Long-term changes in food consumption trends in overweight children in the HIKCUPS intervention

Energy intake is a major contributor to energy imbalance and is a key modifiable factor for successful treatment of obesity. Long-term changes in dietary intake from pediatric obesity treatment programs are rarely reported. The aim of this study was to describe the changes in food intake of children from all intervention groups from baseline to 2-year follow-up after a 6-month obesity intervention.

Overweight children (n = 160, 5-9 years), 58% girls and body mass index z score (mean ± SD) 2.89 ± 0.79, were recruited to the Hunter Illawarra Kids Challenge using the Parent Support randomized controlled trial. Dietary intake was reported by parents for children at baseline and 2-year follow-up (n = 87) using a food frequency questionnaire. Linear mixed models were used to determine differences by time.

Parents reported decreases in total energy (total kcal, kcal/kg), child percentage of total energy from energy-dense, nutrient-poor foods (sweetened drinks, potato crisps, sweets, and carry-out foods) from 42% ± 1.0% at baseline to 34.8% ± 1.0% at 2 years (P < 0.001), with an increase in percentage of energy from nutrient-dense foods (fruits, vegetables, dairy, breads, and cereals) from 57% ± 0.9% at baseline to 65% ± 1.0% at 2 years (P < 0.001).

This is the only one of a few studies that report dietary data of overweight children who participated in a treatment program with long-term follow-up. It provides evidence that improvements in food intake can be sustained up to 2 years through decreased consumption of energy-dense, nutrient-poor foods, particularly sweetened drinks, and increased consumption of core foods following an intervention.