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Study shows limiting fat does no harm to toddlers

SHARE Study shows limiting fat does no harm to toddlers

CHICAGO (AP) — Reducing children's fat intake to prevent heart disease later in life can start before age 2 without harming their brains, Finnish researchers say.

U.S. guidelines recommend against restricting fat before age 2, largely out of concern that fat deficiency could impair proper development of children's rapidly growing brains.

The study of 496 Finnish children who were followed from 7 months of age to 5 years "goes a long way to laying that question to rest," said Dr. Gilman Grave, chief of endocrinology, nutrition and growth at the National Institute of Child Health and Human Development.

At age 5, children on a reduced-fat diet and those on a regular diet performed similarly on tests of speech, language, motor functioning and visual skills.

Grave said the results could help address the nation's "epidemic of childhood obesity."

Other U.S. nutrition experts were more skeptical.

Autopsies have shown that even young children can develop fatty streaks in their heart arteries. And the Finnish researchers hypothesized that limiting fat intake in early childhood might keep that from happening and reduce the risk of heart disease later on.

But the children's arteries were not examined, and they were not followed into adulthood. As a result, the long-term effect of their diets is unknown, said Sheah Rarback, a pediatric dietitian and spokeswoman for the American Dietetic Association.

"They haven't proven the necessity," Rarback said.

The study, led by Dr. Leena Rask-Nissila of the University of Turku, appears in Wednesday's Journal of the American Medical Association. In an earlier phase of the study, the authors reported in 1997 that children on low-fat diets fared well nutritionally except for vitamin D and iron, and they recommended supplements until age 2.

The youngsters and their families were randomly assigned to two groups.

The parents in one group were asked to put their youngsters on a low-fat diet, with a goal of limiting fat to no more than 30 percent to 35 percent of daily calories. By contrast, U.S. guidelines recommend limiting fat to no more than 30 percent of calories starting at age 2.

Breast-feeding or formula were recommended for both groups up to age 1.

The parents of the children in the low-fat group were advised to hold down their youngsters' intake of saturated fat and cholesterol and give them nonfat milk after they were weaned.

The parents of the children in the other group were advised to give them cow's milk containing at least 1.9 percent fat starting at age 1 but otherwise received no specific guidelines on fat intake.

At 13 months, average daily fat intake was 25.5 percent for the low-fat group and 27.6 percent for the control group. It approached 30 percent by age 2 for the low-fat group and remained at about that level for the rest of the study. For the control group it was closer to 33 percent for years 2 to 5.

Cholesterol levels in the low-fat group were 3 percent to 5 percent lower than in the control-group children throughout the study.

Melody Persinger, a dietitian at Children's National Medical Center in Washington, worried the findings could prompt overzealous parents to impose diet restrictions that could put finicky youngsters at risk for nutritional deficiencies.

And Rarback questioned whether the modest reductions in cholesterol achieved by children in the low-fat group were worth the risk.

"These are the growth years," she said. "You need to know the long-term benefit to make those types of changes."


On the Net:

American Academy of Pediatrics: www.aap.org/policy/re9805.html