Children's adaptations to a fat-reduced diet: the Dietary Intervention Study in Children (DISC).
ABSTRACT Prevention of cardiovascular disease through diet and lifestyle change is strongly advocated in adults and is initiated preferably during childhood. The Dietary Intervention Study in Children (DISC) was a multicenter, collaborative, randomized trial in 663 preadolescent children (363 boys and 301 girls) with elevated low-density lipoprotein cholesterol, designed to test the efficacy and safety of a dietary intervention to lower saturated-fat and cholesterol intake while also advocating a healthy eating pattern. DISC results have been published extensively. This ancillary study reports new data regarding changes in eating patterns among this cohort.
We set out to compare children's self-selected eating patterns and approaches to achieving adherence to the DISC fat-reduced diet intervention with children in the usual-care group.
An ancillary study was conducted to develop a detailed food-grouping system and report new analyses on dietary adherence to the recommended eating pattern. Every food in the nutrient database was ranked by its saturated-fat and cholesterol content and classified within its relevant food group as a "go" (less atherogenic) or "whoa" (more atherogenic) food.
At baseline, go foods contributed approximately 57% of total energy intake and 12.4% to 13.1% total fat energy intake in both groups. At 3 years, go foods contributed 67.4% and 13.7% of total and fat energy intake, respectively, in the intervention group versus 56.8% and 12.8% in the usual-care group. Differences between the 2 treatment groups were significant for changes in consumption of dairy foods, desserts, and fats/oils, with the intervention group reporting a 0.2- to 0.3-serving-per-day greater increase in go foods than the usual-care group. The intervention group also reported a 0.2- to 0.8-serving-per-day greater decrease in whoa foods than the usual-care group for breads/grains, dairy, fats/oils, meat/fish/poultry, snacks, and vegetables. Overall, snack foods, desserts, and pizza contributed approximately one third of total daily energy intake in both groups at 3 years.
Children in the intervention group reported consuming more servings per day of go grains, dairy, meats, and vegetable foods compared with children in the usual-care group, but intake of fruits and vegetables was low in both groups. Discovering that snacks, desserts, and pizza actively contribute so heavily to the diets of this age group, even among children who were part of this intervention, offers valuable insights regarding the need for more aggressive, innovative, and realistic approaches for additional dietary counseling.
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ABSTRACT: In Lebanon, childhood obesity doubled during the past decade. Preventive measures should start early in life and Schools are considered an important environment to promote energy balance health behaviours. School-based programmes promoting healthy lifestyles are lacking. The purpose of this study was to evaluate the feasibility and effectiveness of a multicomponent school-based intervention to promote healthy eating and physical activity (and prevent obesity) with school children aged 9-11 years in Lebanon.BMC Public Health 09/2014; 14(1):940. DOI:10.1186/1471-2458-14-940 · 2.32 Impact Factor
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ABSTRACT: Dietary guidance emphasizes plain low-fat and skim milk over whole, reduced-fat, and flavored milk (milk eligible for replacement [MER]). The objective of this study was to evaluate the population-level impact of such a change on energy, macronutrient and nutrient intakes, and diet cost. Cross-sectional modeling study. Data from the 2001-2002 and 2003-2004 National Health and Nutrition Examination Survey. A total of 8,112 children aged 2-19 years. Energy, macronutrient, and micronutrient intake before and after replacement of MER with low-fat or skim milk. Survey-weighted linear regression models. Milk eligible for replacement accounted for 46% of dairy servings. Among MER consumers, replacement with skim or low-fat milk would lead to a projected reduction in energy of 113 (95% confidence interval [CI], 107-119) and 77 (95% CI, 73-82) kcal/d and percent energy from saturated fat by an absolute value of 2.5% of total energy (95% CI, 2.4-2.6) and 1.4% (95% CI, 1.3-1.5), respectively. Replacement of MER does not change diet costs or calcium and potassium intake. Substitution of MER has the potential to reduce energy and total and saturated fat intake with no impact on diet costs or micronutrient density. The feasibility of such replacement has not been examined and there may be negative consequences if replacement is done with non-nutrient-rich beverages. Copyright © 2015. Published by Elsevier Inc.Journal of Nutrition Education and Behavior 02/2015; 47(1):61-68.e1. DOI:10.1016/j.jneb.2014.11.001 · 1.47 Impact Factor
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ABSTRACT: The study was aimed at assessing eating habits of adolescent population, diagnosed with one or more cardiovascular risks (CVR) before and two months after the individual dietary intervention. Food frequency questionnaire, anthropometric measurements, blood pressure and biochemical measurements with individual nutrition education were conducted on a group of 17 adolescents aged 14.5 years. Total calorie intake, proteins, total and saturated fats, cholesterol, total and simple carbohydrates and sodium decreased, while fiber intake increased significantly. Significant decrease showed mean body mass index, total cholesterol, LDL, TAG, and blood pressure. The individual dietary education resulted in a positive shift in eating habits as well as CVR values.02/2014; 11(1):234-7.