EAL

PWM: Foods and Nutrients (2006)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

To investigate the possible relationship between dietary fat intake and sensory preferences for fat
To assess the possible relationship between dietary fat and body composition.

Inclusion Criteria:

Children aged 9-12 y attending one of two elementary schools in Cincinnati, Ohio and were in 5^th or 6^th grade.

Exclusion Criteria:

Children with food allergies or other limitations to the consumption of test stimuli or chronic illness.

Description of Study Protocol:

Usual dietary intake was assessed by 3 day dietary records modified for age appropriate comprehension. The students were instructed on Wednesday to record the foods eaten on Thursday, Friday and Saturday. Parents were also informed of the data collection and participated in the records.

Hedonic evaluation of regular and low fat versions of four baked snack foods most frequently consumed by this group of subjects was performed on two separate testing occasions.

Body composition was calculated from height, weight and tricep and subscapular skinfold measurements.

Data Collection Summary:

Dependent: BMI (measured ht and wt following standardized protocol), Tricep skinfold, Subscapular skinfold; Fat preference (hedonic scale using after sensory testing).

Independent: 3 day diet records (Thursday, Friday, Saturday)

Statistical Analysis: Linear regression and Pearson correlation coefficients.

Description of Actual Data Sample:

Original Sample: 88 children (51 males, 37 females)

Withdrawals/Drop-Outs: 3 children’s questionnaires were not returned or had to be eliminated because of incomplete records.

Final Sample: 85 children

Location: Cinncinnati, Ohio

Race/Ethnicity: not specified

SES: not specified.

Age: aged 9-12 years (Mean 10.8)

Summary of Results:

Correlation analysis:

Variable	Fat Preference	%Fat Intake
Energy Intake	0.40	0.32
%Fat Intake	0.57 (P<0.050)	1.00
Fat Preference	1.00	0.57 (P< 0.050)
BMI	0.51 (P<0.050)	0.38
Tricep Skinfold	0.46 (P<0.050)	0.43
Subscapular Skinfold	0.34	0.40

Nutrient intake corresponded with the typical diet of American children (13.9% calories from Protein, 51.5% calories from Carbohydrate, 35.6% calories from fat)
Student fat preference correlated significantly and positively with student’s % fat intake; energy intake, however, was NOT related.
Tricep skinfold measurements and students BMI were positively correlated with fat preference. Subscapular skinfold measurements were not related.
There was no significant relationship between dietary fat intake and BMI and subscapular skinfolds. Tricep skinfold measurements and dietary fat intake, however, was approaching significance.
The study showed a positive correlation between student preference for high fat food and the overall level of dietary fat in their diet.

Author Conclusion:

These data suggest preference for high fat foods may occur due to diet composition and that increased adiposity may be associated with higher relative fat intakes.

Funding Source:

University/Hospital:

University of Cincinnati

Reviewer Comments:

Quality Criteria Checklist: Primary Research
Relevance Questions
	1.	Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies)	Yes
	2.	Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about?	Yes
	3.	Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice?	Yes
	4.	Is the intervention or procedure feasible? (NA for some epidemiological studies)	Yes

Validity Questions
1.	Was the research question clearly stated?		Yes
	1.1.	Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified?	Yes
	1.2.	Was (were) the outcome(s) [dependent variable(s)] clearly indicated?	Yes
	1.3.	Were the target population and setting specified?	Yes
2.	Was the selection of study subjects/patients free from bias?		Yes
	2.1.	Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study?	Yes
	2.2.	Were criteria applied equally to all study groups?	Yes
	2.3.	Were health, demographics, and other characteristics of subjects described?	No
	2.4.	Were the subjects/patients a representative sample of the relevant population?	Yes
3.	Were study groups comparable?		Yes
	3.1.	Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT)	N/A
	3.2.	Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline?	Yes
	3.3.	Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.)	Yes
	3.4.	If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis?	Yes
	3.5.	If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.)	N/A
	3.6.	If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")?	N/A
4.	Was method of handling withdrawals described?		Yes
	4.1.	Were follow-up methods described and the same for all groups?	Yes
	4.2.	Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.)	Yes
	4.3.	Were all enrolled subjects/patients (in the original sample) accounted for?	Yes
	4.4.	Were reasons for withdrawals similar across groups?	Yes
	4.5.	If diagnostic test, was decision to perform reference test not dependent on results of test under study?	N/A
5.	Was blinding used to prevent introduction of bias?		Yes
	5.1.	In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate?	N/A
	5.2.	Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.)	No
	5.3.	In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded?	???
	5.4.	In case control study, was case definition explicit and case ascertainment not influenced by exposure status?	N/A
	5.5.	In diagnostic study, were test results blinded to patient history and other test results?	N/A
6.	Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described?		Yes
	6.1.	In RCT or other intervention trial, were protocols described for all regimens studied?	Yes
	6.2.	In observational study, were interventions, study settings, and clinicians/provider described?	Yes
	6.3.	Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect?	???
	6.4.	Was the amount of exposure and, if relevant, subject/patient compliance measured?	Yes
	6.5.	Were co-interventions (e.g., ancillary treatments, other therapies) described?	No
	6.6.	Were extra or unplanned treatments described?	No
	6.7.	Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups?	Yes
	6.8.	In diagnostic study, were details of test administration and replication sufficient?	N/A
7.	Were outcomes clearly defined and the measurements valid and reliable?		Yes
	7.1.	Were primary and secondary endpoints described and relevant to the question?	No
	7.2.	Were nutrition measures appropriate to question and outcomes of concern?	Yes
	7.3.	Was the period of follow-up long enough for important outcome(s) to occur?	Yes
	7.4.	Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures?	Yes
	7.5.	Was the measurement of effect at an appropriate level of precision?	Yes
	7.6.	Were other factors accounted for (measured) that could affect outcomes?	No
	7.7.	Were the measurements conducted consistently across groups?	Yes
8.	Was the statistical analysis appropriate for the study design and type of outcome indicators?		Yes
	8.1.	Were statistical analyses adequately described and the results reported appropriately?	Yes
	8.2.	Were correct statistical tests used and assumptions of test not violated?	Yes
	8.3.	Were statistics reported with levels of significance and/or confidence intervals?	Yes
	8.4.	Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)?	No
	8.5.	Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)?	No
	8.6.	Was clinical significance as well as statistical significance reported?	Yes
	8.7.	If negative findings, was a power calculation reported to address type 2 error?	No
9.	Are conclusions supported by results with biases and limitations taken into consideration?		Yes
	9.1.	Is there a discussion of findings?	Yes
	9.2.	Are biases and study limitations identified and discussed?	No
10.	Is bias due to study's funding or sponsorship unlikely?		Yes
	10.1.	Were sources of funding and investigators' affiliations described?	Yes
	10.2.	Was the study free from apparent conflict of interest?	Yes