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Strong and Consistent Evidence Supports Low Energy Density Diets for Weight Loss

2012-04-03

Children and Adults Both Benefit, Report in the Journal of the Academy of Nutrition and Dietetics Finds

Media Contacts: Ryan O'Malley, Allison MacMunn
800/877-1600, ext. 4769, 4802 media@eatright.org

A new report published online today in the Journal of the Academy of Nutrition and Dietetics systematically reviews and updates the evidence underlying the recommendation in the Dietary Guidelines for Americans 2010 to consume a diet low in energy density (ED). The report addresses the growing body of evidence linking ED, or the number of calories in a given amount of food, and body weight in adults as well as children and adolescents. The systematic review concluded that there is strong and consistent evidence in adults showing that consuming a diet higher in ED is associated with increased body weight, while consuming a diet that is relatively low in ED improves weight loss and weight maintenance. In children and adolescents, moderately strong evidence shows a relationship between higher ED diets and increased weight.

"The conclusions reached in our review strengthen the recommendations in the Dietary Guidelines to consume such foods as fruits, vegetables, whole grains, and lean animal protein sources, which are generally lower in ED, while lowering consumption of total fat, saturated fat, and added sugars, which increase ED of foods," says lead investigator Rafael Perez-Escamilla, PhD, of Yale University, and a member of the 2010 Dietary Guidelines Advisory Committee. "It also strengthens the focus on considering overall dietary patterns rather than simply targeting modifications to individual components of the diet."

Investigators evaluated 17 studies of dietary ED and body weight in adults. Seven were randomized controlled trials (RCT), one was a non-controlled trial, and nine were cohort studies. These studies were conducted in the United States, Brazil, Europe, France, Germany, The Netherlands, Denmark, and South Korea. Fifteen of the 17 studies offered evidence that linked diets lower in ED with improved weight loss or weight maintenance. In a number of the weight loss trials reviewed, lowering ED was most effective for promoting weight loss during the active intervention period, but some studies found that the benefit was not always sustained over time.  The relationship between lower ED and improved weight maintenance, based on the cohort studies, was highly consistent.

Six prospective studies from the United States, United Kingdom, and Germany were included in the review of evidence on dietary ED and body weight in children and adolescents. Studies included normal weight and overweight boys and girls. The majority of studies showed a relationship between higher dietary ED and increased weight in children.

"While the mechanisms for the relationship between ED and weight have not been widely studied, it has been hypothesized that lowering ED can enhance satiety and contribute to reductions in calorie intake," explains Dr. Perez-Escamilla.

While the findings from this systematic review suggest that consuming diets lower in ED may be an effective strategy for managing body weight, Dr. Perez-Escamilla notes that there is a need for public health strategies to communicate what ED means and how it is associated with body weight. "Guidelines for how to estimate ED for different products based on food label information, how to decrease dietary ED, and how to sustain weight loss benefits using lower ED diets in the long term are needed," he concludes.

In an accompanying podcast Rafael Pérez-Escamilla, PhD, and Julie E Obbagy, PhD, RD, discuss the relationship between energy density and weight and its impact not only on adults, but also on children and adolescents. The podcast is available at http://andjrnl.org/content/podcast.

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Notes for Editors

"Dietary Energy Density and Body Weight in Adults and Children: A Systematic Review," by Rafael Pérez-Escamilla, PhD; Julie E Obbagy, PhD, RD; Jean M Altman, MS; Eve V. Essery, PhD; Mary M. McGrane, PhD; Yat Ping Wong, MLS, MPH; Joanne M. Spahn, MS, RD, FADA; Christine L Williams, MD, MPH, Journal of the Academy of Nutrition and Dietetics, Volume 112/Issue 5 (May 2012), doi: 10.1016/j.jand.2012.01.020, published by Elsevier.

Full text of this article is available to credentialed journalists upon request. Contact Eileen Leahy at 732/238-3628 or andjrnlmedia@elsevier.com to obtain copies. Journalists wishing to set up interviews with the authors may contact by Rafael Pérez-Escamilla at 1-860/805-2502 or rafael.perez-escamilla@yale.edu.

An audio podcast featuring an interview with Rafael Pérez-Escamilla, PhD, and Julie E Obbagy, PhD, RD, and information specifically for journalists are located athttp://andjrnl.org/content/mediapodcast. Excerpts from the podcast may be reproduced by the media; contact Eileen Leahy to obtain permission.

About the Journal of the Academy of Nutrition and Dietetics

The official journal of the Academy of Nutrition and Dietetics (www.eatright.org), the Journal of the Academy of Nutrition and Dietetics (www.andjrnl.org) is the premier source for the practice and science of food, nutrition and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, food service systems, leadership and management and dietetics education.

The Journal has a current Impact Factor of 3.244 in the Nutrition and Dietetics category of the Journal Citation Reports®, published by Thomson Reuters. It was previously published as the Journal of the American Dietetic Association.

About the Academy of Nutrition and Dietetics

The Academy of Nutrition and Dietetics (www.eatright.org), formerly the American Dietetic Association, is the world's largest organization of food and nutrition professionals. The Academy is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy.

About Elsevier

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet (www.thelancet.com) and Cell (www.cell.com), and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect (www.sciencedirect.com), SciVerse Scopus (www.scopus.com), Reaxys (www.reaxys.com), MD Consult (www.mdconsult.com) and Nursing Consult (www.nursingconsult.com), which enhance the productivity of science and health professionals, and the SciVal suite (www.scival.com) and MEDai's Pinpoint Review (www.medai.com), which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier (www.elsevier.com) employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC (www.reedelsevier.com), a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).