Food Group Intake Research Articles

Food group intakes and all-cause mortality among a young older Japanese population of the same age: the New Integrated Suburban Seniority Investigation Project.

ABSTRACTEvaluating the effects of dietary intake on mortality in older populations has become increasingly important in modern aging societies. The objective of the present study was to investigate the associations between food group intakes and all-cause mortality among a young older population. We conducted a prospective study on 1,324 men and 1,338 women aged 64–65 years at baseline who were living in a suburban city from 1996 to 2005. The participants were followed for all-cause mortality from 1996 through 2015 to assess the effects of 17 food group intakes (g) per 1,000 kcal after multivariable adjustments in proportional hazard models. During follow-up (mean: 13.2 years), 339 deaths were registered. In women, total mortality was significantly and inversely associated with the consumption of milk and dairy products and vegetables. The hazard ratios across intake quartiles after multivariable adjustment were 1, 0.70 (95% confidence interval: 0.42–1.17), 0.66 (0.40–1.10), and 0.40 (0.22–0.75) (P for trend = 0.003) for milk and dairy products, and 1, 0.77 (0.46–1.28), 0.83 (0.50–1.38), and 0.42 (0.23–0.78) (P for trend = 0.008) for vegetables. In men, a positive association was found between total mortality and sugar and sweetener consumption (P for trend = 0.038). Higher consumption of milk and dairy products and vegetables was suggested to reduce all-cause mortality in young older women.

Diet Quality and Eating Practices among Hispanic/Latino Men and Women: NHANES 2011–2016

Dietary quality of Hispanic/Latino adults residing in homes with children may differ by gender, that in turn, may impact youth through role modeling and food availability. Using a nationally representative sample (n = 1039) from the National Health and Nutrition Examination Survey (2011–2016), adjusted regression analyses were used to examine food-related practices, food group intake, and dietary quality among Hispanic/Latino men and women in homes with children (6–17 years). Compared to women, men had lower total 2015 Healthy Eating Index (HEI) scores and component HEI scores for healthy food groups. Men also ate more meals that were not home prepared/week and purchased more foods from non-grocery stores than women. Negative food-related practices and working more hours/week may explain in part the lower dietary quality observed among Hispanic/Latino men than women. Interventions may be improved by targeting gender-specific food-related behaviors that could positively impact dietary quality of youth residing with them.

Association between nutritional and food group intakes and awareness of osteoporosis among calcium intake in female high school students

Association between nutritional and food group intakes and awareness of osteoporosis among calcium intake in female high school students

Are history of dietary intake and food habits of patients with clinical symptoms of COVID 19 different from healthy controls? A case-control study.

BackgroundCoronavirus disease 2019 (COVID-19) is an infectious disease that put unprecedented significant strain on clinical services and healthcare systems. The aim of the present research was to assess dietary food groups and also food habits of patients with clinical symptoms of COVID 19 and healthy controls.MethodsThis case–control research was carried out on 505 participants (279 subjects with clinical symptoms of COVID-19 and 226 controls), in age 18–65 years. Dietary food group's intake last year was investigated by a food frequency questionnaire. Food habits were asked by a general information questionnaire. The strength of the association between food group's intakes with the odds ratios (ORs) of COVID-19 was assessed using Logistic regression models.ResultsAfter adjusting for physical activity in the logistic regression models, intake of dough and yogurt had a significantly protective role on occurrence of COVID19 (OR = 0.62; 95% confidence interval (CI) = 0.44–0.87; P = 0.006) (OR = 0.74; 95% CI = 0.56–0.98; P = 0.044), respectively. No significant differences were seen in food habits between the two groups in the last year ago.ConclusionsHigh risk population for COVID19, advised to consume enough amount of yogurt and dough at the time of this pandemic.

Taxonomic Composition and Diversity of the Gut Microbiota in Relation to Habitual Dietary Intake in Korean Adults.

We investigated associations of habitual dietary intake with the taxonomic composition and diversity of the human gut microbiota in 222 Koreans aged 18–58 years in a cross-sectional study. Gut microbiota data were obtained by 16S rRNA gene sequencing on DNA extracted from fecal samples. The habitual diet for the previous year was assessed by a food frequency questionnaire. After multivariable adjustment, intake of several food groups including vegetables, fermented legumes, legumes, dairy products, processed meat, and non-alcoholic beverages were associated with major phyla of the gut microbiota. A dietary pattern related to higher α-diversity (HiαDP) derived by reduced rank regression was characterized by higher intakes of fermented legumes, vegetables, seaweeds, and nuts/seeds and lower intakes of non-alcoholic beverages. The HiαDP was positively associated with several genera of Firmicutes such as Lactobacillus, Ruminococcus, and Eubacterium (all p < 0.05). Among enterotypes identified by principal coordinate analysis based on the β-diversity, the Ruminococcus enterotype had higher HiαDP scores and was strongly positively associated with intakes of vegetables, seaweeds, and nuts/seeds, compared to the two other enterotypes. We conclude that a plant- and fermented food-based diet was positively associated with some genera of Firmicutes (e.g., Lactobacillus, Ruminococcus, and Eubacterium) reflecting better gut microbial health.

Diet and risk of gastro-oesophageal reflux disease in the Melbourne Collaborative Cohort Study.

To examine associations between diet and risk of developing gastro-oesophageal reflux disease (GERD). Prospective cohort with a median follow-up of 15·8 years. Baseline diet was measured using a FFQ. GERD was defined as self-reported current or history of daily heartburn or acid regurgitation beginning at least 2 years after baseline. Sex-specific logistic regressions were performed to estimate OR for GERD associated with diet quality scores and intakes of nutrients, food groups and individual foods and beverages. The effect of substituting saturated fat for monounsaturated or polyunsaturated fat on GERD risk was examined. Melbourne, Australia. A cohort of 20 926 participants (62 % women) aged 40-59 years at recruitment between 1990 and 1994. For men, total fat intake was associated with increased risk of GERD (OR 1·05 per 5 g/d; 95 % CI 1·01, 1·09; P = 0·016), whereas total carbohydrate (OR 0·89 per 30 g/d; 95 % CI 0·82, 0·98; P = 0·010) and starch intakes (OR 0·84 per 30 g/d; 95 % CI 0·75, 0·94; P = 0·005) were associated with reduced risk. Nutrients were not associated with risk for women. For both sexes, substituting saturated fat for polyunsaturated or monounsaturated fat did not change risk. For both sexes, fish, chicken, cruciferous vegetables and carbonated beverages were associated with increased risk, whereas total fruit and citrus were associated with reduced risk. No association was observed with diet quality scores. Diet is a possible risk factor for GERD, but food considered as triggers of GERD symptoms might not necessarily contribute to disease development. Potential differential associations for men and women warrant further investigation.

Association of Oily and Nonoily Fish Consumption and Fish Oil Supplements With Incident Type 2 Diabetes: A Large Population-Based Prospective Study.

To evaluate associations of oily and nonoily fish consumption and fish oil supplements with incident type 2 diabetes (T2D). We included 392,287 middle-aged and older participants (55.0% women) in the UK Biobank who were free of diabetes, major cardiovascular disease, and cancer and had information on habitual intake of major food groups and use of fish oil supplements at baseline (2006-2010). Of these, 163,706 participated in one to five rounds of 24-h dietary recalls during 2009-2012. During a median 10.1 years of follow-up, 7,262 incident cases of T2D were identified. Compared with participants who reported never consumption of oily fish, the multivariable-adjusted hazard ratios of T2D were 0.84 (95% CI 0.78-0.91), 0.78 (0.72-0.85), and 0.78 (0.71-0.86) for those who reported <1 serving/week, weekly, and ≥2 servings/week of oily fish consumption, respectively (P-trend < 0.001). Consumption of nonoily fish was not associated with risk of T2D (P-trend = 0.45). Participants who reported regular fish oil use at baseline had a 9% (95% CI 4-14%) lower risk of T2D compared with nonusers. Baseline regular users of fish oil who also reported fish oil use during at least one of the 24-h dietary recalls had an 18% (8-27%) lower risk of T2D compared with constant nonusers. Our findings suggest that consumption of oily fish but not nonoily fish was associated with a lower risk of T2D. Use of fish oil supplements, especially constant use over time, was also associated with a lower risk of T2D.

Associations between Food Group Intake and Physical Frailty in Irish Community-Dwelling Older Adults.

Background:Certain nutrients have shown protective effects against frailty, but less is known about the influence of individual food groups. Thus, this study aimed to investigate the relationship between the intake of different food groups and physical frailty in a cohort of community-dwelling older adults in Cork, Ireland.Methods:One hundred and forty-two (n = 81 females, n = 61 males, age 74.1 ± 6.80 years) Irish community-dwelling volunteers aged ⩾65 years participated in this cross-sectional study. Dietary intake was assessed using a validated food frequency questionnaire (FFQ). Frailty was identified as having 3 or more of the following criteria: weight loss, exhaustion, weakness, slow walking speed and low physical activity. Relationships between intakes of food groups and frailty score were determined using Spearman’s rank (and partial rank) correlations and ordinal logistic regression analysis.Results:Negative Spearman’s rank correlations were observed between frailty score and fish and fish products, fruit and vegetables and nuts and seeds, while positive correlations were found between frailty score and potatoes, fats and oils and sugars, preserves and snacks (P < .05). After adjustment for confounders, partial rank correlations remained statistically significant (P < .05) for all of the above dietary variables, with the exception of nuts and seeds (P > .05). Following ordinal logistic regression, the odds ratios (ORs) (95%CI) for frailty incidence for those in the lowest tertile of food group intake compared to the highest were; 3.04 (1.09-8.85) for fish and fish products, 4.34 (1.54-13.13) for fruit and vegetables, 1.52 (0.58-4.15) for nuts and seeds, 0.54 (0.19-1.51) for potatoes, 0.58 (0.17-1.95) for fats and oils and 0.49 (0.16-1.47) for sugars, preserves and snacks.Conclusion:This study suggests that intakes of selected food groups are independently associated with frailty. These findings may hold significant relevance for the development of future frailty prevention strategies.

Relative validity and reproducibility of a food frequency questionnaire to evaluate food group intakes among Jordanian children and adolescents.

Introduction: studies of the impact of diet on the prevention and occurrence of diseases in all life stages require a reliable and valid dietary assessment tool for assessing dietary intake. Objectives: this study aimed to develop and evaluate the relative validity and reproducibility of a culturally sensitive quantitative food frequency questionnaire (FFQ) to assess food group intake among Jordanian children and adolescents. Methods: the validation study was carried out on 136 children and adolescents aged between 6 and 18 years who enrolled from selected public and private schools. Fifty of these children and adolescents participated in the reproducibility phase. Food group intake from a quantitative FFQ was compared with food group intake from 24-hour dietary recalls (24h-DRs). Four 24-HRs were collected weekly for one month. Results: intraclass correlation coefficients between the two FFQs ranged from 0.18 for nuts to 0.98 for tea. De-attenuated and energy-adjusted correlations ranged from 0.08 for nuts to 0.95 for vegetable oils. On average, 46.6 % and 43.6 % of participants were ranked by the FFQ-1 and the 24h-DRs into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed a satisfactory agreement between the two methods for milk and milk products and vegetables. Conclusions: the findings of this study suggested that the developed FFQ has excellent reproducibility and good relative validity for most food groups.

The relationship between food group intake and frailty in older adults living in Ireland

The relationship between food group intake and frailty in older adults living in Ireland

Food Consumption Pattern of Adolescents in Delhi-NCR Born Full Term with Low Birth Weight with Reference to the New Estimated Average Requirement

Introduction: Nutrition and lifestyle transition in India have attributed to the burden of malnutrition in early life. Evidence suggests that children born Low Birth Weight (LBW) are at increased risk of later life diseases. Aim: The study aims to describe the nutrient intake of term LBW children with reference to the new estimated average requirement. Materials and Methods: This questionnaire based cross-sectional study was conducted in the premises of Institute of Home Economics, Delhi. Dietary intake data for 139 term LBW children (9-12 years) was collected using 24-hour recall. Nutrient and food group intake was analysed using Diet Cal (version 10). Gender differences in dietary intake were assessed using Mann-Whitney U test. Proportion of children with micronutrient intake below Estimated Average Requirement (EAR) was also estimated. Data was analysed using Mann-Whitney U test and Chi-square test. Results: The protein intake of more than 50% children provided 10-15% of energy. Carbohydrate contributed to less than 55% of day’s energy while energy from fat was more than 30% for majority of children. Percentage of children with inadequate micronutrient intake ranged from 44.6% for Vitamin C to 100% for Vitamin B12 and Vitamin D. A high proportion of children had low consumption of green leafy vegetables, nuts, oilseeds, and fleshy foods. The intake of milk and milk products were significantly higher in boys as compared to girls (p=0.02). Conclusion: There is a transition from carbohydrate dense foods to high fat processed foods that are inadequate in micronutrients. Findings highlight the need for an intensive public health approach to improve the diet quality of the Indian population.

The role of nutritional factors in the formation of cardiovascular risk in patients with type 2 diabetes mellitus

Cardiovascular diseases are the most common complications of type 2 diabetes mellitus (T2DM) and remain the main cause of mortality in this category of patients. Currently, there is more and more data that confirm the influence of nutritional factors not only on the achievement of target values of metabolic parameters in diabetes, but also on predictors of cardiovascular risk, and also demonstrate their role as independent predictors. In this regard, the study of the role of nutritional factors in the formation of high cardiovascular risk in patients with T2DM is of high practical importance and relevance. The aim was to assess the role of nutritional factors in the formation of high total cardiovascular risk in patients with T2DM. Material and methods. An open clinical controlled prospective observation was carried out for one year in 110 patients with T2DM (87 women and 23 men, mean age 56.7±8.6 years). The average value of glycated hemoglobin (HbA1c) in the group was 8.95±2.09%, the av erage value of the body mass index was 32.3±6.2 kg/m2. All patients were assessed for traditional cardiovascular risk factors, markers of systemic inflammation and endothelial dysfunction, nutritional status was assessed by analyzing the frequency of consumption and a general semi-quantitative assessment of the intake of nutrients, food groups, and energy. During a one-year prospective follow-up, total cardiovascular endpoints were recorded and the effect of patient education on metabolic parameters, nutritional factors, and cardiovascular risk was assessed. Results. In patients with T2DM who had various clinical forms of cardiovascular diseases, the diet had an increased level of fats, which exceeded the intake in individuals without complications (p=0.013), and saturated fatty acids (SFA) (p=0.003). The risk of developing cardiovascular events in patients with T2DM increased by 5 times under excessive consumption of products containing SFA (meat, animal fats, sausages) (OR 5.34; CI 3.05-10.22, p=0.001). The decrease in body weight in the target range (by 7-10% during the year) was characterized by a decrease in the HbA1c by 11.9%, postprandial glycemia by 25.7%, total cholesterol by 20.4%, atherogenic coefficient by 25.0%, plasminogen activator inhibitor-1 by 8.5%, highly sensitive C-reactive protein by 27.4%, systolic blood pressure by 6.9%, and also was accompanied by significant decrease in unfavorable total cardiovascular events during the year (p=0.024). In addition, in the group of patients who underwent training, there was a decrease in the total amount of calories consumed (p=0.018), consumption of SFA (p=0.021) and mono- and disaccharides (p=0.001), an increase in dietary fiber in the diet (p=0.015). Conclusion. In the course of the study, an imbalance in the nutritional components of the diet in patients with T2DM was revealed. The significant role of alimentary factors in the formation of high cardiovascular risk has been demonstrated, as well as the effectiveness of therapeutic education of patients in terms of managing behavioral risk factors.

Association of food quality index with subclinical inflammation in middle-aged obese men

BACKGROUND: High visceral fat storage unbalance secretion inflammatory peptides, however diet plays an important role-protecting metabolism against chronic diseases inherent to this condition. OBJECTIVE: To assess obese diet quality and find association with inflammatory biomarkers. METHODS: aMED, a Food Quality Index, classified the inflammatory power of 26 obese men’s diet (aged: 48.1±5.1; BMI: 31.1±2.45). Pearson correlation coefficient associated diet quality in tertiles (1st as low, 2nd as average and 3 rd as high quality diet) with inflammatory variables (cytokines and waist circumference). RESULTS: The intake of anti-inflammatory food groups was significantly higher among tertiles (3rd &gt; 2nd &gt; 1st; P &lt; 0.001). Adiponectin was lower in the 2nd tertile than in the 1st (P &lt; 0.05). Whole cereal presented a positive correlation with TNF-alpha (p = 0.049), and a negative correlation with IL–15 (p = 0.002). Fish presented a positive correlation with IL–10 (p = 0.024), Resistin (p = 0.039) and PGE–2 (p = 0.001). These findings pointed to pro and anti-inflammatory responses. CONCLUSIONS: The method may need adjustments when used to assess obese food intake, since they don’t usually meet the daily-recommended intake. Other lifestyles variables should be considered, which may affect the inflammatory status.

Development and validation of food frequency questionnaire for food and nutrient intakes of adults in Butajira, Southern Ethiopia.

We developed a culturally-specific Food Frequency Questionnaire (FFQ) to the Ethiopian context and evaluate its validity in comparison to two 24-h dietary recalls (24-HRs) of food and nutrient intake. To evaluate the validity of a culturally-specific FFQ against two 24-HRs, we used a paired t-test, Wilcoxon-signed-rank test, Correlation coefficients, cross-classification, κ and Bland-Altman analysis. The FFQ was obtained 15 d after the second 24-HR was completed. A total of 105 adults, of which 43 (41 %) were men and 62 (59 %) women, aged 20-65 years participated in this present study. Mean energy and macronutrient intake obtained from the FFQ were significantly higher than those obtained from the mean of two 24-HRs. For energy and nutrient intakes, the crude correlation ranged from 0⋅05 (total fat) to 0⋅49 (vitamin B1). The de-attenuated correlation ranged from to 0⋅10 (total fat) to 0⋅80 (vitamin A). For the majority of food groups, no significant difference was observed in the median intake of food and nutrients. Crude correlation for food groups ranged from 0⋅12 (egg) to 0⋅78 (legumes). The de-attenuated correlation ranged from 0⋅24 (egg) to 1⋅00 (meat/poultry/fish and dairy). The FFQ is valid to assess and rank individuals in terms of intake of most food groups according to high and low intake categories.

Relations Between Urinary Albumin Excretion and a Dietary Intake of Fruits in Patients With Type 2 Diabetes.

BackgroundIt was reported that microalbuminuria and a decline in renal function were associated with cardiovascular disease (CVD) mortality and renal events and prognostic serious complications. Dietary factors and nutrients affecting microalbuminuria in type 2 diabetes remain unclear, and accordingly we conducted a cross-sectional study on the possible relevance of dietary factors to urinary albumin excretion in patients with type 2 diabetes.MethodsForty-two patients with type 2 diabetes participated in this study, and these subjects were categorized into patients without microalbuminuria group with urine albumin-to-creatinine ratio (ACR) of less than 30 mg/g Cr (n = 29) and a microalbuminuria group with ACR of 30 - 299 mg/g Cr (n = 13). ACR levels were measured using spot urine samples. At the time of examination, body mass index (BMI) and systolic and diastolic blood pressures were measured and recorded. We performed sampling fasting-blood and spot urine and conducted a food frequency questionnaire based on food groups to examine dietary habits for the past 1 - 2 months.ResultsThere were no significant differences in sex, age, duration, BMI, blood pressures, biochemical data, and the median of daily intakes of energy and macronutrients between patients without microalbuminuria and microalbuminuria groups. In the intake of 17 food groups per day, fruits were significantly lower in the microalbuminuria group than in patients without microalbuminuria group (the median was 38 g vs. 120 g/day, P < 0.05), but intakes of other food groups were not significantly different between the two groups. Moreover, we examined a model of partial correlation between ACR to the intake of fruits, adjusted by age, sex, glycated hemoglobin and BMI. This partial correlation was insignificantly seen but close to a significant level (partial correlation coefficient: -0.270, P = 0.102).ConclusionsThese results suggest that the intake of fruits may be inversely associated with microalbuminuria in Japanese type 2 diabetic patients. It would be necessary to investigate the exact types and amounts of fruits to be consumed to address microalbuminuria.

Evaluation of nutritional status and health behaviors of patients infected with COVID-19.

Introduction:Coronavirus disease 2019 (COVID-19) was a health emergency for the world in which started in 2019. Various factors are involved in the pathogenesis of this virus, including age, gender, body mass index (BMI), the type of diet, the degree of observance of health protocols, and the health status of people. The purpose of this study was to evaluate the nutritional status and health behaviors of patients infected with COVID-19.Methods:A descriptive-analytical research method was used in this study. One of the outpatient centers for the patients infected with COVID-19 in Kermanshah was selected as the research setting. The study population included all patients infected with COVID-19 and the sample size was 200 people. Data were analyzed by SPSS version 22.Results:Most patients (51%) were females and most of them suffered from body aches (81%) and headaches (94%). Most of the patients (76%) did not use a mask. Regarding the nutritional status, a large number of patients used all food groups such as carbohydrates, proteins, fruits, and vegetables less than the standard amount.Conclusion:It can be concluded that people with underlying diseases are more prone to the disease than others and adherence to social distancing and mask use helps a lot to control the disease. In addition, the appropriate intake of food groups reduces the severity of the disease by strengthening the immune system in people.

Food Group Intake of Pregnant Jordanian Women Based on the Three Pregnancy Trimesters.

Inadequate diets have adverse effects on maternal, fetal, and, possibly, childhood health. This cross-sectional study aimed to examine daily food group intake of pregnant Jordanian women during the three pregnancy trimesters and to compare these to the recommended servings of the five food groups reported by The United States Department of Agriculture and My Plate Plan. A total of 283 pregnant Jordanian women were recruited during their antenatal visits. Data were obtained by interviewer-administered structured questionnaires. Our results showed that 1.1% of participants consumed the recommended number of servings for all five food groups during pregnancy and 10.2% did not consume the minimum number of servings of the five food groups. Nearly half of the participants in the first trimester met the recommended daily servings for three food groups but only approximately two-third of participants met the minimum recommended daily servings for one or two food groups in the second and third trimesters. Consumption of grains and sweets was significantly higher in the third trimester compared with the first and second trimesters. Overall, the majority of pregnant Jordanian women in this study did not consume the recommended number of servings for all five food groups during pregnancy.

Food and Nutrient Intake Pattern of Three Generations Living Together in Middle Income Urban Households of Delhi, India

ABSTRACT The aim of the study was to assess the inter-generational differences in food and nutrient intake of three generations (grandparents, parents and children) living together. A cross-sectional survey assessed the food group and nutrient intake, changes in the intake over the years by using 24-hour dietary recall repeated over three days and focus group discussions. A total of 226 middle income families including 1,038 participants, grandparents (n=302), parents (n=423) and children (n=313) completed the diet survey. Focus group discussions with different generations explored the dietary transition over a period of time and the generation(s) responsible for menu related decisions. Children had significantly higher intake of cereals, other vegetables, sugars and fats as compared to their parents and grandparents (p&lt;0.001) and highest mean percent adequacy of energy, protein and calcium (p&lt;0.001). Information generated can be used to understand dynamics of food selection within a household and improve diet quality of all generations.

The Need for Investment in Rigorous Interventions to Improve Child Food Security

The Need for Investment in Rigorous Interventions to Improve Child Food Security

Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis

The impact of obesity interventions on dietary intake in children and adolescents with overweight or obesity is unclear. This systematic review aimed to investigate the impact of the dietary component of weight management interventions on the change in diet in children and adolescents with overweight or obesity. Eligible randomised controlled trials (RCTs) published between 1975 and 2020 were identified by a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Meta-analyses of eligible study outcomes were performed using statistical software. A multilevel random effects model was used with three significant random effects fitted using restricted maximum likelihood estimation. This review identified 109 RCTs, including 95 that reported at least one statistically significant dietary outcome change and 14 reporting no significant dietary change. Results from the meta-analyses (n=29 studies) indicated that, compared to control groups, intervention groups achieved significantly greater reductions in mean total energy intake at ≤6months (-194kcalday-1 , 95% confidence interval=-275.80 to -112.90kcalday-1 , P<0.001) and up to 12months (-112kcalday-1 95% confidence interval=-218.92 to -5.83kcalday-1 ) P=0.038), increases in fruit and/or vegetable intakes over 2-12months (n=34, range +0.6 to +1.5 servingsday-1 ) and reductions in consumption of sugar-sweetened beverages (n=28, range -0.25 to -1.5servingsday-1 ) at 4-24months follow-up. Obesity interventions with a dietary component have a modest but sustained impact on reducing total energy intake and improving intakes of specific food groups in children and adolescents with overweight or obesity. High quality RCTs that are powered to detect change in diet as a primary outcome are warranted.