Int. J. Environ. Res. Public Health 2012, 9 1377 which multiple proxy report may be necessary to capture all the items consumed in a day, such as what was done in this study [18]. Though several limitations exist, this is the first non-observational study to directly investigate the relationship between change in FVs and SFs across time in overweight children. As none of the conditions had recommendations to increase FVs and decrease SFs, (a combined message) this study is able to examine the natural relationship between changes in intake of these food groups when there is no prescription for energy intake during a pediatric weight management trial. This secondary data analysis provides preliminary data to help understand the relationship between changes in intake between FVs and SFs. 5. Conclusions Study outcomes suggest FVs do not displace energy-dense SFs in overweight children aged 4 to 9 years participating in a pediatric weight management intervention. To better understand how FVs and SFs impact energy balance and nutrient quality in children, future intervention investigations should explore the effects of these dietary targets alone and in combination on dietary intake and weight status to determine the most efficacious dietary strategies to treat childhood obesity. Conflict of Interest Acknowledgments References The authors declare no conflict of interest. The original trial was supported by a grant (ADA 7-05-HFC-27) from the American Diabetes Association. 1. Epstein, L.H.; Valoski, A.; Wing, R.R.; McCurley, J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994, 13, 373-383. 2. Spear, B.A.; Barlow, S.E.; Ervin, C.; Ludwig, D.S.; Saelens, B.E.; Schetzina, K.E.; Taveras, E.M. Recommendations for the treatment of child and adolescent overweight and obesity. Pediatrics 2007, 120, S254-S288. 3. Cohen, D.A.; Sturm, R.; Scott, M.; Farle, T.A.; Bluthenthal, R. Not enough fruit and vegetables or much cookies, candy, salty snacks and soda? Public Health Rep. 2010, 125, 88-95. 4. Field, A.E.; Gillman, M.W.; Rosner, B.; Rockett, H.R.; Colditz, G.A. Association between fruit and vegetable intake and change in body mass index among a large sample of children and adolescents in the United States. Int. J. Obes. (Lond.) 2003, 27, 821-826. 5. Epstein, L.H.; Saelens, B.E. Behavioral Economics of Obesity: Food Intake and Energy Expenditure. In Reframing Health Behavior Change with Behavioral Economics; Bickel, W.K., Vuchinich, R.E., Eds.; Lawrence Associate, Inc.: Mahwah, NJ, USA, 2000; pp. 293-311. 6. Just, D.R.; Mancino, L.; Wansink, B. Could Behavioral Economics Help Improve Diet Quality for Nutrition Assistance Program Participants? Economic Research Report No. ERR-43; U.S. Department of Agriculture: Washington, DC, USA, 2007.