Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial.
BACKGROUND
Dietary energy density (ED) reductions are associated with energy intake (EI) reductions. Little is known about influences on body weight (BW).


OBJECTIVE
We examined the effects of behavioral interventions on ED values and explored how 6-mo ED changes relate to BW.


METHODS
Prehypertensive and hypertensive persons were randomly assigned to 1 of 3 groups: the established group received an 18-session intervention implementing well-established hypertension recommendations (eg, weight loss, sodium reduction, and physical activity), the established+Dietary Approaches to Stop Hypertension (DASH) group received an 18-session intervention also implementing the DASH diet, and the advice group received 1 session on these topics. Two 24-h dietary recalls were collected (n=658).


RESULTS
Each group had significant declines in EI, ED, and BW. The established and established+DASH groups had the greatest EI and BW reductions. The established+DASH group had the greatest ED reduction and the greatest increase in the weight of food consumed. When groups were combined and analyzed by ED change tertiles, participants in the highest tertile (ie, largest ED reduction) lost more weight (5.9 kg) than did those in the middle (4.0 kg) or lowest (2.4 kg) tertile. Participants in the highest and middle tertiles increased the weight of food they consumed (300 and 80 g/d, respectively) but decreased their EI (500 and 250 kcal/d). Conversely, those in the lowest tertile decreased the weight of food consumed (100 g/d), with little change in EI. The highest and middle tertiles had favorable changes in fruit, vegetable, vitamin, and mineral intakes.


CONCLUSIONS
Both large and modest ED reductions were associated with weight loss and improved diet quality.
Ledikwe
Jenny H
JH
Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA. mvh111@psu.edu
Rolls
Barbara J
BJ
Smiciklas-Wright
Helen
H
Mitchell
Diane C
DC
Ard
Jamy D
JD
Champagne
Catherine
C
Karanja
Njeri
N
Lin
Pao-Hwa
PH
Stevens
Victor J
VJ
Appel
Lawrence J
LJ
D001835:Body Weight / Q000502:physiology*; D004038:Diet, Reducing / Q000592:standards; D004039:Diet, Sodium-Restricted; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009753:Nutritive Value; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D010353:Patient Education as Topic; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D015431:Weight Loss
D017673:Sodium Chloride, Dietary