Flashback Friday: Eating More to Weigh Less

What happens if you have people add fruit to their regular diet? Three apples or three pears a day as snacks between meals on top of whatever else they were eating. Fruit is low in calories, but not zero; so, if you add food to people’s diets, even healthy foods, won’t they gain weight? No, they lost a couple pounds. Maybe it was all that fiber? If you remember, we learned our gut bacteria can create anti-obesity compounds from fiber. That’s why they also had a cookie group. Three apples, three pears, or three cookies with enough oats in them to have about the same amount of fiber as the fruit. Despite the fiber, adding cookies to one’s diet does not lead to weight loss. They think the weight-reducing secret of fruit is its low energy density, meaning you get a lot of food for just a few calories. So, it fills you up.

Energy density is a relatively new concept that has been identified as an important factor in body weight control in both adults and in children and adolescents. Energy density is defined as the amount of calories per unit weight of a food or beverage. Water, for example, provides a significant amount of weight without adding calories. Fiber, too. Thus, foods high in water and fiber are generally lower in energy density. On the other hand, because dietary fat provides the greatest amount of calories per unit weight, foods high in fat are generally high in energy density.

The CDC offers some examples. High energy density foods are like bacon—lots of calories in a small package. A medium energy density food is like a bagel, and low density foods are typified by fruits and vegetables. In general, the lower the better, with two exceptions. Soda is so heavy that by energy density it looks less harmful than it is. And nuts have so much fat, they appear less healthy than they are.

Otherwise, though, the science supports a relationship between energy density and body weight, such that consuming diets lower in energy density may be an effective strategy for weight control. This is because people tend to eat a consistent weight of food. So, when there’s less calories per pound, caloric intake is reduced.

A small drop in energy density can lead to a small drop in weight, and the greater the decrease in energy density, the greater the weight loss.

Energy density can be reduced in a variety of ways, such as the addition of vegetables and fruits to recipes or by lowering the fat or sugar content. And indeed, that’s how we evolved, eating predominantly low energy density foods, such as fruits, vegetables, plants and tubers, starch-filled roots like sweet potatoes. The first study to emphasize how fruits and vegetables could affect energy density and food intake was conducted more than 30 years ago.

Researchers were able to cut people’s caloric intake nearly in half, from 3000 calories a day down to 1570 without cutting portions, just by substituting less calorie dense foods, which means lots of fruits, vegetables, whole grains, and beans, compared to a high energy density meal with lots of meat and sugar. Nearly half the calories, but they enjoyed the meals just as much.

They tried this in Hawaii, putting  people on a traditional Hawaiian diet with all the plant foods they could eat. They lost an average of 17 pounds in just 21 days, resulting in better cholesterol, triglycerides, blood sugars, and blood pressure. Caloric intake dropped 40%, but not by eating less food; in fact, they lost 17 pounds in 21 days eating more food, four pounds of food per day. But because plants tend to be so calorically dilute, one can stuff oneself without getting the same kind of weight gain.

And the energy density of foods is of interest for weight management not only because it allows people to eat satisfying portions while limiting calories, but also because reductions in energy density are associated with improved diet quality. For example, lower energy dense diets are associated with lower risk of pancreatic cancer. Lower energy dense diets tend to be of healthier foods; so, we get the best of both worlds.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

• R Pérez-Escamilla, J E Obbagy, J M Altman, E V Essery, M M McGrane, Y P Wong, J M Spahn, C L Williams. Dietary energy density and body weight in adults and children: a systematic review. J Acad Nutr Diet. 2012 May;112(5):671-84.
• C J Rebello, A G Liu, F L Greenway, N V Dhurandhar. Dietary strategies to increase satiety. Adv Food Nutr Res. 2013;69:105-82.
• B J Rolls. The relationship between dietary energy density and energy intake. Physiol Behav. 2009 Jul 14;97(5):609-15.
• M C de Oliveira, R Sichieri, R Venturim Mozzer. A low-energy-dense diet adding fruit reduces weight and energy intake in women. Appetite. 2008 Sep;51(2):291-5.
• B J Rolls. Dietary strategies for weight management. Nestle Nutr Inst Workshop Ser. 2012;73:37-48.
• J Wang, W Zhang, L Sun, H Yu, Q X Ni, H A Risch, Y T Gao. Dietary energy density is positively associated with risk of pancreatic cancer in urban Shanghai Chinese. J Nutr. 2013 Oct;143(10):1626-9.
• C J K Henry. How much food does man require? New insights. Nutrition Bulletin Volume 37, Issue 3, pages 241–246, September 2012.
• B J Rolls, J A Ello-Martin, B C Tohill. What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev. 2004 Jan;62(1):1-17.
• K H Duncan, J A Bacon, R L Weinsier. The effects of high and low energy density diets on satiety, energy intake, and eating time of obese and nonobese subjects. Am J Clin Nutr. 1983 May;37(5):763-7.
• T T Shintani, C K Hughes, S Beckham, H K O'Connor. Obesity and cardiovascular risk intervention through the ad libitum feeding of traditional Hawaiian diet. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1647S-1651S.
• J H Ledikwe, B J Rolls, H Smiciklas-Wright, D C Mitchell, J D Ard, C Champagne, N Karanja, P H Lin, V J Stevens, L J Appel. Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial. Am J Clin Nutr. 2007 May;85(5):1212-21.
• Can eating fruits and vegetables help people to manage their weight?

Image thanks to lightwise via 123RF. This image has been modified.