Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes

Abstract

BACKGROUND/OBJECTIVE Although reducing energy density (ED) enhances weight loss, it is unclear whether all dietary strategies that reduce ED are comparable, hindering effective ED guidelines for obesity treatment. This study examined how changes in number of low-energy-dense (LED) (<4.186 kJ/1.0 kcal g−1) and high-energy-dense (HED) (>12.56 kJ/3.0 kcal g−1) foods consumed affected dietary ED and weight loss within an 18-month weight loss trial. METHODS This secondary analysis examined data from participants randomized to an energy-restricted lifestyle intervention or lifestyle intervention plus limited non-nutrient dense, energy-dense food variety (n = 183). Number of daily LED and HED foods consumed was calculated from three, 24-h dietary recalls and anthropometrics were measured at 0, 6 and 18 months. Multivariable-adjusted generalized linear models and repeated-measures mixed linear models examined associations between 6-month changes in number of LED and HED foods and changes in ED, body mass index (BMI), and percent weight loss at 6 and 18 months. RESULTS Among mostly female (58%), White (92%) participants aged 51.9 years following an energy-restricted diet, increasing number of LED foods or decreasing number of HED foods consumed was associated with 6- and 18-month reductions in ED (β = − 0.25 to − 0.38 kJ g−1 (−0.06 to − 0.09 kcal g−1), P<0.001). Only increasing number of LED foods consumed was associated with 6- and 18-month reductions in BMI (β = − 0.16 to − 0.2 kg m−2, P<0.05) and 6-month reductions in percent weight loss (β = − 0.5%, P<0.05). Participants consuming ≤2 HED foods per day and ≥6.6 LED foods per day experienced better weight loss outcomes at 6- and 18-month than participants only consuming ≤2 HED foods per day. CONCLUSION Despite similar reductions in ED from reducing number of HED foods or increasing number of LED foods consumed, only increasing number of LED foods related to weight loss. This provides preliminary evidence that methods used to reduce dietary ED may differentially influence weight loss trajectories. Randomized controlled trials are needed to inform ED recommendations for weight loss.

Dietary Diversity: Implications for Obesity Prevention in Adult Populations: A Science Advisory From the American Heart Association

“…In 1 secondary analysis including data from 183 overweight and obese participants in an 18-month weight loss trial (age range at baseline, 21–65 years), increasing diversity in intakes of low-energy-dense foods (<4.186 kJ/kcal·g −1 ), assessed with food count, was associated with a decrease in body mass index after 6 and 18 months (≈−0.2 kg/ m 2 ; P <0.05). 55 In this analysis, diversity in intakes of high-energy–dense foods (>12.56 kJ/3.0 kcal·g −1 ) was not associated with change in body mass index. 55 Two observational studies investigated prospective associations in Chinese and US adults.…”

“…55 In this analysis, diversity in intakes of high-energy–dense foods (>12.56 kJ/3.0 kcal·g −1 ) was not associated with change in body mass index. 55 Two observational studies investigated prospective associations in Chinese and US adults. After 5 to 9 years of follow-up, Chinese adults (n=732; age range at baseline, 25–74 years) reporting greater diversity in intakes of snacks, but not grains, vegetables, fruits, meats, or beverages, had 45% greater odds of being overweight (odds ratio, 1.45; 95% confidence interval, 1.06–1.98) compared with those reporting lower diversity in snack consumption.…”

Identifying usual food choices at meals in overweight and obese study volunteers: implications for dietary advice

“…Therefore, effective strategies for reducing intake at dinner are required for weight loss. In addition, increasing the number of low-energy-dense food items consumed irrespective of intake of quantities is suggested as an effective strategy to lose weight ( 49 ) . Given that vegetables are a nutrient-dense food group but are low in energy, increasing vegetable consumption in the diet tends to have desirable effect on controlling energy intakes ( 50 ) .…”

The Effects of Nutrition on the Gastrointestinal Microbiome of Cats and Dogs: Impact on Health and Disease

“…A “one-health perspective” has been proposed to address the problem of obesity in both humans and pets because of interdependencies among diet, physical activity, genetics, metabolism, and the GI microbiome related to weight gain ( Chandler et al, 2017 ). Numerous dietary modifications have been proposed to reduce weight and are well-documented in the literature, including the elimination of high-energy density foods, altering the macronutrient composition of the diet (i.e., high-protein, high fat, and/or high fiber diets), and adding dietary diacylglycerols and probiotics ( Astrup et al, 2015 ; Kathrani et al, 2016 ; Alexander et al, 2017 ; Vadiveloo et al, 2017 ). However, current weight management guidelines for cats and dogs do not take into consideration the GI microbiome ( Brooks et al, 2014 ).…”