|New NHLBI-Sponsored Study Shows Programs Can Teach Children to Eat Healthier
Family Involvement and Access to Healthy Foods are Key, Say Researchers
Parents, take heart: You can teach your child to eat healthier.
A study of preadolescent children found that those who attended
a behaviorally oriented nutrition education program and were taught
to follow a diet low in saturated fat and dietary cholesterol adopted
significantly better dietary habits over several years compared
to their peers who received only general nutritional information.
The study showed that after three years, children in the intervention group
consumed more than 67 percent of their total calories on average from heart-healthy
foods, compared to less than 57 percent for children in the usual care group.
The results, published in the June issue of Pediatrics, are from a new
ancillary study of the Dietary Intervention Study in Children (DISC). Scientists
reviewed dietary recalls from 595 children who were ages 8 to 10 and who
had high blood cholesterol levels at the start of the study. The researchers
analyzed dietary information by food groups and measured adherence to recommended
food patterns and changes over time.
“These new findings offer valuable lessons for finding effective
ways to help children develop healthier eating habits a critical
need in light of the rising rates of obesity and related conditions among
children,” said Elizabeth G. Nabel, MD, director of the National Heart,
Lung, and Blood Institute (NHLBI), which sponsored the study. NHLBI is part
of the National Institutes of Health (NIH).
The study provides glimpses of real-world eating behavior and reveals the
challenges of trying to eat a healthy diet in a fast-paced world. For example,
the study documents a long-suspected phenomenon of modern society: approximately
one-third of the total daily calories consumed by the children in both groups
came from snack foods, desserts, and pizza.
The main DISC trial is the first long-term clinical trial of the effects
of a fat-reduced dietary intervention on growing children. Over the seven
years of the original study, children who adopted a low-fat, low-cholesterol
diet decreased their intake of total fat, saturated fat and cholesterol
within the first year of the study and maintained lower levels for several
more years. Those selected for the intervention group participated in a
nutrition education program which included a behavioral component to promote
healthier eating. Parents of the children in the intervention group participated
in a similar program. Researchers previously reported that the dietary changes
made by children in the intervention group did not adversely affect the
children’s nutritional status, growth, or development.
In the latest analysis, researchers analyzed the dietary recalls collected
over three days at the beginning of the study and again after three years.
They found that the dairy food group and the desserts/snacks/pizza group
had the greatest impact on the children’s body mass index (BMI) and
their levels of LDL, or “bad,” cholesterol. Girls and boys who
consumed more dairy products were more likely to have a lower BMI. In addition,
boys who consumed more desserts, snacks, and pizza were more likely to have
higher BMI and LDL levels.
Specific foods within each food group were also classified based on the
ingredients or preparation methods as either “Whoa” foods those
that were high in saturated fat and dietary cholesterol or heart-healthy “Go” foods those
that were low in saturated fat and dietary cholesterol.
Compared to baseline, after three years, children in the intervention group
consumed more of the “Go” food choices in all of the food groups
except fruit, and they consumed fewer of the “Whoa” food choices
with one exception: pizza. They also consumed on average slightly fewer
snacks and desserts after three years compared to the usual care group.
In addition, children in the intervention group chose more “Go” versions
of desserts (such as lowfat frozen yogurt, gelatin or angel food cake) and
more “Go” versions of pizza (such as those made with lowfat
cheese) compared to those in the usual care group. However, the authors
note, children in both groups ate fewer than recommended servings of fruits
The intervention group’s greater consumption of total daily calories
from “Go” foods shows that children and their families can be
taught to improve children’s diets, according to Linda Van Horn, PhD,
RD, professor of preventive medicine at Northwestern University, lead author
of the study.
“You can raise a child to enjoy healthy eating and to be selective
about food choices. Habits developed in childhood will hopefully last throughout
their lives,” said Van Horn. “With the right guidance and nutrition
education, children learn to prefer healthy foods such as carrots and raisins
or cereal as snacks, for example. We could really help improve both the
nutritional quality and energy balance of our children’s diets by
teaching them to make healthy food choices at an early age.”
Eva Obarzanek, PhD, RD, NHLBI nutritionist and DISC project officer, agrees
that most children could benefit from healthier eating patterns like those
followed by DISC participants. “DISC has shown that following a diet
low in saturated fat and cholesterol is safe for children in this age group and
a heart-healthy diet can lower blood cholesterol levels,” she noted.
Lower levels of LDL cholesterol are known to reduce the risk for heart
disease. Obarzanek added, “It’s never too early to start protecting
your heart or your child’s heart.”
Studies have shown that atherosclerosis, or hardening of the arteries the
leading cause of heart disease begins in childhood. The National Cholesterol
Education Program recommends that children over the age of about 2 years,
as well as all adults, adopt a heart-healthy eating pattern to reduce their
risk of developing heart disease as adults. Children and adults can also
lower their risk by maintaining a healthy weight and by being physically
Parents and others play an important role in shaping their children’s
dietary habits. “In addition to being strong advocates for their children
by helping them learn to make good food choices, parents and other adults
need to take responsibility for ensuring that children have access to healthy
foods at home, at school, and at sporting or recreational events,” Van
Horn added. “For example, when it’s your turn to bring the snack
for the kids on the soccer team, instead of chips or candy, how about having
orange slices and strawberries instead? Children can learn to say ‘no
thanks’ to a sugar-sweetened soda and to request water or skim milk
instead, but those foods have to be available to them.”
The six DISC clinical center sites were Kaiser Foundation Research Institute,
Johns Hopkins University, Louisiana State University, New Jersey Medical
College, Northwestern University, and the University of Iowa. The coordinating
center was the Maryland Medical Research Institute.
To help families adopt healthier lifestyles, NIH launched today a new national
public education program targeting parents and caregivers of children ages
8 to 13. Developed by NHLBI and promoted in collaboration with several other
NIH institutes, national health and youth organizations, and community-based
groups, We Can! (Ways to Enhance Children’s Activity & Nutrition!)
provides resources to encourage healthy eating, increase physical activity,
and reduce sedentary time. The program offers a parents’ handbook
in Spanish and English as well as a new six-lesson curriculum for parents
and tested curricula for children through community-based sites. A new online
resource provides parents, caregivers, communities, national partners, and
media up-to-date health information and tips on maintaining a healthy weight
for families. For more information, visit http://wecan.nhlbi.nih.gov or
call toll-free 866-35-WE CAN (866-359-3226).
To interview an NHLBI expert, please contact the NHLBI Communications
Office at (301) 496-4236 or firstname.lastname@example.org. To interview Dr. Van
Horn, please contact Elizabeth Crown, 312-503-8928 or email@example.com.
NHLBI is part of the National Institutes of Health (NIH), the Federal Government's
primary agency for biomedical and behavioral research. NIH is a component
of the U.S. Department of Health and Human Services. Additional information
about cardiovascular disease and other NHLBI-supported research and educational
programs are available online at the NHLBI Website, www.nhlbi.nih.gov.
NOTE TO MEDIA: See companion release at http://www.nhlbi.nih.gov/new/press/05-06-01a.htm: “HHS
Secretary Leavitt, NIH Director Tell Parents: Together, ‘We Can!’ Prevent