Is There a Relationship Between Dietary Fat and Stature or Growth in Children Three to Five Years of Age?

STUDY OBJECTIVE: To determine whether a moderately reduced fat diet affects the stature or growth of healthy preschool children. DESIGN: Cohort study with mean of 25 months of follow-up. SETTING: Primary care pediatrics practice at a large urban medical center. SUBJECTS: A predominantly Hispanic group of 215 children aged 3 to 4 years at baseline. MEASUREMENTS AND MAIN RESULTS: The children's diet was assessed using four 24-hour recalls and three Willett semiquantitative food-frequency questionnaires administered to the children's mothers over a 1-year baseline period. Stature was defined in terms of height, weight, and body mass index at baseline. Growth was defined in terms of change during follow-up in height, weight, and body mass index. Total fat provided a mean of 27.1% of caloric intake in the lowest quintile of intake compared with 38.4% in the highest quintile. There were no differences in stature or growth across quintiles of children defined by consumption of total fat, saturated fat, or cholesterol. These findings were consistent across the two methods of diet assessment. Children who consumed a smaller percentage of total calories from fat consumed significantly less total calories, saturated fat, cholesterol, calcium, and phosphorus, as well as more carbohydrates, iron, thiamine, niacin, vitamin A, and vitamin C. CONCLUSIONS: These data support the safety of a moderately reduced fat diet in healthy preschool children. Maintenance of calcium and phosphorus intake should be part of any program of dietary fat reduction. Substitution of low-fat milk for whole milk, rather than elimination of whole milk, is one such strategy.