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

Nutrition Journal 2008,
7:28doi:10.1186/1475-2891-7-28. Open Access article distributed under the terms of the Creative Commons Attribution License

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.