The cumulative effect of small dietary changes may significantly improve nutritional intakes in free-living children and adults

Francis Bornet (1) , Damien Paineau (1) , François Beaufils (1) , Alain Boulier (1) , Dominique-Adèle Cassuto (1) , Judith Chwalow (1) , Pierre Combris (1) , Charles Couet (1) , Béatrice Jouret (1) , Lionel Lafay (1) , Martine Laville (1) , Sylvain Mahé (1) , Claude Ricour (1) , Monique Romon (1) , Chantal Simon (1) , Maïté Tauber (1) , Paul Valensi (1) , Véronique Chapalain (1) , Othar Zourabichvili (1)

1 Global Nutrition Departement

Background/Objectives: The ELPAS 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 (Paineau et al., 2008). 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 ASPCC food-consumption database to identify the most efficient dietary intervention strategy. During the study, all participants performed monthly 3 non-consecutive 24-h dietary recalls: this allowed for measuring changes in number-of-serving per day and serving size for each targeted food categories 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 (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-serving per day was indeed significantly modified for only 7% of targeted food categories in children and 17% in parents. Mean serving size was modified for only 12% of targeted food categories in children and 9% in parents. Conclusion: The cumulative effect of small dietary changes may induce significant nutritional improvements, with limited burden for populations.

Mots clés: obesity; food habits; dietary modification; nutrition policy; modeling analyses

Domaines: Sciences de l'Homme et Société

Francis Bornet, Damien Paineau, François Beaufils, Alain Boulier, Dominique-Adèle Cassuto, et al.. The cumulative effect of small dietary changes may significantly improve nutritional intakes in free-living children and adults. European Journal of Clinical Nutrition, 2010, 64 (8), pp.782-791. ⟨10.1038/ejcn.2010.78⟩. ⟨hal-00540034⟩