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Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis

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  • Lisa Te Morenga
  • Jason M Montez

Abstract

Background: Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The aim of this review is to examine the evidence for health effects associated with reducing SFA and TFA intake in free-living children, adolescents and young adults between 2 to 19 years of age. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective cohort studies. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. Data were pooled using inverse variance models with random effects. Data sources: EMBASE; PubMed; Cochrane Central Register of Controlled Trials; LILACS; and WHO Clinical Trial Registry (up to July 2016). Eligibility criteria for selecting trials: RCTs involving dietary interventions aiming to reduce SFA or TFA intakes and a control group, and cohort studies reporting the effects of SFA or TFA exposures, on outcomes including blood lipids; measures of growth; blood pressure; insulin resistance; and potential adverse effects. Minimum duration was 13 days for RCTs and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Results: Compared with control diets, there was a highly statistically significant effect of reduced SFA intake on total cholesterol (mean difference (MD) -0.16 mmol/l, [95% confidence interval (CI): -0.25 to -0.07]), LDL cholesterol (MD -0.13 mmol/l [95% CI:-0.22 to -0.03]) and diastolic blood pressure (MD -1.45 mmol/l [95% CI:-2.34 to -0.56]). There were no significant effects on any other risk factors and no evidence of adverse effects. Conclusions: Advice to reduce saturated fatty acids intake of children results in a significant reduction in total and LDL-cholesterol levels as well as diastolic blood pressure without evidence of adverse effects on growth and development. Dietary guidelines for children and adolescents should continue to recommend diets low in saturated fat.

Suggested Citation

  • Lisa Te Morenga & Jason M Montez, 2017. "Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-20, November.
    • Handle: RePEc:plo:pone00:0186672
    DOI: 10.1371/journal.pone.0186672
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    3. Tershakovec, A.M. & Shannon, B.M. & Achterberg, C.L. & McKenzie, J.M. & Martel, J.K. & Smiciklas-Wright, H. & Pammer, S.E. & Cortner, J.A., 1998. "One-year follow-up of nutrition education for hypercholesterolemic children," American Journal of Public Health, American Public Health Association, vol. 88(2), pages 258-261.
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    2. Arbeláez, María Angélica & Cadena, Ximena & Alejandro, Becerra & Benitez, Miguel & Mejía, María José, 2022. "Elementos para el diseño de un impuesto a alimentos y bebidas altos en sodio, grasas y/o azúcares en Colombia," Informes de Investigación 21027, Fedesarrollo.
    3. Nelia P. Steyn & Johanna H. Nel & Sonia Malczyk & Linda Drummond & Marjanne Senekal, 2020. "Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in ," IJERPH, MDPI, vol. 17(5), pages 1-37, March.

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