Dietary energy density and body weight changes after 3 years in the PREDIMED study (original) (raw)
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Olive oil consumption and weight change: The SUN prospective cohort study
Lipids, 2006
The aim of this dynamic prospective follow-up study was to assess the association between olive oil consumption and the likelihood of weight gain or the incidence of overweight or obesity in a large Mediterranean cohort of 7,368 male and female Spanish university graduates (the SUN Project) who were followed for a median period of 28.5 mon. A validated Food Frequency Questionnaire was administered at baseline, and respondents also completed a follow-up questionnaire after 28.5 mon. Changes in participants' consumption of olive oil and their weight were assessed during follow-up. A higher baseline consumption of olive oil was associated with a lower likelihood of weight gain, although the differences were not statistically significant. The adjusted difference in weight gain (kg) was −0.16 [95% confidence interval (CI): −0.42 to +0.11] for participants in the upper quintile of olive oil consumption (median: 46 g/d) compared with those in the lowest quintile (median: 6 g/d). For participants with a high baseline consumption of olive oil whose olive oil consumption also increased during follow-up, we found a slightly increased but nonsignificant risk of incidence of overweight or obesity (adjusted odds ratio = 1.19, 95% CI: 0.73 to 1.95). Our study, carried out in a sample of free-living people, shows that a high amount of olive oil consumption is not associated with higher weight gain or a significantly higher risk of developing overweight or obesity in the context of the Mediterranean food pattern.
Prospective study of dietary energy density and weight gain in women
The American journal of clinical nutrition, 2008
Little is known about the long-term effects of dietary energy density (ED) on weight gain. The objective was to assess the long-term relation between changes in dietary ED and age-related weight gain. We conducted a prospective study of 50 026 women (x +/- SD age: 36.5 +/- 4.6 y) in the Nurses' Health Study II followed from 1991 to 1999. Dietary ED and body weight were ascertained in 1991, 1995, and 1999. Total dietary ED was calculated by dividing each subject's daily energy intake (kcal) by the reported weight (g) of all foods consumed. Dietary ED was positively correlated with saturated fat (r = 0.16), trans fat (r = 0.15), and the glycemic index (r = 0.16), but was inversely correlated with vegetable protein (r = -0.30), vegetables (r = -0.27), and fruit (r = -0.17). ED was not significantly correlated with total fat intake as a percentage of energy (r = 0.08). Women who increased their dietary ED during follow-up the most (5th quintile) had a significantly greater multi...
American Journal of Clinical Nutrition, 2010
Background: There is an association between a greater adherence to a Mediterranean diet and a reduced risk of developing chronic diseases. However, it is not clear whether this dietary pattern may be protective also against the development of obesity. Objective: We assessed the association between the adherence to the Mediterranean dietary pattern (MDP), prospective weight change, and the incidence of overweight or obesity. Design: We conducted a prospective cohort study [the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol Consumption, Cessation of Smoking, Eating Out of Home, and Obesity (EPIC-PANACEA) project] in 373,803 individuals (103,455 men and 270,348 women; age range: 25-70 y) from 10 European countries. Anthropometric measurements were obtained at recruitment and after a median follow-up time of 5 y. The relative Mediterranean Diet Score (rMED; score range: 0-18) was used to assess adherence to the MDP according to the consumption of 9 dietary components that are characteristic of the Mediterranean diet. The association between the rMED and 5-y weight change was modeled through multiadjusted mixed-effects linear regression. Results: Individuals with a high adherence to the MDP according to the rMED (11-18 points) showed a 5-y weight change of 20.16 kg (95% CI: 20.24, 20.07 kg) and were 10% (95% CI: 4%, 18%) less likely to develop overweight or obesity than were individuals with a low adherence to the MDP (0-6 points). The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain. Conclusion: This study shows that promoting the MDP as a model of healthy eating may help to prevent weight gain and the development of obesity.
Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort
International Journal of Obesity, 2006
Introduction: The promotion of Mediterranean Diets has generated some doubts, because of the concern that its high fat content might lead to the development of obesity. Methods: Longitudinal analysis of 6319 participants in the SUN cohort study. We used a validated semiquantitative food frequency questionnaire (136 items). Baseline adherence to a Mediterranean dietary pattern (MDP) was assessed using a score (score_1) including vegetables, fruits, cereals, nuts, pulses, fish, olive oil and moderate consumption of red wine (positively weighted), whereas meat and dairy products were negatively weighted. We assessed the association between the overall baseline adherence to the MDP (score_1) and subsequent weight change after 28 months of follow-up. We also built another score (score_2) to assess changes in diet during follow-up and appraised the association between the joint exposure to both scores and weight change during follow-up. Results: Participants in the first quartile of score_1 (lowest baseline adherence to MDP) showed a higher weight gain ( þ 0.73 kg) than those in the top quartile ( þ 0.45 kg). The results indicated an inverse dose-response relationship (P for trend ¼ 0.016). A similar inverse association was apparent when we used change in adherence to the MDP (score_2). However, both inverse associations did not remain statistically significant after adjusting for relevant confounders. Consumption of dairy products was inversely associated with weight gain. Conclusions: Although participants increased their average weight during the follow-up period, weight increments were smaller among those with a higher adherence to an 'a priori' defined MDP. Results did not remain statistically significant after multivariate adjustment.
Nutrients, 2018
A moderately high-fat Mediterranean diet does not promote weight gain. This study aimed to investigate the association between dietary intake of specific types of fat and obesity and body weight. A prospective cohort study was performed using data of 6942 participants in the PREDIMED trial, with yearly repeated validated food-frequency questionnaires, and anthropometric outcomes (median follow-up: 4.8 years). The effects of replacing dietary fat subtypes for one another, proteins or carbohydrates were estimated using generalized estimating equations substitution models. Replacement of 5% energy from saturated fatty acids (SFA) with monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA) resulted in weight changes of −0.38 kg (95% Confidece Iinterval (CI): −0.69, −0.07), and −0.51 kg (95% CI: −0.81, −0.20), respectively. Replacing proteins with MUFA or PUFA decreased the odds of becoming obese. Estimates for the daily substitution of one portion of red meat with whit...
Types of fat intake and body mass index in a Mediterranean country
Public Health Nutrition, 2000
Background: Although the fatty acid fractions provide similar metabolizable energy, the type of dietary fat consumed could be relevant to the development of obesity. Objective: To investigate the relationship between body mass index (BMI), obesity and the consumption of different types of fat and olive oil in a Mediterranean country with high prevalence of obesity, and high intake of monounsaturated fatty acids (MUFA) and olive oil. Subjects: The study was carried out in Spain among 23 289 women and 14 374 men, aged 29±69 years, who were participants of a large European prospective cohort. Methods: Information on usual food intake was collected by interviewers by means of a dietary history questionnaire. The association between obesity (BMI > 30 kg m 2 ), dietary fat, other dietary patterns and other non-dietary factors were tested using multilinear regression analysis. The ratio of reported energy intake to energy requirement was used as an estimation of dietary underreporting. Results: The association between fatty acid fractions intake (saturated fatty acids (SFA) in women, and MUFA and polyunsaturated fatty acids (PUFA) in both sexes) and BMI was very weak, accounting for less than 1% of variance. All dietary and non-dietary variables accounted for 21% of variance in the measurement of BMI in women and only 6.7% of variance in men. Estimated underreporting of energy intake was 17.5% in obese women and 5.5% in obese men. Conclusions: The association between consumption of speci®c types of dietary fat, olive oil and obesity in Spain is not very important. However, because of the crosssectional design and some level of underreporting of energy intake observed in overweight subjects and overreporting in underweight subjects, systematic bias cannot be completely discarded.
The Lancet Diabetes & Endocrinology, 2016
Background Because of the high density of fat, high-fat diets are perceived as likely to lead to increased bodyweight, hence health-care providers are reluctant to recommend them to overweight or obese individuals. We assessed the long-term effects of ad libitum, high-fat, high-vegetable-fat Mediterranean diets on bodyweight and waist circumference in older people at risk of cardiovascular disease, most of whom were overweight or obese. Methods PREDIMED was a 5 year parallel-group, multicentre, randomised, controlled clinical trial done in primary care centres affiliated to 11 hospitals in Spain. 7447 asymptomatic men (aged 55-80 years) and women (aged 60-80 years) who had type 2 diabetes or three or more cardiovascular risk factors were randomly assigned (1:1:1) with a computergenerated number sequence to one of three interventions: Mediterranean diet supplemented with extra-virgin olive oil (n=2543); Mediterranean diet supplemented with nuts (n=2454); or a control diet (advice to reduce dietary fat; n=2450). Energy restriction was not advised, nor was physical activity promoted. In this analysis of the trial, we measured bodyweight and waist circumference at baseline and yearly for 5 years in the intention-to-treat population. The PREDIMED trial is registered with ISRCTN.com, number ISRCTN35739639. Findings After a median 4•8 years (IQR 2•8-5•8) of follow-up, participants in all three groups had marginally reduced bodyweight and increased waist circumference. The adjusted difference in 5 year changes in bodyweight in the Mediterranean diet with olive oil group was-0•43 kg (95% CI-0•86 to-0•01; p=0•044) and in the nut group was 0•08 kg (-0•50 to 0•35; p=0•730), compared with the control group. The adjusted difference in 5 year changes in waist circumference was-0•55 cm (-1•16 to-0•06; p=0•048) in the Mediterranean diet with olive oil group and-0•94 cm (-1•60 to-0•27; p=0•006) in the nut group, compared with the control group. Interpretation A long-term intervention with an unrestricted-calorie, high-vegetable-fat Mediterranean diet was associated with decreases in bodyweight and less gain in central adiposity compared with a control diet. These results lend support to advice not restricting intake of healthy fats for bodyweight maintenance.
Carbohydrate quality, weight change and incident obesity in a Mediterranean cohort: the SUN Project
European journal of clinical nutrition, 2014
Background/Objectives:To evaluate the association between the carbohydrate quality index (CQI) and weight change or incident overweight/obesity (body mass index ⩾25 kg/m(2)) in the 'Seguimiento Universidad de Navarra (SUN)' cohort.Subjects/Methods:A total of 8741 participants who were initially free of overweight/obesity were followed up for a median of 7.9 years. We evaluated at baseline the CQI according to four criteria: dietary fiber intake, glycemic index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. Subjects were classified into quintiles according to CQI. Weight was recorded at baseline and updated every 2 years during follow-up.Results:Increasing CQI of diet was not significantly associated with lower weight gain, although participants in the highest quintile had the lowest average crude weight gain (+211 g/year). We observed 1862 incident cases of overweight/obesity during follow-up. CQI was significantly associated (P for trend...
2015
Introduction: The Mediterranean diet is known to support the prevention of several chronic diseases and excessive weight gains. However, relevant investigations were performed in a clinical setting. The aim of this study was therefore to understand the effects of protein supplements intake on body mass index (BMI) in healthy active individuals following the Mediterranean diet. Materials and methods: A face-to-face questionnaire was administered to 667 subjects, 627 living in a Mediterranean area (MD) and 40 in a non-Mediterranean area (NMD); questionnaire enquired dietary behaviours, including a comparison between dietary patterns and protein consumption between these two populations and within each population. Results: Dietary patterns significantly varied between the MD and NMD populations (p < 0.001), although, BMI was not significantly different. The major significant differences were found between the BMI of protein supplement users and non-protein supplement users within an...
Dietary Energy Density and Body Weight: Is There a Relationship?
Nutrition Reviews, 2004
The energy density of foods and beverages is defined as the available energy per unit weight (kJ/g). Energy density of the diet is usually calculated excluding non-caloric beverages and drinking water. Because water contributes more to the weight of foods than any macronutrient, energydense foods are not necessarily those high in sugar or fat, but those that are dry. Evidence linking dietary energy density with body weight is critically evaluated in this review. Existing reports of a positive association between dietary energy density, higher energy intakes, and weight gain are based on laboratory and clinical studies. Although some cross-sectional epidemiological studies have linked dietary energy density with higher body mass index (BMI) values, the data are not consistent. At this time, there are no longitudinal cohort data linking dietary energy density with higher obesity risk.