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An increase of cereal intake as an approach to weight reduction in children is effective only when accompanied by nutrition education: a randomized controlled trial.

Rosado JL, del R Arellano M, Montemayor K, García OP, Caamaño Mdel C - Nutr J (2008)

Bottom Line: After 12 weeks of intervention only the children that received 33 +/- 7 g of RTEC and nutrition education had significantly lower body weight [-1.01 (-1.69, -0.34) ], p < 0.01], lower BMI [-0.95 (-1.71, -0.20), p < 0.01] and lower total body fat [-0.71 (-1.71, 0.28), p < 0.05] compared with the control group [1.19 (0.39, 1.98), 0.01 (-0.38, 0.41), 0.44 (-0.46, 1.35) respectively].Plasma triglycerides and VLDL were significantly reduced [-20.74 (-36.44, -5.05), -3.78 (-6.91, -0.64) respectively, p < 0.05] and HDL increased significantly [6.61 (2.15, 11.08), p < 0.01] only in this treatment group.A strategy to increase RTEC consumption, as a source of carbohydrate, to reduce obesity is effective only when accompanied by nutrition education.

View Article: PubMed Central - HTML - PubMed

Affiliation: Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México. jlrosado@avantel.net

ABSTRACT

Background: The main emphasis of dietary advice for control of obesity has been on reducing dietary fat. Increasing ready to eat cereal (RTEC) consumption could be a strategy to reduce fat intake and increase carbohydrate intake resulting in a diet with lower energy density.

Objectives: 1. To determine if an increase in RTEC intake is an effective strategy to reduce excess body weight and blood lipids in overweight or at risk of overweight children. 2. To determine if a nutrition education program would make a difference on the response to an increase in cereal intake. 3) To determine if increase in RTEC intake alone or with a nutrition education program has an effect on plasma lipid profile.

Experimental design: One hundred and forty seven overweight or at risk of overweight children (6-12 y of age) were assigned to one of four different treatments: a. One serving of 33 +/- 7 g of RTEC for breakfast; b. one serving of 33 +/- 7 g of RTEC for breakfast and another one for dinner; c. one serving of 33 +/- 7 g of RTEC for breakfast and a nutrition education program. d. Non intervention, control group. Anthropometry, body composition, physical activity and blood lipids were measured at baseline, before treatments, and 12 weeks after treatments.

Results: After 12 weeks of intervention only the children that received 33 +/- 7 g of RTEC and nutrition education had significantly lower body weight [-1.01 (-1.69, -0.34) ], p < 0.01], lower BMI [-0.95 (-1.71, -0.20), p < 0.01] and lower total body fat [-0.71 (-1.71, 0.28), p < 0.05] compared with the control group [1.19 (0.39, 1.98), 0.01 (-0.38, 0.41), 0.44 (-0.46, 1.35) respectively]. Plasma triglycerides and VLDL were significantly reduced [-20.74 (-36.44, -5.05), -3.78 (-6.91, -0.64) respectively, p < 0.05] and HDL increased significantly [6.61 (2.15, 11.08), p < 0.01] only in this treatment group. The groups that received 1 or 2 doses of RTEC alone were not significantly different to the control group.

Conclusion: A strategy to increase RTEC consumption, as a source of carbohydrate, to reduce obesity is effective only when accompanied by nutrition education. The need for education could be extrapolated to other strategies intended for treatment of obesity.

Trial registration: Australian New Zealand Clincial Trial Registry. Request no: ACTRN12608000025336.

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Mentions: Children were recruited from October to December 2002 and the fieldwork was from January to June 2003. The statistical analyses considered all children that had initial and final measurements in an intention to treat basis. Only one child that had an extreme weight final value was excluded from analysis. The participants' flow chart is shown in figure 1. Age, gender and height were not different between children included and children excluded from the analysis. Characteristics of subjects in the experimental groups at the beginning of the study are shown in table 2. Changes in weight, BMI and body composition are shown in Table 3. After 12 weeks of intervention there was a significant increase in body weight in the two RTEC groups and in the control group, only the group that had RTEC plus nutrition education had no increment in body weight. In analysis of variance, children that consumed one serving of RTEC and had nutrition education had a difference in unadjusted weight change of 2.03 kg compared with children in the control group (p < 0.01). Body weight change in the RTEC and nutrition education group adjusted for gender, school and baseline body weight was also significantly different from the control (p < 0.001) and the other two treatment groups (p < 0.01). Unadjusted and adjusted changes in body weight with both treatments with RTEC alone were not statistically different from the control group. BMI reduced significantly only in the group of children that received RTEC and nutrition education (p < 0.01); children in this group had an unadjusted change in mean BMI of 0.64 kg//m2 higher than the control group (p < 0.01). This group's adjusted change in BMI was also statistically greater than control (p < 0.01) and the other two treatments with RTEC only (p < 0.05). Children in the RTEC and nutrition education group showed an unadjusted decrease in total body fat of 1.15 kg compared to the control group (p < 0.05) and the change adjusted for sex, school and baseline body fat was different from the control group and from the group with 1 dose or two of RTEC. Boys reduced total body fat 1.3% more than girls did (p < 0.05) (Data not shown). Unadjusted and adjusted changes in indicators of body composition in the two RTEC groups that did not receive any nutrition education were not different compared with the control group.


An increase of cereal intake as an approach to weight reduction in children is effective only when accompanied by nutrition education: a randomized controlled trial.

Rosado JL, del R Arellano M, Montemayor K, García OP, Caamaño Mdel C - Nutr J (2008)

Flow-chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2543040&req=5

Figure 1: Flow-chart.
Mentions: Children were recruited from October to December 2002 and the fieldwork was from January to June 2003. The statistical analyses considered all children that had initial and final measurements in an intention to treat basis. Only one child that had an extreme weight final value was excluded from analysis. The participants' flow chart is shown in figure 1. Age, gender and height were not different between children included and children excluded from the analysis. Characteristics of subjects in the experimental groups at the beginning of the study are shown in table 2. Changes in weight, BMI and body composition are shown in Table 3. After 12 weeks of intervention there was a significant increase in body weight in the two RTEC groups and in the control group, only the group that had RTEC plus nutrition education had no increment in body weight. In analysis of variance, children that consumed one serving of RTEC and had nutrition education had a difference in unadjusted weight change of 2.03 kg compared with children in the control group (p < 0.01). Body weight change in the RTEC and nutrition education group adjusted for gender, school and baseline body weight was also significantly different from the control (p < 0.001) and the other two treatment groups (p < 0.01). Unadjusted and adjusted changes in body weight with both treatments with RTEC alone were not statistically different from the control group. BMI reduced significantly only in the group of children that received RTEC and nutrition education (p < 0.01); children in this group had an unadjusted change in mean BMI of 0.64 kg//m2 higher than the control group (p < 0.01). This group's adjusted change in BMI was also statistically greater than control (p < 0.01) and the other two treatments with RTEC only (p < 0.05). Children in the RTEC and nutrition education group showed an unadjusted decrease in total body fat of 1.15 kg compared to the control group (p < 0.05) and the change adjusted for sex, school and baseline body fat was different from the control group and from the group with 1 dose or two of RTEC. Boys reduced total body fat 1.3% more than girls did (p < 0.05) (Data not shown). Unadjusted and adjusted changes in indicators of body composition in the two RTEC groups that did not receive any nutrition education were not different compared with the control group.

Bottom Line: After 12 weeks of intervention only the children that received 33 +/- 7 g of RTEC and nutrition education had significantly lower body weight [-1.01 (-1.69, -0.34) ], p < 0.01], lower BMI [-0.95 (-1.71, -0.20), p < 0.01] and lower total body fat [-0.71 (-1.71, 0.28), p < 0.05] compared with the control group [1.19 (0.39, 1.98), 0.01 (-0.38, 0.41), 0.44 (-0.46, 1.35) respectively].Plasma triglycerides and VLDL were significantly reduced [-20.74 (-36.44, -5.05), -3.78 (-6.91, -0.64) respectively, p < 0.05] and HDL increased significantly [6.61 (2.15, 11.08), p < 0.01] only in this treatment group.A strategy to increase RTEC consumption, as a source of carbohydrate, to reduce obesity is effective only when accompanied by nutrition education.

View Article: PubMed Central - HTML - PubMed

Affiliation: Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México. jlrosado@avantel.net

ABSTRACT

Background: The main emphasis of dietary advice for control of obesity has been on reducing dietary fat. Increasing ready to eat cereal (RTEC) consumption could be a strategy to reduce fat intake and increase carbohydrate intake resulting in a diet with lower energy density.

Objectives: 1. To determine if an increase in RTEC intake is an effective strategy to reduce excess body weight and blood lipids in overweight or at risk of overweight children. 2. To determine if a nutrition education program would make a difference on the response to an increase in cereal intake. 3) To determine if increase in RTEC intake alone or with a nutrition education program has an effect on plasma lipid profile.

Experimental design: One hundred and forty seven overweight or at risk of overweight children (6-12 y of age) were assigned to one of four different treatments: a. One serving of 33 +/- 7 g of RTEC for breakfast; b. one serving of 33 +/- 7 g of RTEC for breakfast and another one for dinner; c. one serving of 33 +/- 7 g of RTEC for breakfast and a nutrition education program. d. Non intervention, control group. Anthropometry, body composition, physical activity and blood lipids were measured at baseline, before treatments, and 12 weeks after treatments.

Results: After 12 weeks of intervention only the children that received 33 +/- 7 g of RTEC and nutrition education had significantly lower body weight [-1.01 (-1.69, -0.34) ], p < 0.01], lower BMI [-0.95 (-1.71, -0.20), p < 0.01] and lower total body fat [-0.71 (-1.71, 0.28), p < 0.05] compared with the control group [1.19 (0.39, 1.98), 0.01 (-0.38, 0.41), 0.44 (-0.46, 1.35) respectively]. Plasma triglycerides and VLDL were significantly reduced [-20.74 (-36.44, -5.05), -3.78 (-6.91, -0.64) respectively, p < 0.05] and HDL increased significantly [6.61 (2.15, 11.08), p < 0.01] only in this treatment group. The groups that received 1 or 2 doses of RTEC alone were not significantly different to the control group.

Conclusion: A strategy to increase RTEC consumption, as a source of carbohydrate, to reduce obesity is effective only when accompanied by nutrition education. The need for education could be extrapolated to other strategies intended for treatment of obesity.

Trial registration: Australian New Zealand Clincial Trial Registry. Request no: ACTRN12608000025336.

Show MeSH
Related in: MedlinePlus