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A Randomized Controlled Trial

Damien L. Paineau, MS; François Beaufils, MD; Alain Boulier, MD, PhD; Dominique-Adèle Cassuto, MD; Judith Chwalow, PhD; Pierre Combris, PhD; Charles Couet, MD; Béatrice Jouret, MD; Lionel Lafay, PhD; Martine Laville, MD, PhD; Sylvain Mahe, PhD; Claude Ricour, MD; Monique Romon, MD; Chantal Simon, MD, PhD; Maïté Tauber, MD; Paul Valensi, MD; Véronique Chapalain, MS; Othar Zourabichvili, MD, PhD; Francis Bornet, MD, PhD

Arch Pediatr Adolesc Med. 2008;162(1):34-43.

Objective  To test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in free-living (noninstitutionalized) children and parents.

Design  Randomized controlled trial.

Setting  Fifty-four elementary schools in Paris, France.

Participants  One thousand thirteen children (mean age, 7.7 years) and 1013 parents (mean age, 40.5 years).

Intervention  Families were randomly assigned to group A (advised to reduce fat and to increase complex carbohydrate intake), group B (advised to reduce both fat and sugar and to increase complex carbohydrate intake), or a control group (given no advice). Groups A and B received monthly phone counseling and Internet-based monitoring for 8 months.

Outcome Measures  Changes in nutritional intake, body mass index (calculated as weight in kilograms divided by height in meters squared), fat mass, physical activity, blood indicators, and quality of life.

Results  Compared with controls, participants in the intervention groups achieved their nutritional targets for fat intake and to a smaller extent for sugar and complex carbohydrate intake, leading to a decrease in energy intake (children, P < .001; parents, P = .02). Mean changes in body mass index were similar among children (group A, + 0.05, 95% confidence interval [CI], – 0.06 to 0.16; group B, + 0.10, 95% CI, – 0.03 to 0.23; control group, + 0.13, 95% CI, 0.04-0.22; P = .45), but differed in parents (group A, + 0.13, 95% CI, – 0.01 to 0.27; group B, – 0.02, 95% CI, – 0.14 to 0.11; control group, + 0.24, 95% CI, 0.13-0.34; P = .001), with a significant difference between group B and the control group (P = .01).

Conclusions  Family dietary coaching improves nutritional intake in free-living children and parents, with beneficial effects on weight control in parents.

Trial Registration  clinicaltrials.gov Identifier: NCT00456911

Author Affiliations: Nutri-Health, Rueil-Malmaison, France (Mr Paineau and Drs Zourabichvili and Bornet); Department of Internal Medicine, Poissy St-Germain-en-Laye Hospital, St-Germain-en-Laye, France (Dr Beaufils); Department of Nutrition and Functional Investigations, INSERM U695, Bichat-Claude Bernard Hospital, Paris, France (Dr Boulier); Department of Nutrition, EA3502, Hôtel-Dieu, Paris, France (Dr Chwalow); INRA-CORELA, Ivry-sur-Seine, France (Dr Combris); INSERM E211, Tours Hospital, Tours, France (Dr Couet); Department of Pediatrics, Children's Hospital, Toulouse, France (Drs Jouret and Tauber); Agence Française de Sécurité Sanitaire des Aliments, Maisons-Alfort, France (Dr Lafay); CRNH Rhône-Alpes, Lyon 1 University, Hospices Civils de Lyon, INSERM U870, INRA U1235, Lyon, France (Dr Laville); French Ministry of Research, Paris, France (Dr Mahe); Department of Pediatrics, Necker Hospital, Paris, France (Dr Ricour); Department of Nutrition, EA2694 Lille 2 University, Lille, France (Dr Romon); Louis Pasteur University, Medical Faculty, EA 1801, Strasbourg, France (Dr Simon); Department of Endocrinology, CRNH Ile-de-France, Jean Verdier Hospital, Bondy, France (Dr Valensi); and Quanta Medical, Rueil-Malmaison, France (Ms Chapalain and Dr Zourabichvili). Dr Cassuto is in private practice in Paris, France.