title: 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).
abstract: 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.
  
  
  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.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00223600.
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.). mainnu@utu.fi.
authors.forename: Mari
authors.initials: M
authors.lastname: Nupponen
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Katja
authors.initials: K
authors.lastname: Pahkala
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Tapani
authors.initials: T
authors.lastname: Rönnemaa
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Maiju
authors.initials: M
authors.lastname: Saarinen
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Hanna
authors.initials: H
authors.lastname: Lagström
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Antti
authors.initials: A
authors.lastname: Jula
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Olli
authors.initials: O
authors.lastname: Simell
authors.affiliation: From the Research Centre of Applied and Preventive Cardiovascular Medicine, Turku, Finland (M.N., K.P., M.J., C.G.M., M.S., O.S., O.T.R.); Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Health and Physical Activity, Turku, Finland (K.P.); Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (M.J., T.R., J.S.A.V.); Murdoch Children's Research Institute, Melbourne, Australia (M.J.); Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia (C.G.M.); Departments of Pediatrics and Adolescent Medicine (H.N., O.S.) and Clinical Physiology and Nuclear Medicine (O.T.R.), University of Turku and Turku University Hospital, Turku, Finland; Turku Institute for Child and Youth Research, Turku, Finland (A.J.); and Institute for Health and Welfare, Turku, Finland (A.J.).
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003376:Counseling / Q000379:methods; D018752:Diet, Fat-Restricted / Q000379:methods; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D061345:Early Medical Intervention / Q000379:methods; D005227:Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids
keywords: atherosclerosis; diabetes mellitus; diet; longitudinal studies; metabolic syndrome X; prevention and control