Metabolic syndrome from adolescence to early adulthood: effect of infancy-onset dietary counseling of low saturated fat: the Special Turku Coronary Risk Factor Intervention Project (STRIP)

Background: Adolescent metabolic syndrome (MetS) predicts type 2 diabetes mellitus and subclinical atherosclerosis in adulthood. Our aim was to establish the relationship between an infancy-onset dietary intervention and risk of having MetS between 15 and 20 years of age.

Methods and Results: The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study is a longitudinal, randomized atherosclerosis prevention trial in which repeated dietary counseling aiming at reducing intake of saturated fat took place from infancy to early adulthood. Participants who had complete data on the MetS components (waist circumference, blood pressure, triglycerides, glucose, high-density lipoprotein cholesterol) at 15 (n = 512), 16 (n = 485), 17 (n = 475), 18 (n=459), 19 (n = 439), and 20 (n = 407) years of age were included in the study. Modified International Diabetes Foundation criteria with 80th/20th percentile cutoff points for the components were primarily applied in statistical analyses, and the results were replicated with the use of other pediatric MetS definitions. Between the ages of 15 and 20 years, the prevalence of MetS varied between 6.0% and 7.5% in participants in the intervention group and between 10% and 14% in the control group. The long-term relative risk of MetS was significantly lower in the intervention group (relative risk, 0.59; 95% confidence interval, 0.40-0.88; P = 0.009). Of the individual MetS components, the intervention decreased risk of high blood pressure in both sexes (relative risk, 0.83; 95% confidence interval, 0.70-0.99) and high triglycerides in male subjects (relative risk, 0.71; 95% confidence interval, 0.52-0.98). A statistically nonsignificant reduction was seen in the risk of high waist circumference in the intervention individuals (relative risk, 0.78; 95% confidence interval, 0.59-1.03).

Conclusions: Repeated infancy-onset dietary intervention is effective in the prevention of MetS in adolescence.