Background: The rising prevalence of overweight and obesity among adolescents, especially in low- and middle-income countries, highlights the need for effective, culturally adaptable interventions. Fruits consumed before meals and nut-based snacks are associated with enhanced satiety, better metabolic profiles, and improved weight management. However, limited evidence exists on their combined impact in structured communal settings like Islamic boarding schools in East Java, Indonesia.Methods: A randomized controlled trial was conducted enrolling 100 overweight female adolescents (aged 13-18 years) living in an Islamic boarding schools in Indonesia. Participants were randomly assigned to four groups of control receiving dietary education alone, and three intervention groups (T1, T2, T3) receiving education plus daily mixednuts (15, 20 and 25 g) and fruit (200-300 g) with low, moderate, or high glycemic index (GI), consumed prior to meals for 28 days. Body weight and dietary intake (energy, fat, carbohydrates, protein, fiber) were assessed at baseline, day 14, and day 28.Results: All intervention groups showed significant weight reduction over 28 days (p<0.001), with the greatest decrease in T3 (high-GI fruit). Energy, fat, carbohydrate, protein, and fiber intakes increased significantly in T1- T3 groups in comparison to the control group (p<0.001). Fiber intake increased 2.5 times from baseline, indicating an improved diet quality.Conclusion: A combined approach using pre-meal fruits of varying GI and nut-based snacks, paired with nutritional education could effectively reduce body weight and improve macronutrient intake in overweight adolescents. This culturally appropriate strategy can be feasible for addressing adolescent obesity in Islamic boarding schools.
Pinasti et al. (Sun,) studied this question.
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