Diet Proves 'Eat More, Weigh Less' Can Work

http://www.medpagetoday.com/PrimaryCare/DietNutrition/dh/5896

Diet Proves 'Eat More, Weigh Less' Can Work

By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the
University of Pennsylvania School of Medicine.
June 08, 2007


Add Your KnowledgeT Additional Diet & Nutrition Coverage


UNIVERSITY PARK, Pa., June 8 -- Eating more water-rich foods,
especially fruits and vegetables, helped women drop more pounds than simply
moderating fat intake.
Action Points

a.. Explain to patients that foods with a low energy density,
such as fruits and vegetables, are high in water content but low in
calories, meaning that they can eat more of these foods and feel more
satisfied than when eating more energy-dense, high-fat foods.
That's what Barbara J. Rolls, Ph.D., and colleagues at Penn
State University, here, found when they put 97 obese women (body mass index
in kg/m2 from 30 to 40) on diets.


The women, ranging in age from 20 to 60, were randomly assigned
to groups that were counseled either to reduce their fat intake or to reduce
their fat intake and increase their intake of water-rich foods, which are
low in energy density (kcal/g). They were given no calorie restrictions.


Both weight-loss strategies were accompanied by an increase in
physical activity focused on walking with a pedometer, and both were
successful, but women on the low energy-density diet lost more weight,
despite eating more food, by weight, and eating at will, the authors wrote
in the June 1 issue of the American Journal of Clinical Nutrition.


Their findings support the idea that people who eat
nutritionally balanced diets that are high in water content will feel fuller
longer, and thus have a greater chance of losing weight, the authors wrote.


"Such diets are known to reduce the intake of calories in the
short term, but their role in promoting weight loss over the long term was
not clear," said Dr. Rolls, a professor of nutritional sciences.


Women in each group received the same amount of instruction on
fat reduction, behavior change, physical activity, and the principles of
their diets, and within each group they were taught to make food choices
that were reduced in energy density and appropriate in portion size.


"Neither group was given daily limits for energy or fat intake;
the subjects were instructed to eat ad libitum amounts of food while
following the principles of their assigned diets," the authors noted.


Overall the 71 patients who completed the one-year study (35 in
the reduced fats plus fruits and vegetables group, and 36 in the reduced fat
alone group) had significant decreases in body weight (P<0.0001).


Women in the fruits-and-vegetable group lost 33% more weight
during the first six months of the trial than women in the reduced-fat only
group (8.9 + 0.8 kg, or 19.6 +1.8 lb, compared with 6.7 + 0.7 kg, or 14.7 +
1.5 lb P=0.034). During the second six months of the trial, however, there
were no significant differences in the pattern of weight change.


In the second six months of the study, when contact with the
participants was less frequent by study design, the authors found that women
in both groups were successful at keeping the weight off. In each group, the
participants regained only 0.7 + 0.4 kg (1.5 +0.9 lb).


At the end of the trial, the mean weight loss in the
fruits-and-vegetables group was 7.9 + 0.9 kg (17.4 + 1.9 lb); it was 6.4 +
0.9 kg (14.1 + 1.9 lb) in the reduced-fat-only group.


An analysis of diet records showed that while both groups had
similar reductions in fat intake, the women in the water-rich-foods group
consumed significantly fewer kcal/g (P=0.019), while eating significantly
more food, by weight (P=0.025). That was especially true for women who ate
more fruits and vegetables than, say, soups (P=0.037).


Women who ate more fruits and vegetables also reported feeling
significantly less hungry, the authors noted.


"Diets that are low in energy density, particularly those that
encourage increased consumption of water-rich foods, allow individuals to
eat adequate amounts of food while restricting energy intake, which helps to
control hunger," they wrote.


"Because a wide variety of foods can be included in a diet that
is reduced in energy density, this type of eating plan can be adapted to
individual food preferences. Individuals should be encouraged to find a low
energy-density eating pattern that is nutritionally balanced and can be
sustained for lifelong weight management," they concluded.


The authors acknowledged that there were no significant
between-group differences in reported energy intake that corresponded with
the differences in weight loss, which could be explained by wide variations
in daily energy intake. They also noted the possibility of reporting bias by
the patients, although they pointed out that the degree of underreporting
was likely to be similar between the groups.


The study was supported by the National Institutes of
Health. No conflicts of interest were listed.





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