title: Limiting variety in non-nutrient-dense, energy-dense foods during a lifestyle intervention: a randomized controlled trial.
abstract: BACKGROUND
  Dietary variety is a factor that influences consumption but has received little attention in obesity treatment.
  
  
  OBJECTIVE
  This study examined the effect of limiting the variety of different non-nutrient-dense, energy-dense foods (NND-EDFs) (i.e., chips, ice cream, cookies) on dietary intake and weight loss during an 18-mo lifestyle intervention.
  
  
  METHODS
  Two hundred two adults aged 51.3 ± 9.5 y with a BMI (in kg/m2) of 34.9 ± 4.3 (57.8% women, 92.2% white) were randomly assigned to 1 of 2 interventions: Lifestyle (1200-1500 kcal/d, ≤30% of energy as fat; n = 101) or Lifestyle + limited variety (LV) (limit variety of NND-EDFs, i.e., 2 choices; n = 101). Both interventions involved 48 group sessions. Dietary intake, NND-EDF hedonics, NND-EDF variety in the home, and weight were assessed at 0, 6, 12, and 18 mo.
  
  
  RESULTS
  Intent-to-treat analyses showed that the Lifestyle+LV group consumed less variety (P < 0.01) and energy daily (P < 0.05) from NND-EDFs than did the Lifestyle group at 6, 12, and 18 mo. The Lifestyle+LV group consumed less total energy daily (P < 0.05) at 6 mo than did the Lifestyle group. The Lifestyle+LV group reported less (P < 0.05) NND-EDF variety in the home at 6 and 18 mo than did the Lifestyle group. The hedonics of one chosen NND-EDF decreased more (P < 0.05) in the Lifestyle+LV group. Despite these effects, no difference in percentage weight loss occurred at 18 mo (Lifestyle+LV: -9.9 ± 7.6%; Lifestyle: -9.6 ± 9.2%).
  
  
  CONCLUSIONS
  Limitations in dietary variety decreased intakes in the targeted area but did not affect weight loss. Limiting variety in more areas may be needed to improve weight loss and weight-loss maintenance. This trial was registered at clinicaltrials.gov as NCT01096719.
authors.affiliation: Department of Nutrition, University of Tennessee, Knoxville 37996-1920, USA. hraynor@utk.edu
authors.forename: Hollie A
authors.initials: HA
authors.lastname: Raynor
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Steeves
authors.forename: Jacki
authors.initials: J
authors.lastname: Hecht
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Fava
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004038:Diet, Reducing; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D015431:Weight Loss