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Are changes in consumption of "healthy" foods related to changes in consumption of "unhealthy" foods during pediatric obesity treatment?

ABSTRACT: Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight (? 85th to <95th percentile for body mass index [BMI]) and obese (? 95th percentile for BMI) children (7.2 ± 1.7 years) with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1) increased growth monitoring with feedback; (2) decrease SFs and sugar sweetened beverages; or (3) increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake.

SUBMITTER: Looney SM

PROVIDER: S-EPMC3366617 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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Are changes in consumption of "healthy" foods related to changes in consumption of "unhealthy" foods during pediatric obesity treatment?

Looney Shannon M SM Raynor Hollie A HA

International journal of environmental research and public health 20120416 4

Increasing fruits and vegetables (FVs), a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs). This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight (≥ 85th to <95th percentile for body mass index [B ...[more]

PMID: 22690199

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Project description:Over one third of Australians' daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19-24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.

Project description:BACKGROUND:Relative prices of healthy/unhealthy foods have been implicated in the obesity epidemic, but never extensively quantified across countries or empirically linked to undernutrition. OBJECTIVES:This study compared relative caloric prices (RCPs) for different food categories across 176 countries and ascertained their associations with dietary indicators and nutrition outcomes. METHODS:We converted prices for 657 standardized food products from the 2011 International Comparison Program into caloric prices using USDA Food Composition tables. We classified products into 21 specific food groups. We constructed RCPs as the ratio of the 3 cheapest products in each food group, relative to the weighted cost of a basket of starchy staples. We analyzed RCP differences across World Bank income levels and regions and used cross-country regressions to explore associations with Demographic Health Survey dietary indicators for women 15-49 y old and children 12-23 mo old and with WHO indicators of the under-5 stunting prevalence and adult overweight prevalence. RESULTS:Most noncereal foods were relatively cheap in high-income countries, including sugar- and fat-rich foods. In lower-income countries, healthy foods were generally expensive, especially most animal-sourced foods and fortified infant cereals (FICs). Higher RCPs for a food predict lower consumption among children for 7 of 9 food groups. Higher milk and FIC prices were positively associated with international child stunting patterns: a 1-SD increase in milk prices was associated with a 2.8 percentage point increase in the stunting prevalence. Similarly, a 1-SD increase in soft drink prices was associated with a reduction in the overweight prevalence of ∼3.6 percentage points. CONCLUSIONS:Relative food prices vary systematically across countries and partially explain international differences in the prevalences of undernutrition and overweight adults. Future research should focus on how to alter relative prices to achieve better dietary and nutrition outcomes.

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Are changes in consumption of "healthy" foods related to changes in consumption of "unhealthy" foods during pediatric obesity treatment?

Publications

Are changes in consumption of "healthy" foods related to changes in consumption of "unhealthy" foods during pediatric obesity treatment?

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