title: No consistent association between consumption of energy-dense snack foods and annual weight and waist circumference changes in Dutch adults.
abstract: BACKGROUND
  There is conflicting evidence regarding an association between the consumption of energy-dense snack (EDS) foods and the development of overweight.
  
  
  OBJECTIVE
  In the current study, we examined whether there was an association between the intake of EDS foods and annual weight and waist circumference changes in normal-weight and overweight Dutch adults.
  
  
  METHODS
  The study population included 9383 men and women from the MORGEN-EPIC (Monitoring Project on Risk Factors for Chronic Diseases in the Netherlands-European Prospective Investigation into Cancer and Nutrition) study, which is a population-based cohort study in 3 towns in the Netherlands (Amsterdam, Maastricht, and Doetinchem), who had a body mass index (in kg/m(2)) <30 and who were not dieting. Participants were enrolled between 1993 and 1997 and followed for an average of 8.1 y (Amsterdam and Maastricht: 9.9 y; Doetinchem: 4.9 y). Intake of EDS foods (sweets, cakes and pastries, and savory snacks) was assessed at baseline by using a validated food-frequency questionnaire. Multivariate linear and multinomial logistic regression models were applied and stratified by center to examine the association between energy from EDS foods (kcal) and annual weight and waist circumference changes.
  
  
  RESULTS
  The mean (±SD) daily energy intake from EDS foods was 294 ± 192 kcal. In Amsterdam and Maastricht, the annual weight change was 168 ± 572 g/y, whereas in Doetinchem, the annual weight change was 444 ± 816 g/y. In the multivariate regression analysis adjusted for follow-up duration and anthropometric, dietary, and lifestyle factors, there was some, but inconsistent, evidence of an association of EDS-food consumption with annual weight change.
  
  
  CONCLUSIONS
  Our study provides some, but inconsistent, evidence that consumption of EDS foods is positively associated with an increase in annual weight in normal- to overweight Dutch adults.
authors: National Institute for Public Health and the Environment, Bilthoven, Netherlands. marieke.hendriksen@rivm.nl
authors: Marieke A H
authors: MA
authors: Hendriksen
authors: Jolanda M A
authors: JM
authors: Boer
authors: Huaidong
authors: H
authors: Du
authors: Edith J M
authors: EJ
authors: Feskens
authors: Daphne L
authors: DL
authors: van der A