Low-Fat Diets Safe for Children

From the WebMD Archives

Jan. 28, 2000 (Baltimore) -- Some studies have shown that when people try to switch the types of fats they consume to less harmful ones, they end up eating more trans fatty acids, which have an adverse effect on cholesterol in the blood. Additionally, in children, there has been concern that trans fatty acids may inhibit the formation of long-chain polyunsaturated fatty acids, which are needed for growth and development -- especially of the brain.

But new research shows that it's safe for children to consume a low-saturated-fat and low-cholesterol diet. "This study shows that reduced use of saturated fat and cholesterol and increased use of vegetable oil-based foods did not increase consumption of trans fatty acids," write lead author Pia Salo, MD, of the University of Turku in Finland, and colleagues. The findings are published in the January issue of the Journal of Pediatrics.

This study was part of a larger project called the STRIP study, which followed more than 800 Finnish children since the age of 7 months. When the children were enrolled in the study, they were assigned either to a group that received advice from a nutritionist on their diet or to a group that did not receive such advice. Individualized dietary counseling based on the child's diet was provided by the nutritionist, but a fixed diet was not ordered. Instead the nutritionist made suggestions for small dietary changes, leading the diet toward optimal composition of a fat ratio of 1:1:1 (saturated to monounsaturated to polyunsaturated) and fat intake of 30-35% of energy after the age of 1 year. This is similar to diets recommended by U.S. agencies.

The children's diets were followed with the use of food diaries kept by their parents or caregivers. Blood was drawn from a representative group of the children and analyzed for cholesterol and its subgroups as well as other markers found in the blood.

Children who received the advice of a nutritionist did not consume more trans fatty acids than those who did not receive nutritional advice. In addition, there were significant reductions in total and LDL (bad) cholesterol levels in the children on the diet. The researchers conclude that low-saturated-fat and low-cholesterol diets appear to be safe in children and cause no adverse effects on growth and development. Their results were especially encouraging since the diet was begun at such a young age.

"The intake of trans fatty acids by the STRIP children in this study is low in international comparisons," write the authors. "Possible sources of trans fatty acids include fried foods, milk fat, meat, snacks, and vegetable oil-based products such as cheese and ice cream. Fried foods are used in Finland markedly less often than in the United States and are uncommon in the diets of 3-year-old children."

Richard Deckelbaum, MD, professor of pediatrics and head of the Institute of Human Nutrition at Columbia University in New York, wrote an editorial accompanying the paper. According to Deckelbaum, the consumption of trans fatty acids among children in the U.S. is probably quite similar to that in Finland. "We need more data on this, but it is unlikely that American children are consuming more trans fatty acids when they make the switch from saturated to unsaturated fats," he tells WebMD. "There's been a lot of emphasis in this country on reducing consumption of trans fatty acids."

In 1998, the American Academy of Pediatrics issued the following recommendations regarding fat and cholesterol intake in children: "No restriction of fat or cholesterol is recommended for infants <2 years, when rapid growth and development require high energy intakes. After 2 years of age, children and adolescents should gradually adopt a diet that, by ~5 years of age, contains total fat of <30% of total calories, saturated fatty acids <10% of total calories, and dietary cholesterol of 300 mg per day."

"The results of the STRIP study are encouraging and suggest that there is no need to change current U.S. dietary recommendations regarding fat intake in children older than 2 years," Deckelbaum says. "Instead of devoting resources to making small changes in the diets of our children, we believe the emphasis should be placed on increasing energy expenditure and consuming fewer total calories."