title: Increasing healthy eating vs. reducing high energy-dense foods to treat pediatric obesity.
abstract: OBJECTIVE
  The objective was to compare targeting increased eating of healthy foods vs. reducing intake of high energy-dense foods within the context of a family-based behavioral weight control program.
  
  
  METHODS
  Forty-one 8-12 year-old children >85th BMI percentile were randomly assigned to a 24-month family-based behavioral treatment that targeted increasing fruits and vegetables and low-fat dairy vs. reducing intake of high energy-dense foods.
  
  
  RESULTS
  Children in the increase healthy food group showed greater reduction in zBMI compared to children in the reduce high energy-dense food group at 12- (-0.30 zBMI units vs. -0.15 zBMI units, P = 0.01) and 24- (-0.36 zBMI units vs -0.13 zBMI units, P = 0.04) month follow-up. Parents in the increase healthy food group showed greater reductions in concern about child weight (P = 0.007), and these changes were associated with child zBMI change (P = 0.008). Children in the reduce high energy-dense group showed larger sustained reductions in high energy-dense foods (P < 0.05). Baseline levels of high energy-dense foods (P < 0.05), parent food restraint (P = 0.01), parent concern over parent weight (P = 0.01) and parent acceptance of the child (P < 0.05) moderated child zBMI change, with greater sustained reductions in zBMI for children in the increase healthy food group for each measure. Parent zBMI change followed the same pattern as child changes, and parent and child zBMI changes were correlated (P < 0.001).
  
  
  CONCLUSIONS
  Focusing on healthy food choices within an energy restricted diet may be useful in family-based weight control programs.
authors.affiliation: Department of Pediatrics, University at Buffalo, Buffalo, NY, USA. lhenet@acsu.buffalo.edu
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
authors.forename: Rocco A
authors.initials: RA
authors.lastname: Paluch
authors.forename: Meghan D
authors.initials: MD
authors.lastname: Beecher
authors.forename: James N
authors.initials: JN
authors.lastname: Roemmich
mesh_terms: D001521:Behavior Therapy; D015992:Body Mass Index; D031204:Caloric Restriction; D002648:Child; D018752:Diet, Fat-Restricted; D004435:Eating / Q000502:physiology*; D002149:Energy Intake / Q000502:physiology*; D005192:Family Health; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy* / Q000503:physiopathology; D010287:Parent-Child Relations; D014675:Vegetables; D015431:Weight Loss / Q000502:physiology