title: The impact of a long-term reduction in dietary energy density on body weight within a randomized diet trial.
abstract: We examined the effect of dietary energy density change on body weight in participants of a randomized trial. Intervention participants markedly increased fruit and vegetable intake while reducing energy intake from fat. Participants were 2,718 breast cancer survivors, aged 26-74 yr, with baseline mean body mass index of 27.3 kg/m(2) (SD = 6.3). We assessed dietary intake by sets of four 24-h dietary recalls and validated with plasma carotenoid concentrations. Weight and height were measured at baseline, 1 yr, and 4 yr. Dietary energy density was calculated using food but excluding beverages. Intervention participants significantly reduced dietary energy density compared to controls and maintained it over 4 yr -- both in cross-sectional (P < 0.0001) and longitudinal (Group x Time interaction, P < 0.0001) analyses. Total energy intake or physical activity did not vary between groups. The intervention group had a small but significant weight loss at 1 yr (Group x Time interaction, P < 0.0001), but no between-group weight difference was observed at 4 yr. Our study showed that reducing dietary energy density did not result in a reduction in total energy intake and suggests that this strategy alone is not sufficient to promote long-term weight loss in a free-living population.
authors.affiliation: Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California San Diego, La Jolla, CA 92093-0901, USA.
authors.forename: Nazmus
authors.initials: N
authors.lastname: Saquib
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Lisa
authors.initials: L
authors.lastname: Madlensky
authors.forename: Sheila
authors.initials: S
authors.lastname: Kealey
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D001943:Breast Neoplasms / Q000517:prevention & control; D002338:Carotenoids / Q000097:blood; D018752:Diet, Fat-Restricted; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005638:Fruit; D006801:Humans; D008137:Longitudinal Studies; D011939:Mental Recall; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009753:Nutritive Value; D014675:Vegetables; D015431:Weight Loss
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D002338:Carotenoids