The effects of a 2-year physical activity and dietary intervention on plasma lipid concentrations in children: the PANIC Study

Abstract

Purpose We studied the effects of a physical activity and dietary intervention on plasma lipids in a general population of children. We also investigated how lifestyle changes contributed to the intervention effects. Methods We carried out a 2-year controlled, non-randomized lifestyle intervention study among 504 mainly prepubertal children aged 6-9 years at baseline. We assigned 306 children to the intervention group and 198 children to the control group. We assessed plasma concentrations of total, LDL, HDL, and VLDL cholesterol, triglycerides, HDL triglycerides, and VLDL triglycerides. We evaluated the consumption of foods using 4-day food records and physical activity using a movement and heart rate sensor. We analyzed data using linear mixed-effect models adjusted for age at baseline, sex, and pubertal stage at both time points. Furthermore, specific lifestyle variables were entered in these models. Results Plasma LDL cholesterol decreased in the intervention group but did not change in the control group (− 0.05 vs. 0.00 mmol/L, regression coefficient (β) = − 0.0385, p = 0.040 for group*time interaction). This effect was mainly explained by the changes in the consumption of high-fat vegetable oil-based spreads (β = − 0.0203, + 47% change in β) and butter-based spreads (β = − 0.0294, + 30% change in β), moderate-to-vigorous physical activity (β = − 0.0268, + 30% change in β), light physical activity (β = − 0.0274, + 29% change in β) and sedentary time (β = − 0.0270, + 30% change in β). The intervention had no effect on other plasma lipids. Conclusion Lifestyle intervention resulted a small decrease in plasma LDL cholesterol concentration in children. The effect was explained by changes in quality and quantity of dietary fat and physical activity. Clinical Trial Registry Number NCT01803776, ClinicalTrials.gov

The effects of an 8-year individualised lifestyle intervention on food consumption and nutrient intake from childhood to adolescence: the PANIC Study

“…These observations are of potential clinical importance, since replacing saturated fat with polyunsaturated fat has been shown to decrease the plasma concentration of low-density lipoprotein cholesterol and to reduce the risk of coronary heart disease in adults (28) . We have earlier found that the diet and physical activity intervention decreased plasma levels of low-density lipoprotein cholesterol over 2 years in the present study sample (13) . These observations together suggest that the improved quality of dietary fat since childhood may help prevent cardiovascular diseases in adulthood.…”

“…Adolescents in the intervention group may have been more likely to be aware of the recommended diet and misreport their diet towards these recommendations than those in the control group. However, the improved plasma fatty acid profile (12) and the decreased plasma levels of low-density lipoprotein cholesterol (13) after 2 years supported the improved diet quality assessed by food records in the intervention group. One also has to be aware that the season when the food record is filled may affect the dietary data.…”

“…We have previously reported that our individualised and family-based diet and physical activity intervention increased the consumption of vegetables, high-fat vegetable oil-based spreads and low-fat milk and decreased the consumption of butter-based spreads during the first 2 years of intervention (11) . Accordingly, the lifestyle intervention increased the plasma proportion of polyunsaturated fatty acids and decreased the proportion of some saturated fatty acids (12) , decreased the plasma concentration of low-density lipoprotein cholesterol (13) and attenuated the increase in insulin resistance (14) during the first two intervention years.…”

Associations between weight loss history and factors related to type 2 diabetes risk in the Stop Diabetes study

“…In order to study how weight loss history contributed to changes in outcome measures during 1 year of intervention, we tested for the 'lifetime history of weight loss × time' interaction using the intention-to-treat principle, including all 2684 participants in the analyses. Linear mixedeffect model analysis was used, and for each of the outcome measures we tested several models with allowing/ignoring random intercept and random slope on subject and/or study province level [48]. The Bayesian information criterion (BIC) was used as a measure of model adequacy [49,50].…”

Association of Non–High-Density Lipoprotein Cholesterol Measured in Adolescence, Young Adulthood, and Mid-Adulthood With Coronary Artery Calcification Measured in Mid-Adulthood

“…This is exemplified by recent data from the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study, in which participants who received individualized dietary counselling from age 7 months to 20 years were more likely to have ideal total cholesterol levels 6 years later (at age 26 years) compared with controls. Moreover, shorter (2-year) family-based interventions may also be effective, as highlighted by findings from the Physical Activity and Nutrition in Children (PANIC) study, in which individuals receiving physical activity and dietary interventions saw reductions in LDL-C levels compared with controls. These data align with our previous work showing that body mass index may be a key determinant of lipid and lipoprotein tracking .…”