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Relationship between changes in food group variety, dietary intake, and weight during obesity treatment

Abstract

BACKGROUND: Experimental studies show diets with greater variety in energy-dense foods increase consumption and body weight. Reducing variety in energy-dense food groups may decrease energy and dietary fat intake, promoting weight loss.

OBJECTIVE: This study examined changes in food group variety during obesity treatment and the relation between changes in food group variety, dietary intake, and weight.

DESIGN: Overweight men and women (n=202) were randomly assigned to one of two standard behavioral treatments with varying exercise prescriptions (exercise level of 4186 kJ/week (1000 kcal/week) or 10465 kJ/week (2500 kcal/week)), but received the same diet. Complete measures were obtained from 122 participants, of which 70 (58%) were female, with a mean body mass index of 31.3 kg/m2 (s.d.=2.5).

MEASUREMENTS: Food group variety and diet composition were assessed at 0, 6, and 18 months from food-frequency questionnaires. Food group variety was calculated as percent of foods consumed on a weekly basis within a food group, irrespective of servings consumed.

RESULTS: Participants reported increased variety (P≤0.001) in low-fat breads (LFB) and vegetables, and decreased variety (P≤0.001) in high-fat foods (HFF), and fats, oils, and sweets (FOS) over the course of the 18-month study. From 0 to 6 months, decreased HFF and FOS variety was associated with reduced energy and percent dietary fat intake, and decreased HFF variety was related to weight loss. From 6 to 18 months, decreased HFF variety and increased LFB variety was associated with reduced percent dietary fat consumed and weight loss.

CONCLUSION: Changing variety in specific food groups may help in adopting and sustaining a diet low in energy and fat, producing better weight loss and weight loss maintenance.

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Acknowledgements

HAR was primarily responsible for drafting the manuscript and was the primary data analyst. RWJ, DFT, and RRW provided detailed input at each stage, including conceptualization, data presentation, data analyses, and style. None of the authors had a financial or personal conflict of interest related to the funding or outcomes of this research. This research was supported by grants HL41330 and HL41332 from the National Heart, Lung, and Blood Institute. This research was supported by grants HL41330 and HL41332 from the National Heart, Lung, and Blood Institute.

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Correspondence to H A Raynor.

Appendix A. Complete listing of food types in all eight food groups used in dietary variety analysis

Appendix A. Complete listing of food types in all eight food groups used in dietary variety analysis

(1) Low-fat bread cereal, rice, and pasta: High-fiber cereals; highly fortified cereals; other cold cereals; cooked cereal or grits; rice; white bread (including sandwiches, bagels, etc, crackers); and dark bread, including whole wheat, rye, pumpernickel.

(2) Fruits: Apples, applesauce, pears; cantaloupe (in season); oranges; grapefruit; orange juice or grapefruit juice; and other fruit juices, fortified fruit drinks.

(3) Low-fat vegetables: Tomatoes, tomato juice; broccoli; spinach; mustard greens, turnip greens, collards; carrots, or mixed vegetables containing carrots; green salad; sweet potatoes, yams; and other potatoes, including boiled, baked, mashed, and potato salad.

(4) Low-fat meat, poultry, fish, dry beans, eggs, and nuts: Eggs; beans, such as baked beans, pintos, kidney, limas, or in chili; beef (steaks, roasts); liver, including chicken livers; pork, including chops, roasts; chicken or turkey (roasted, stewed, or broiled); and other fish (baked or boiled).

(5) High-fat foods from the five main food groups of the FGP: Corn bread, corn muffins, corn tortillas; doughnuts, cookies, cake, pastry; pies; french fries and fried potatoes; cheeses and cheese spreads, not including cottage cheese; ice cream; whole milk and beverages with whole milk; two milk and beverages with 2% milk; sausage; fried chicken; fried fish or fish sandwich; hot dogs; and ham, lunch meats; peanuts, peanut butter.

(6) Fats, oils, and sweets: Bacon; sugar in coffee or tea or on cereal; regular salad dressing and mayonnaise, including on sandwiches; butter on bread or rolls; margarine on bread or rolls; salty snacks (such as chips, popcorn); chocolate candy; regular soft drinks; and milk or cream in coffee or tea.

(7) Combinations foods: Hamburgers, cheeseburgers, meatloaf; beef stew or pot pie with carrots or other vegetables; spaghetti, lasagna, other pasta with tomato sauce; and vegetable soup, vegetable beef, minestrone, tomato soup.

(8) Snacks: Salty snacks (such as chips, popcorn); peanuts, peanut butter; ice cream; doughnuts, cookies, cake, pastry; pies; chocolate candy; regular soft drinks.

Note. The first seven food groups contain food items that do not overlap, while the last food group, snacks, contains food items from other food groups. Low-fat food groups have food items with <30% energy from fat, while HFF groups have ≥30% energy from fat or ≥8 g fat/oz of meat. FGP=Food Guide Pyramid. In the Block FFQ, a few of the grouped items are different in terms of fat composition (eg, other potatoes, including boiled, baked, mashed, and potato salad), a component used in differentiating food groups.

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Raynor, H., Jeffery, R., Tate, D. et al. Relationship between changes in food group variety, dietary intake, and weight during obesity treatment. Int J Obes 28, 813–820 (2004). https://doi.org/10.1038/sj.ijo.0802612

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