High Fat and Sugar Consumption During Ad Libitum Intake Predicts Weight Gain

Abstract

Objective: To determine how macronutrients accompanying foods with high energy density (EnDen) affect energy intake and weight gain.

Methods: A total of 214 subjects (130 males, BMI: 32 ± 7 kg/m² ) ate ad libitum for 3 days. Food intake was expressed as the mean daily intake (in kilocalories) and the percentage of weight-maintaining energy needs (%WMEN). EnDen was expressed as the ratio of intake (in kilocalories) to food weight (in grams). Food choices were expressed as absolute and percent intake (kilocalories), categorized as high in fat (HF; ≥ 45% kcal) or low in fat (LF; < 20% kcal), and further categorized as high in complex carbohydrates (≥ 30% kcal), high in simple sugars (HSS; ≥ 30% kcal), or high in protein (HP; ≥ 13% kcal). Follow-up weights were available from 99 subjects (65 males, range: 6 months to 11 years).

Results: EnDen was associated with BMI (r = 0.28, P < 0.0001), percent body fat (r = 0.18, P = 0.007), and percent intake from HF/HP (r = 0.34, P < 0.0001), HF/HSS (r = 0.31, P < 0.0001), LF/HP (r = -0.37, P < 0.0001) and LF/HSS (r = -0.68, P < 0.0001). The %WMEN was associated with EnDen (r = 0.16, P = 0.01), HF/HSS (r = 0.33, P < 0.0001), and LF/HP intake (r = -0.25, P = 0.0002). In a multivariate model, only HF/HSS intake remained a significant predictor of %WMEN (β = 1.4% per 1% change, P < 0.0001). The percent intake from HF/HSS (r = 0.23, P = 0.02), not EnDen (P = 0.54), was associated with weight gain, even after adjusting for follow-up time (in years) and covariates.

Conclusions: Relatively greater consumption of HF/HSS foods independently predicted overeating and weight gain. Nutrient compositions of high-EnDen foods may be important for weight management.

Trial registration: ClinicalTrials.gov NCT00342732.

Fig. 1A

Baseline correlations between energy density (kcal/g) and percent daily energy intake from the (A) HF/HP food group.

Fig. 1B

Baseline correlations between energy density (kcal/g) and percent daily energy intake from the (B) HF/HSS food group.

Fig. 1C

Baseline correlations between energy density (kcal/g) and percent daily energy intake from the (C) LF/HP.

Fig. 1D

Baseline correlations between energy density (kcal/g) and percent daily energy intake from the (D) LF/HSS food group.

Fig. 2

Mean energy intake (kcal) by food group. Means with different letters were significantly different (p < .05) as assessed with Bonferroni adjustment for multiple comparisons.

Fig. 3

Association between change in weight (kg) and percent daily energy intake from the HF/HSS food group. Unadjusted Pearson correlation coefficient is shown. Adjusted (age, sex, race, FU time) Pearson correlation coefficient (r = .23, p = .02).