Int. J. Environ. Res. Public Health 2012, 9 1376 behavioral pediatric weight management randomized control trial. Results indicated there was no relationship between changes in FV and SF consumption; therefore increases in consumption of FVs were not related to decreases in consumption of SFs. Additionally, reductions in SF consumption were significantly related to reductions in energy intake. Increases in FV consumption were not related to decreases in energy intake. The lack of a relationship between FVs and SFs is consistent with previous research in adults [3,8] and children at-risk for obesity [9]. Results of this study suggest while increasing FVs may increase the nutrient quality of the diet, as FVs are nutrient-dense foods, increasing FVs may not automatically reduce intake of high-energy-dense, non-nutrient-dense foods or energy intake. As no relationship was found between change in FVs and SFs, to produce changes in consumption of these two types of foods, they both may need to be targeted in an intervention. Thus, to optimally increase consumption of FVs and decrease consumption of SFs and reduce energy intake, interventions may need to actually target both food groups, rather than relying on only targeting one of these types of food groups during an intervention. While the current investigation found significant increases in FVs, it did not find significant decreases in SFs and energy, which the main trial [12] did. Differences in these findings may be due to differences in the types of analyses conducted (intention-to-treat vs. completers analyses), which influenced the sample size used in the analyses, and the time frame of the analyses (12 month follow-up vs. 6-month intervention only). However, while not significant, it is important to note that children included in this subsample did decrease SFs and energy intake. Interestingly, results also indicate that children with greater intake of SF servings at baseline had smaller reductions in energy intake. Potentially, children entering the trials with higher SF serving intake may have found it more difficult to make overall changes in the diet that could assist with reducing overall energy intake. Limitations of the study include use of dietary change scores in analyses, as change scores may have reduced variability. However, it is important to note that baseline values were controlled for in analyses to address regression to the mean issues related to the use of change scores. Also, energy consumed from only FVs and SFs was not able to be determined, as while the dietary software used provides food group servings consumed from combination foods, it does not provide energy intake from each individual food group that may make up a combination food. Thus, this limits the ability to examine the relationship between energy intake from food groups and overall energy intake. The study also had a relatively small sample size; but, the high rate of retention from the main trial [12] is an important strength to note. A posterior power calculation of Model 4 (Block I, II, III and IV) revealed an effect size of 0.125 (small to medium) could be detected with the sample size of this investigation (N = 80) [16]. The sample was also fairly homogenous, limiting the ability to generalize the results to overweight and obese children from underrepresented racial and ethnic groups. Analyses used completer, rather than intention-to-treat analyses, as the investigation was a secondary data analyses. Results are also limited to highly motivated, treatment seeking families. An additional limitation is the use of self-reported dietary measures [17]. Three recent reviews [18-20] of dietary assessment methodology specifically in children noted the challenges of collecting accurate dietary data and suggested that specific demographic characteristics (e.g., weight status, age, sex, ethnicity) can be related to the misreporting of dietary intake. An additional barrier to collecting accurate dietary data from children is when a child is under the supervision of another caretaker in