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J Pediatr. 2019 Aug;211:105-111.e2. doi: 10.1016/j.jpeds.2019.03.047. Epub 2019 May 17.

A Positive Association Between Dietary Intake of Higher Cow's Milk-Fat Percentage and Non-High-Density Lipoprotein Cholesterol in Young Children.

Author information

1
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
2
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Ontario, Canada; Division of Paediatric Medicine and the Paediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
3
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
4
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
5
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
6
Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Ontario, Canada; Division of Paediatric Medicine and the Paediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Ontario, Canada.
7
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
8
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Ontario, Canada; Division of Paediatric Medicine and the Paediatric Outcomes Research Team, Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: catherine.birken@sickkids.ca.

Abstract

OBJECTIVES:

To determine the association between cow's milk-fat and non-high-density lipoprotein (non-HDL) cholesterol, a marker of cardiovascular disease (CVD) risk in young children, and whether this association is mediated by the typical volume of cow's milk consumed.

STUDY DESIGN:

A longitudinal study in 2- to 8-year-old children (n = 2890) was conducted through The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Generalized estimating equations were used to examine the relationship between parent-reported cow's milk-fat percentage intake and serum non-HDL cholesterol concentrations as well as having high non-HDL cholesterol (≥3.75 mmol/L [145 mg/dL]), adjusting for covariates including age, sex, body mass index z score, breastfeeding duration, mother's ethnicity, and parental history of CVD. Bootstrap resampling (10 000 repetitions) was used to assess whether typical volume consumed mediated the association between cow's milk-fat percentage and non-HDL cholesterol.

RESULTS:

In total, 156 (5.4%) had high non-HDL cholesterol. Each percent increase in cow's milk-fat was associated with a 0.035 mmol/L (1.35 mg/dL) (P < .001) and 0.024 mmol/L (0.92 mg/dL) (P = .01) increase in non-HDL cholesterol, unadjusted and adjusted for covariates respectively. Cow's milk-fat percentage was not associated with greater odds of having high non-HDL cholesterol. Volume of cow's milk partially mediated the association between cow's milk-fat percentage and non-HDL cholesterol, accounting for 28% of the relationship (P < .001).

CONCLUSIONS:

Consumption of higher-fat cow's milk was associated with a small increase in non-HDL cholesterol but not greater odds of having high non-HDL cholesterol. Further research is needed to assess this relationship with other CVD risk factors in young children.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT01869530.

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