Abstract
Background/Objectives:
The ELPAS (Etude Longitudinale Prospective Alimentation et Santé) study was an 8-month randomized controlled dietary modification trial designed to test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in 2026 free-living children and parents. It resulted in significant nutritional changes, with beneficial effects on body mass index in adults. In these ancillary analyses, we investigated dietary changes throughout the intervention.
Subjects/Methods:
Before the study, modeling analyses were carried out on the French Association Sucre Produits Sucrés Consommation et Communication (ASPCC) food-consumption database to identify the most efficient dietary intervention strategy. During the study, all participants performed monthly three nonconsecutive 24-h dietary recalls: this allowed for measuring changes in the number of servings per day and serving size for each targeted food category throughout the intervention.
Results:
Modeling analyses showed that targeting only the 10 main foods contributing to fat and carbohydrate intakes did not allow for reaching the ELPAS nutritional goals. As a result, it was decided to target more foods and to propose several types of dietary advice (such as change in serving size, change in cooking method, food substitution). This strategy led to many appropriate dietary changes during the intervention, but only a few of them reached significance. The mean number of servings per day was indeed significantly modified for only 7% of the targeted food categories in children and 17% in parents. The mean serving size was modified for only 12% of targeted food categories in children and 9% in parents.
Conclusions:
The cumulative effect of small dietary changes may induce significant nutritional improvements, with limited burden for populations.
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Acknowledgements
We thank the families, schools and administrators (Rectorat de Paris) who participated in this project. Michel Vidailhet, MD, Brabois Hospital, Vandoeuvre les Nancy, France, helped with supervising the study and drafting the manuscript. Ambroise Martin, MD, PhD, Lyon Medical Faculty, Lyon, France, helped with drafting the paper. Mohamed Grairia, Socio Logiciels, Paris, France, contributed to statistical analyses. Funding was provided by the French Ministry of Research (2002 Réseau Alimentation Référence Europe), and by the ELPAS study's private partners (Avenance Enseignement, the Centre d’Etudes et de Documentation du Sucre, and the Louis Bonduelle Foundation). The private partners did not participate in conduct of the study; collection, management, analyses or interpretation of the data; or preparation, review or approval of the paper. The Centre d’Etudes et de Documentation du Sucre participated in the study design.
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Dr Cassuto served as an independent consultant for the Centre d’Etudes et de Documentation du Sucre. All other authors have no competing financial interests in relation to the work described.
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Paineau, D., Beaufils, F., Boulier, A. et al. The cumulative effect of small dietary changes may significantly improve nutritional intakes in free-living children and adults. Eur J Clin Nutr 64, 782–791 (2010). https://doi.org/10.1038/ejcn.2010.78
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DOI: https://doi.org/10.1038/ejcn.2010.78
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