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Evaluating an Intervention to Increase Cereal Fiber Intake in Children: A Randomized Controlled Feasibility Trial

Donin, AS; Nightingale, CM; Perkin, MR; Ussher, M; Jebb, SA; Landberg, R; Welsh, P; Sattar, N; Adab, P; Owen, CG; et al. Donin, AS; Nightingale, CM; Perkin, MR; Ussher, M; Jebb, SA; Landberg, R; Welsh, P; Sattar, N; Adab, P; Owen, CG; Rudnicka, AR; Cook, DG; Whincup, PH (2021) Evaluating an Intervention to Increase Cereal Fiber Intake in Children: A Randomized Controlled Feasibility Trial. J Nutr, 151 (2). pp. 379-386. ISSN 1541-6100 https://doi.org/10.1093/jn/nxaa347
SGUL Authors: Donin, Angela Nightingale, Claire Perkin, Michael Richard Ussher, Michael Henry Owen, Christopher Grant Rudnicka, Alicja Regina Whincup, Peter Hynes

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Abstract

BACKGROUND: Observational studies have shown that higher cereal fiber intake is associated with reduced type 2 diabetes risk. However, it remains uncertain whether this association is causal. OBJECTIVE: This study evaluated the feasibility of an intervention to increase cereal fiber intake in children using breakfast cereals. METHODS: The study was a 2-arm parallel group randomized controlled trial in 9-10-y-old children, who received free supplies of high-fiber breakfast cereals (>3.5 g/portion) or low-fiber breakfast cereals (<1.0 g/portion) to eat daily for 1 mo with behavioral support to promote adherence. Children provided baseline and 1-mo fasting blood samples, physical measurements, and 24-h dietary recalls. The primary outcome was the group difference in change in plasma total alkylresorcinol (AR) concentration; secondary outcomes were group differences in nutrient intakes and adiposity indices. Analyses (complete case and multiple imputation) were conducted by regressing the final AR concentration on baseline AR in models adjusted for sex, ethnicity, age, and school (random effect). RESULTS: Two-hundred seventy-two children were randomly assigned (137 receiving a low-fiber and 135 a high-fiber diet) and 193 (71%) provided fasting blood samples at baseline and follow-up. Among randomized participants, median (IQR) of baseline AR was 43.1 (24.6-85.5) nmol/L and of cereal fiber intake was 4.5 (2.7-6.4) g; 87% of participants reported consuming the cereal on most or all days. Compared with changes in the low-fiber group, the high-fiber group had greater increases in AR (40.7 nmol/L; 95% CI: 21.7, 59.8 nmol/L, P < 0.0001) and in reported cereal fiber intake (2.9g/d; 95% CI: 2.0, 3.7 g; P < 0.0001). There were no appreciable differences in other secondary outcomes. CONCLUSIONS: We have developed a simple and acceptable nutritional intervention that increases markers of daily cereal fiber intake in children. This intervention could be used to test whether increases in cereal fiber intake in children might reduce insulin resistance. This trial was registered at www.isrctn.com as ISRCTN33260236.

Item Type: Article
Additional Information: © The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Cereal fiber, children, dietary intervention, feasibility trial, type 2 diabetes risk, 1111 Nutrition and Dietetics, 0702 Animal Production, 0908 Food Sciences, Nutrition & Dietetics
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: J Nutr
ISSN: 1541-6100
Language: eng
Dates:
DateEvent
February 2021Published
9 December 2020Published Online
12 October 2020Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
200611/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
204809/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
PubMed ID: 33296467
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112488
Publisher's version: https://doi.org/10.1093/jn/nxaa347

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