Long-term Effectiveness of Maternal Dietary Counseling in a Low-Income Population: A Randomized Field Trial

OBJECTIVE: To assess the impact of dietary counseling given to mothers during the first year of infants' lives on food consumption, nutritional status, and lipid profile of the children up to 7 to 8 years old. METHODS: The randomized trial was conducted with 500 mothers who gave birth to full-term infants with birth weight >= 2500 g between October 2001 and June 2002 in Sao Leopoldo, Brazil. Mothers were randomly assigned to intervention (n = 200) and control groups (n = 300) and those in the intervention group received counseling on breastfeeding and complementary feeding by 12 fieldworkers on 10 home visits during the first year of children's lives. Blinded fieldworkers assessed dietary and anthropometric data at 12 to 16 months, 3 to 4 years, and 7 to 8 years and lipid profiles at 3 to 4 years and 7 to 8 years old. The lipid profile was the primary outcome. RESULTS: Of the 500 recruited children, 397 underwent the 12- to 16-month, 354 the 3- to 4-year, and 315 the 7- to 8-year assessment. The energy-dense foods intake was significantly lower in the intervention group at 12 to 16 months and 3 to 4 years old. At 3 to 4 years, serum lipid levels did not differ between groups. At 7 to 8 years, high-density lipoprotein levels were 0.11 mmol/L higher (0.00 to 0.20), and triglycerides concentration was 0.13 mmol/L lower (-0.25 to -0.01) in intervention children but only among the girls. Overweight/obesity rates did not differ between groups. CONCLUSIONS: Dietary counseling for mothers during infancy decreased the energy-dense foods consumption and improved lipid profile. Pediatrics 2012;129:e1477-e1484