Abstract
To study the possible effects of a dietary intervention with minimal and unprocessed foods, high in natural saturated fats on the lipid profile and body mass index of children. This study combines three intervention studies; one non-randomized retrospective cohort study and two randomized controlled trials, to a pooled analysis. The intervention group received a dietary intervention of minimal and unprocessed foods for three to six months, consisting of five times per week green vegetables, three times per week beef, daily 200-300 mL whole cow's milk (3.4% fat) and whole dairy butter (80% fat) on each slice of bread. The control group continued their usual dietary habits. Raw data of the three intervention studies where combined into one single dataset for data analysis, using mixed effects analysis of covariance to test the effects of the dietary advice on the main study outcomes, which are measurements of the lipid profile. In total, 267 children aged 1 to 16 years were followed. 135 children were included in the intervention group and 139 children in the control group. Characteristics (age, gender and follow-up period) were equally distributed between the groups at baseline. In the intervention group HDL-cholesterol increased significantly from 1.22 mmol/L, 95% confidence interval (CI) 1.14-1.32 to 1.42 mmol/L 95% CI 1.30-1.65 (p = 0.007). The increase over time in HDL cholesterol in the intervention group was significantly different compared to the increase in the control group (from 1.26 mmol/L, 95% CI 1.19-1.35, to 1.30 mmol/L, 95% CI 1.26-1.37) (p = 0.04). Due to the increased HDL concentration in the intervention group, the total cholesterol/HDL cholesterol ratio decreased significantly from 3.70 mmol/L, 95% CI 3.38-3.87, to 3.25 mmol/L, 95% CI 2.96-3.31 (p = 0.05). Consumption of minimal and unprocessed foods (high in natural saturated fats) has favourable effects on HDL cholesterol in children. Therefore, this dietary advice can safely be recommended to children.
Highlights
Worldwide the prevalence of childhood obesity is increasing dramatically
Consumption of minimal and unprocessed foods has favourable effects on high-density lipoprotein (HDL) cholesterol in children. This dietary advice can safely be recommended to children
Seven participants had an incomplete lipid profile, 22 participants suffered from a disorder that might influence the lipid profile such as obesity and diabetes mellitus and four participants had other reasons for exclusion
Summary
Worldwide the prevalence of childhood obesity is increasing dramatically. Childhood obesity often results in obesity in adults with its well-known negative effects on human health, like cardiovascular disease (CVD) [1]. UNICEF investigated so-called healthy food products specially made for children, such as porridge, breakfast cereals and snacks, and concluded that 70% of these ‘healthy’ products are unhealthy since they are high sources of energy, trans-fatty acids, sugar and sodium [3]. Many of these products are processed or ultra-processed. It was concluded that early ultra-processed food consumption (at the age of 3–4 years) played a role in a negative altered lipid profile of the children later in life (at the age of 7–8 years). Eating more natural food products (unprocessed or minimally processed) at a younger age could contribute to a more positive lipid profile, and to a healthier life
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