and girls who had the nutrition sessions reported getting fewer of their calories from saturated fat than those in the comparison group.
The individual differences were small: at age 19, for example, saturated fat accounted for 11.8 percent of calories consumed by boys in the counseling group, compared to 12.7 percent in the non-counseling group. For girls, those numbers were 11.4 percent and 12.0 percent of calories from saturated fat, respectively, Niinikoski's team reported in Pediatrics on Monday.
Kids who were counseled also had lower levels of LDL, or "bad" cholesterol, on blood tests in their teens -- again a small but consistent difference. At age 19, average LDL cholesterol levels in both groups were in the range considered ideal or near-ideal for adults.
There was no difference in teens' body mass index, a measure of weight in relation to height, based on whether they had gotten diet counseling.
"One way of looking at this is, we need to do a better job across the whole population of improving diet," including lowering saturated fat intake, Daniels said.
While one option is focusing on those kids that already have a family risk of high cholesterol or have especially poor diet and lifestyle, Daniels said the real goal is to prevent problems before they start. He said that even if it might take up extra time, nutrition counseling should be part of every well-child visit -- and that any extra costs are likely to pay off with fewer health problems over the long run.
Those costs would depend on whether counseling would also help when done only once a year, and by a kid's pediatrician.
"Getting lifestyle right early and keeping it right over the lifespan I think is a really important idea," Daniels concluded.