The evaluation of a low fat dietary intervention in children with diabetes
The aim of the study was to test an intervention aimed at reducing fat intake in type 1 diabetic children. Method: The intervention involved an individual assessment of the child's dietary intake and a personalised behavioural approach which included the setting of goals to facilitate appropriate food choices. Several quantitative measures were used to assess dietary intake, blood indices, knowledge and perceptions, at the intervention and one year thereafter. Results: Total fat intake in these children was lower than expected before the intervention, probably because dietary changes had occurred following the diagnosis of diabetes. Nevertheless, following the intervention, a modest but statistically significant, decrease in fat intake of 1.4% of total energy was achieved from 36.3% to 34.9%. Other measurable and desirable changes were found in food choices and most foods chosen as dietary goals. Some of these changes were statistically significant. Individuals who reported the achievement of all dietary goals accomplished the greatest fat reduction (2.1% of total energy). The consumption of high fibre foods, including fruit and vegetables was low. No changes were observed in serum lipoproteins or glycaemic control. Knowledge of healthy eating principles was good but appeared to be superficial, as the perception of fat intake was not related to actual intake. The majority of participants did not perceive that the intervention made a substantial difference to their fat intake. Conclusion: In the absence of a contemporaneous control group it is difficult to disentangle the effects of background secular trends. However, the overall findings suggest that fat intake can be reduced through an individualised, focused and practical approach to dietary education in motivated children with diabetes. Recommendations are made to improve the intervention and to target groups with specific dietary needs.