Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Clinical Studies and Practice

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

International Journal of Obesity volume 42, pages 479–486 (2018)Cite this article

Subjects

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Flegal KM, Carroll MD, Kit BK, Ogden CL . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307: 491–497.

    Article  Google Scholar 

  2. NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 2016; 387: 1377–1396.

    Article  Google Scholar 

  3. Marczak L, O’Rourke K, Shepard D . When and why people die in the United States, 1990-2013. JAMA 2016; 315: 241.

    Article  CAS  Google Scholar 

  4. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009; 360: 859–873.

    Article  CAS  Google Scholar 

  5. Barte JC, ter Bogt NC, Bogers RP, Teixiera PJ, Blissmer B, Mori TA et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev 2010; 11: 899–906.

    Article  CAS  Google Scholar 

  6. Hartmann-Boyce J, Johns DJ, Jebb SA, Aveyard P, Behavioural Weight Management Review Group. Effect of behavioural techniques and delivery mode on effectiveness of weight management: systematic review, meta-analysis and meta-regression. Obes Rev 2014; 15: 598–609.

    Article  CAS  Google Scholar 

  7. Loveman E, Frampton GK, Shepherd J, Picot J, Cooper K, Bryant J et al. The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review. Health Technol Assess 2011; 15: 1–182.

    Article  CAS  Google Scholar 

  8. Looney SM, Raynor HA . Behavioral lifestyle intervention in the treatment of obesity. Health Serv Insights 2013; 6: 15–31.

    PubMed  PubMed Central  Google Scholar 

  9. Geiselman PJ . Control of food intake. A physiologically complex, motivated behavioral system. Endocrinol Metab Clin North Am 1996; 25: 815–829.

    Article  CAS  Google Scholar 

  10. Stubbs J, Ferres S, Horgan G . Energy density of foods: effects on energy intake. Crit Rev Food Sci Nutr 2000; 40: 481–515.

    Article  CAS  Google Scholar 

  11. Poppitt SD, Prentice AM . Energy density and its role in the control of food intake: evidence from metabolic and community studies. Appetite 1996; 26: 153–174.

    Article  CAS  Google Scholar 

  12. Rolls BJ, Bell EA . Dietary approaches to the treatment of obesity. Med Clin North Am 2000; 84: 401–418.

    Article  CAS  Google Scholar 

  13. Karl JP, Roberts SB . Energy density, energy intake, and body weight regulation in adults. Adv Nutr 2014; 5: 835–850.

    Article  CAS  Google Scholar 

  14. Rolls BJ . The relationship between dietary energy density and energy intake. Physiol Behav 2009; 97: 609–615.

    Article  CAS  Google Scholar 

  15. Ello-Martin JA, Roe LS, Ledikwe JH, Beach AM, Rolls BJ . Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am J Clin Nutr. 2007; 85: 1465–1477.

    Article  CAS  Google Scholar 

  16. Lowe MR, Butryn ML, Thomas JG, Coletta M . Meal replacements, reduced energy density eating, and weight loss maintenance in primary care patients: a randomized controlled trial. Obesity 2014; 22: 94–100.

    Article  Google Scholar 

  17. Raynor HA, Looney SM, Steeves EA, Spence M, Gorin AA . The effects of an energy density prescription on diet quality and weight loss: a pilot randomized controlled trial. J Acad Nutr Diet 2012; 112: 1397–1402.

    Article  Google Scholar 

  18. Ledikwe JH, Rolls BJ, Smiciklas-Wright H, Mitchell DC, Ard JD, Champagne C et al. Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial. Am J Clin Nutr 2007; 85: 1212–1221.

    Article  CAS  Google Scholar 

  19. Ledikwe JH, Blanck HM, Khan LK, Serdula MK, Seymour JD, Tohill BC et al. Dietary energy density determined by eight calculation methods in a nationally representative United States population. J Nutr 2005; 135: 273–278.

    Article  CAS  Google Scholar 

  20. Levitsky DA, Iyer S, Pacanowski CR . Number of foods available at a meal determines the amount consumed. Eat Behav 2012; 13: 183–187.

    Article  Google Scholar 

  21. Apolzan JW, Myers CA, Champagne CM, Beyl RA, Raynor HA, Anton SA et al. Frequency of consuming foods predicts changes in cravings for those foods during weight loss: the POUNDS lost study. Obesity 2017; 25: 1343–1348.

    Article  Google Scholar 

  22. Kaiser KA, Brown AW, Bohan Brown MM, Shikany JM, Mattes RD, Allison DB . Increased fruit and vegetable intake has no discernible effect on weight loss: a systematic review and meta-analysis. Am J Clin Nutr 2014; 100: 567–576.

    Article  CAS  Google Scholar 

  23. Mytton OT, Nnoaham K, Eyles H, Scarborough P, Ni Mhurchu C . Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake. BMC Public Health 2014; 14: 886.

    Article  Google Scholar 

  24. Grieger JA, Johnson BJ, Wycherley TP, Golley RK . Evaluation of simulation models that estimate the effect of dietary strategies on nutritional intake: a systematic review. J Nutr 2017; 147: 908–931.

    Article  CAS  Google Scholar 

  25. Raynor HA, Steeves EA, Hecht J, Fava JL, Wing RR . Limiting variety in non-nutrient-dense, energy-dense foods during a lifestyle intervention: a randomized controlled trial. Am J Clin Nutr 2012; 95: 1305–1314.

    Article  CAS  Google Scholar 

  26. Stelmach-Mardas M, Rodacki T, Dobrowolska-Iwanek J, Brzozowska A, Walkowiak J, Wojtanowska-Krosniak A et al. Link between food energy density and body weight changes in obese adults. Nutrients 2016; 8: 229.

    Article  Google Scholar 

  27. Han SF, Jiao J, Zhang W, Xu JY, Zhang W, Chun-Ling F et al. Lipolysis and thermogenesis in adipose tissues as new potential mechanisms for metabolic benefits of dietary fiber. Nutrition 2017; 33: 118–124.

    Article  CAS  Google Scholar 

  28. Slavin JL . Dietary fiber and body weight. Nutrition 2005; 21: 411–418.

    Article  Google Scholar 

  29. Yao M, Roberts SB . Dietary energy density and weight regulation. Nutr Rev 2001; 59: 247–258.

    Article  CAS  Google Scholar 

  30. Ammerman AS, Hartman T, DeMarco MM . Behavioral economics and the supplemental nutrition assistance program. Am J Prev Med 2017; 52: S145–S150.

    Article  Google Scholar 

  31. Raynor HA, Niemeier HM, Wing RR . Effect of limiting snack food variety on long-term sensory-specific satiety and monotony during obesity treatment. Eat Behav 2006; 7: 1–14.

    Article  Google Scholar 

  32. Anderson JJ, Nieman DC . Diet quality-the Greeks had it right!. Nutrients 2016; 8: 636.

    Article  Google Scholar 

  33. Vernarelli JA, Mitchell DC, Rolls BJ, Hartman TJ . Dietary energy density and obesity: how consumption patterns differ by body weight status. Eur J Nutr 2016. e-pub ahead of print 13 October 2016; e-pub ahead of print 13 October 2016; https://doi.org/10.1007/s00394-016-1324-8.

    Article  Google Scholar 

  34. Hill AJ . The psychology of food craving. Proc Nutr Soc 2007; 66: 277–285.

    Article  Google Scholar 

  35. Sainsbury A, Zhang L . Role of the hypothalamus in the neuroendocrine regulation of body weight and composition during energy deficit. Obes Rev 2012; 13: 234–257.

    Article  CAS  Google Scholar 

  36. Drewnowski A, Henderson SA, Driscoll A, Rolls BJ . The dietary variety score: assessing diet quality in healthy young and older adults. J Am Diet Assoc 1997; 97: 266–271.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA

    M Vadiveloo & H Parker

  2. Department of Nutrition, University of Tennessee, Knoxville, TN, USA

    H Raynor

Authors
  1. M Vadiveloo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H Raynor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Vadiveloo.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on International Journal of Obesity website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vadiveloo, M., Parker, H. & Raynor, H. Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes. Int J Obes 42, 479–486 (2018). https://doi.org/10.1038/ijo.2017.303

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2017.303

This article is cited by

Search

Advanced search

Quick links