The impact of replacing regular- with reduced-fat dairy foods on children's wider food intake: secondary analysis of a cluster RCT.

BACKGROUND/OBJECTIVES: The effect of changing one aspect of diet needs to be considered within the context of total diet. The study aim was to evaluate the changes in children's overall food intake following replacement of regular-fat with reduced-fat dairy foods.

SUBJECTS/METHODS: Secondary analysis of a cluster Randomized Controlled Trial where families were received parental behavioral nutrition education to change to reduced-fat dairy foods (intervention) or reduce screen time (comparison control). Food intake was assessed via multiple 24-h recalls at baseline, week 12 (end of the intervention) and week 24. Participants were parents and their children (4-13 years, N=145) who were regular-fat dairy food consumers. The intervention effect was based on mixed model analysis adjusted for covariates, and baseline food intake.

RESULTS

At week 24, total dairy servings per day were similar between groups and servings of reduced-fat dairy foods were higher in the intervention group (0.8 servings per day 95% confidence interval (CI) 0.5-1.1, P<0.0001). Fruit intake was higher in the intervention group (0.5 servings per day 95% CI 0.02-0.9, P=0.040), with no other statistically significant differences in food intake. In the intervention group, the contribution of core food groups to saturated fat intake was 45% at baseline and 31% at week 24, with 'extra foods' being the largest contributor to total energy (28%) and saturated fat (40%) intake at follow-up.

CONCLUSIONS

Changing children's dairy food choices to reduced-fat varieties did not adversely affect overall food intake. Replacing energy-dense foods with nutrient-rich foods should be the focus of interventions to lower in saturated fat.