title: Impact of the Pathways intervention on dietary intakes of American Indian schoolchildren.
abstract: BACKGROUND
  The Pathways study was a randomized, 3-year trial of obesity prevention in American Indian Children. An important goal of the Pathways intervention was to significantly decrease the percentage of calories eaten as fat by the intervention children, relative to controls. This paper reports the effects of the Pathways intervention on dietary intake.
  
  
  METHODS
  Two types of dietary data were analyzed from random samples of children in 41 schools: direct observation of school lunch intake at baseline (2nd grade) and follow-up (5th grade) (n=470), and 24-hour dietary recalls at follow-up only (n=620). Nutrient contents of school meals and recalls were calculated by NDS and NDS-R software (University of Minnesota), using vendor products and recipes from each school.
  
  
  RESULTS
  Based on lunch observations, the intervention was associated with significant decreases in mean percentage of calories from total fat (3.6%) and saturated fat (2.1%) relative to controls, and a significant increase in the percentage of calories from total carbohydrate (3.7%). Compared with the control children, intervention children reported significantly smaller 24-hour intakes of energy (263 kcal), protein (9.5 g), total fat (15.1 g), saturated fat (6.0 g), and polyunsaturated fat (2.3 g); and as a percent of calories, total fat (2.5%) and saturated fat (1.1%). Mean intake of carbohydrates as a percentage of calories was significantly greater in intervention children by 2.5%, compared with controls.
  
  
  CONCLUSIONS
  The Pathways intervention successfully reduced the intake of percent calories from fat and saturated fat, at school lunch and over the whole day.
authors.affiliation: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA. himes@epi.umn.edu
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.forename: Kim
authors.initials: K
authors.lastname: Ring
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: Leslie
authors.initials: L
authors.lastname: Cunningham-Sabo
authors.forename: Judith
authors.initials: J
authors.lastname: Weber
authors.forename: Janice
authors.initials: J
authors.lastname: Thompson
authors.forename: Lisa
authors.initials: L
authors.lastname: Harnack
authors.forename: Chirayath
authors.initials: C
authors.lastname: Suchindran
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D005522:Food Services / Q000592:standards*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D012574:Schools; D014481:United States
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins