Energy density and 6-year anthropometric changes in a middle-aged adult cohort

Dietary energy density (ED) may be a good predictor of weight gain because of its association with the regulation of appetite control signals. Among the participants of the 'SUpplementation en VItamines et Mineraux AntioXydants' prospective study, 2707 subjects were included in the present study. Changes in weight, waist circumference (WC), hip circumference (HC) and waist:hip ratio were calculated using measured data collected in 1995/1996 and 2001/2002. The mean changes in various anthropometric indicators according to baseline body-weight status (BMI < or > or = 25 kg/m2) and sex-specific tertiles of baseline ED level or 6-year changes in ED were compared by covariance analysis. In overweight subjects, weight gain was positively associated with high dietary ED at baseline (P for trend = 0.03) and with increasing ED during the follow-up (P for trend = 0.0008). Both the WC and HC changes were also positively related to baseline ED and change in ED in overweight subjects. However, the relationships observed for the WC and HC changes were no longer significant after adjustment for weight change. These results support the hypothesis of a deleterious effect of high-energy-dense diets on weight change for overweight subjects. This relationship could be mediated by physical activity level. Further research needs to be performed in other populations to determine whether ED could be effective strategies to prevent weight gain.