***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 AND PROCEDURES Forty-one 8 - 12 year-old children > 85th BMI percentile were r and omly 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 z BMI compared to children in the reduce high energy-dense food group at 12- ( -0.30 z BMI units vs. -0.15 z BMI units , P = 0.01 ) and 24- ( -0.36 z BMI units vs -0.13 z BMI 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 z BMI 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 z BMI change , with greater sustained reductions in z BMI for children in the increase healthy food group for each measure . Parent z BMI change followed the same pattern as child changes , and parent and child z BMI changes were correlated ( P < 0.001 ) . DISCUSSION Focusing on healthy food choices within an energy restricted diet may be useful in family-based weight control programs Background . Prevention of cardiovascular disease through diet and lifestyle change is strongly advocated in adults and is initiated preferably during childhood . The Dietary Intervention Study in Children ( DISC ) was a multicenter , collaborative , r and omized trial in 663 preadolescent children ( 363 boys and 301 girls ) with elevated low-density lipoprotein cholesterol , design ed to test the efficacy and safety of a dietary intervention to lower saturated-fat and cholesterol intake while also advocating a healthy eating pattern . DISC results have been published extensively . This ancillary study reports new data regarding changes in eating patterns among this cohort . Objective . We set out to compare children 's self-selected eating patterns and approaches to achieving adherence to the DISC fat-reduced diet intervention with children in the usual-care group . Methods . An ancillary study was conducted to develop a detailed food-grouping system and report new analyses on dietary adherence to the recommended eating pattern . Every food in the nutrient data base was ranked by its saturated-fat and cholesterol content and classified within its relevant food group as a “ go ” ( less atherogenic ) or “ whoa ” ( more atherogenic ) food . Results . At baseline , go foods contributed ∼57 % of total energy intake and 12.4 % to 13.1 % total fat energy intake in both groups . At 3 years , go foods contributed 67.4 % and 13.7 % of total and fat energy intake , respectively , in the intervention group versus 56.8 % and 12.8 % in the usual-care group . Differences between the 2 treatment groups were significant for changes in consumption of dairy foods , desserts , and fats/oils , with the intervention group reporting a 0.2- to 0.3-serving-per-day greater increase in go foods than the usual-care group . The intervention group also reported a 0.2- to 0.8-serving-per-day greater decrease in whoa foods than the usual-care group for breads/grains , dairy , fats/oils , meat/fish/poultry , snacks , and vegetables . Overall , snack foods , desserts , and pizza contributed approximately one third of total daily energy intake in both groups at 3 years . Conclusions . Children in the intervention group reported consuming more servings per day of go grains , dairy , meats , and vegetable foods compared with children in the usual-care group , but intake of fruits and vegetables was low in both groups . Discovering that snacks , desserts , and pizza actively contribute so heavily to the diets of this age group , even among children who were part of this intervention , offers valuable insights regarding the need for more aggressive , innovative , and realistic approaches for additional dietary counseling BACKGROUND During the nutrition transition in Chile , dietary changes were marked by increased consumption of high-energy , nutrient-poor products , including sugar-sweetened beverages ( SSBs ) . Obesity is now the primary nutritional problem in posttransitional Chile . OBJECTIVE We conducted a r and omized controlled trial to examine the effects on body composition of delivering milk beverages to the homes of overweight and obese children to displace SSBs . DESIGN We r and omly assigned 98 children aged 8 - 10 y who regularly consumed SSBs  to intervention and control groups . During a 16-wk intervention , children were instructed to drink 3 servings/d ( approximately 200 g per serving ) of the milk delivered to their homes and to not consume SSBs .  Body composition was measured by dual-energy X-ray absorptiometry . Data were analyzed by multiple regression analysis according to the intention-to-treat principle . RESULTS For the intervention group , milk consumption increased by a mean ( + /- SEM ) of 452.5 + /- 37.7 g/d ( P < 0.0001 ) , and consumption of SSBs  decreased by -711.0 + /- 33.7 g/d ( P < 0.0001 ) . For the control group , milk consumption did not change , and consumption of SSBs  increased by 71.9 + /- 33.6 g/d ( P = 0.04 ) . Changes in percentage body fat , the primary endpoint , did not differ between groups . Nevertheless , the mean ( + /- SE ) accretion of lean body mass was greater ( P = 0.04 ) in the intervention ( 0.92 + /- 0.10 kg ) than in the control ( 0.62 + /- 0.11 kg ) group . The increase in height was also greater ( P = 0.01 ) in the intervention group ( 2.50 + /- 0.21 cm ) than in the control group ( 1.77 + /- 0.20 cm ) for boys but not for girls . CONCLUSION Replacing habitual consumption of SSBs with milk may have beneficial effects on lean body mass and growth in children , despite no changes in percentage body fat . This trial was registered at clinical trials.gov as NCT00149695 Background A two-year , community-based , group-r and omized trial to promote bone mass gains among 9–11 year-old girls through increased intake of calcium-rich foods and weight-bearing physical activity was evaluated . Methods Following baseline data collection , 30 5th- grade Girl Scout troops were r and omized to a two-year behavioral intervention program or to a no-treatment control group . Evaluations were conducted at baseline , one year , and two years . Measures included bone mineral content , density , and area ( measured by DXA ) , dietary calcium intake ( 24-hour recall ) , and weight-bearing physical activity ( physical activity checklist interview ) . Mixed-model regression was used to evaluate treatment-related changes in bone mineral content ( g ) for the total body , lumbar spine ( L1-L4 ) , proximal femur , one-third distal radius , and femoral neck . Changes in eating and physical activity behavioral outcomes were examined . Results Although the intervention was implemented with high fidelity , no significant intervention effects were observed for total bone mineral content or any specific bone sites . Significant intervention effects were observed for increases in dietary calcium . No significant intervention effects were observed for increases in weight-bearing physical activity . Conclusion Future research needs to identify the optimal dosage of weight-bearing physical activity and calcium-rich dietary behavior change required to maximize bone mass gains in pre-adolescent and adolescent girls The purpose was to study if serving milk or water with the lunch at preschool influenced 6- to 7-year-old children 's preferences for and later choice between milk and water at lunch in elementary school later . Children ( n = 147 ) at 12 daycare centres were usually served water at lunch but , for 3 months , six r and omly chosen centres served milk at lunch ( Intervention group ) and six matched centres continued serving water ( Control group ) . The groups did not differ with respect to preferences for seven types of beverages ( including water and four varieties of milk ) either before or after the intervention . Four and 12 months later , their choice of lunch drink ( milk or water ) at school was studied for two 5-week periods . At the 4-month assessment , the children in the Intervention group chose milk at lunch significantly more often than did those in the Control group ( 92 % vs. 81 % of the days ) , while there were no significant differences at 12 months ( 85 % vs. 81 % ) . Since there were no demonstrable effects on preferences , one interpretation of the results is that children tend to associate the type of drink regularly served at a meal with that specific meal Objectives : To examine if and how ready-to-eat cereals ( RTEC ) contribute to the quality of the diet of children , adolescents and young adults in a Mediterranean setting . Methods : A r and om sample of 3534 subjects aged 2 to 24 years in Spain was studied . Food and nutrient intakes were determined by a 24 hour recall . RTEC consumption was assessed by a quantitative food frequency question naire . Additional questions on socioeconomic level and nutritional knowledge were administered . Cereal consumption was classified into non-consumers and daily intakes between 1 and 20 g , 21 and 40 g , and more than 40 g . After excluding the underreporters the final sample consisted of 2852 individuals . Results : About half of the population ( 49.8 % ) reported eating RTEC .  Macronutrient profile improved with increasing cereal consumption . Intakes of thiamine , riboflavin and vitamin B6 increased significantly with increasing consumption of RTEC in all age-sex groups , whereas niacin and folate intake improved in almost all groups and calcium , iron and vitamin D in at least half of the groups . Except for magnesium , vitamin B12 and vitamin E in males , consumption of RTEC was significantly associated with increased coverage of the daily nutrient requirements for all micronutrients studied . Higher levels of  RTEC  consumption was associated with a greater consumption of dairy products , and related to better breakfast quality . Conclusions : Level of RTEC consumption is associated with a better nutritional profile in the diets of Spanish children , adolescents and young adults and a lower risk for inadequate micronutrient intakes . RTEC consumers have better quality breakfasts , in terms of both food choices as well as energy and nutrient content BACKGROUND This paper describes the impact of the Eat Smart School Nutrition Program , the food service component of the Child and Adolescent Trial for Cardiovascular Health ( CATCH ) , on the percentage of calories from total fat and saturated fat and the sodium content of school breakfasts . METHODS Fifty-nine of the 96 CATCH schools offered breakfast .  We collected 5 consecutive days of school breakfast menu , recipe , and vendor product information at three periods to assess the nutrient content of the school menus as offered . RESULTS At baseline ( Fall 1991 ) , intervention school breakfasts provided 28 % of calories from total fat and control schools 30 % . Decreases occurred over time in both groups , but no significant differences were attributable to the intervention ( adjusted mean difference = -0.4 ; P = 0.77 ) . Saturated fat exceeded the Eat Smart goal at baseline in all schools and by follow-up ( Spring 1994 ) , the reduction in mean percentage of calories from saturated fat was greater in intervention than in control schools ( adjusted mean difference = -1.6 % ; P = 0.052 ) . Sodium goals were not achieved . Mean calorie levels were maintained at or above Eat Smart goals throughout the study in both groups . Differences over time in other dietary variables ( percentage of calories from protein and carbohydrate and mean levels of protein , carbohydrate , calcium , iron , vitamin A value , vitamin C , total sugars , and dietary fiber ) were not statistically significant between groups . No significant reductions in student participation in the School Breakfast Program ( SBP ) occurred . CONCLUSIONS The Eat Smart food service intervention improved school breakfast composition , but not significantly more so than in control schools . Fat and saturated fat in school breakfasts were lowered while maintaining calories , other essential nutrient levels , and student participation in the SBP . Secular trends and also the possibility that control schools were affected by the Eat Smart intervention may account for these findings BACKGROUND Poor nutrition and inactivity are widespread and contribute to the epidemic problem of childhood obesity . This study examined the effectiveness of a school-based pilot program to improve nutrition and activity in elementary ( ES ) and high school ( HS ) students . METHODS The Improving Meals and Physical Activity in Children and Teens ( IMPACT ) school-based curriculum used a train-the-trainer model to improve activity and nutrition . Nine students were recruited from one rural North Carolina high school and trained in the IMPACT curriculum 
    Output:
    
Effective interventions tended to be higher in intensity , provide dairy foods and were delivered across a variety of setting s to a range of primary targets .
The number of behaviour change techniques used did not differentiate effective and ineffective interventions , but the use of taste exposure and prompting practice appeared to be important for effective intervention .
Interventions that target an increase in  children 's dairy food or Ca intake could potentially increase  children 's dairy food intake by about one serving daily .
The review has identified some promising strategies likely to be part of effective interventions for improving dairy and Ca intakes in countries where children 's intake is insufficient