Strong and consistent evidence indicates that adults consuming a higher energy density (ED) diet have a higher body weight, whilst those who eat a relatively low ED diet experience weight loss and maintain their weight, whilst there is moderate proof that children and adolescents who eat higher ED diets are linked to higher weight.

The study, published in the Journal of the Academy of Nutrition and Dietetics, consisted of systematical reviews and updates of the Dietary Guidelines for Americans 2010 recommendations to consume a low energy density diet. The study examines mounting evidence that ED, i.e. the amount of calories in a certain amount of foods, is associated with body weight in children, adolescents and adults.

Leading author Rafael Perez-Escamilla, PhD, of Yale University, who is a member of the 2010 Dietary Guidelines Advisory Committee, declared:

"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. It also strengthens the focus on considering overall dietary patterns rather than simply targeting modifications to individual components of the diet."

The authors reviewed 17 studies of dietary ED and body weight in adults. The studies were performed in Brazil, the U.S., South Korea and in European countries, including Denmark, France, Germany and the Netherlands. Seven of the studies were randomized controlled trials (RCT), one was a non-controlled trial, and 9 were cohort studies. The review demonstrated that 15 of the 17 studies supported the evidence that a lower ED diet was associated with improved weight loss or maintaining weight.

According to numerous reviewed weight loss trials, during the active intervention period, decreasing ED proved most beneficial in terms of improving weight loss, although some studies reported that the weight loss was not always maintained over time. Based on the reviewed cohort studies, the researchers found that the association between lower ED and improved weight maintenance proved highly consistent.

They also reviewed evidence on dietary ED and body weight in children and adolescents from six prospective studies in Germany, the U.K. and in the U.S. that included boys and girls of normal weight and those who were overweight. The findings of most of these studies confirmed the link between higher dietary ED and higher weight in children.

Dr. Perez-Escamilla explained:

"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."

Even though the findings of the review indicate that eating foods that are lower in ED could be an effective method to control one's body weight, Dr. Perez-Escamilla remarks that public health strategies need to explain what ED means that how it is linked to body weight. He concludes, saying:

"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."

Both, Dr. Rafael Pérez-Escamilla, PhD, and Dr. Julie E Obbagy, PhD, RD, discuss the association between energy density and weight and its effect on children, adolescents and adults in a podcast, which is available here.

Written by Petra Rattue