Are energy dense diets also nutrient dense?

Authors: Nicklas, Theresa; O'NEIL, CAROL - LOUISIANA STATE UNIV; Mendoza, Jason; LIU, YAN - BAYLOR COLLEGE OF MED; ZAKERI, ISSA - DREXEL UNIVERSITY; BERENSON, GERALD - TULANE MEDICAL CENTER

Submitted to: Journal of the American College of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/1/2008
Publication Date: 10/1/2008
Citation: Nicklas, T.A., O'Neil, C.E., Mendoza, J., Liu, Y., Zakeri, I.F., Berenson, G.S. 2008. Are energy dense diets also nutrient dense? Journal of the American College of Nutrition. 27(5):553-560.

Interpretive Summary: The 2005 Dietary Guidelines Advisory Committee (DGAC) concluded that eating foods of low energy density (ED) might be a helpful strategy to reduce energy intake when trying to maintain or lose weight. At the same time, the 2005 DGAC encouraged the consumption of nutrient dense foods within and among the major food groups. ED is influenced by the fat content of the foods/beverages consumed and the higher fat content of ED foods/beverages provides vitamins, fatty acids, and amino acids. The present study was undertaken to examine whether energy dense intakes were also nutrient dense, with special emphasis on fatty acids, fat-soluble vitamins, and amino acids based on consumption patterns of young adults in Bogalusa, Louisiana. Individuals who had high ED intakes had increased intakes of total energy, total fat, and saturated fatty acids. The increased consumption of energy dense foods was reflected in increased consumption of total meats and a decreased consumption of fruits/juices, vegetables, beverages and total sweets. The data suggest that promoting the consumption of foods that are less energy dense may come with subtle consequences in overall dietary intake of nutrients often forgotten or seen less significant in the diet. Promoting less energy dense foods may result in very low fat intakes, which have been shown to result in adverse changes in cholesterol and triglycerides.

Technical Abstract: Some beverages are nutrient dense, but they are often excluded from nutrient density calculations. The purpose of this study was to assess whether the energy-nutrient association changed when beverages were included in these calculations. Applying a cross-sectional design, a 24-hour dietary recall was collected on each participant. Four hundred and forty young adults (ages 19–28 years) in Bogalusa, Louisiana, participated in this study. Mean nutrient intakes and food group consumption were examined across the energy density (ED) tertiles using two calculation methods: one with food and all beverages (excluding water) (ED1) and one including food and only energy containing beverages (ED2). Regression models were used and multiple comparisons were performed using the Tukey-Kramer procedure. A p-value < 0.05 was considered significant. With increasing ED, there was a significant increase in the consumption of total meats (ED1 p < 0.05; ED2 p < 0.01). In contrast, there was a significant decrease in consumption of fruits/juices (ED1 p < 0.01; ED2 p < 0.0001), vegetables (ED1 p < 0.01; ED2 p < 0.05), beverages (both p < 0.0001) and total sweets with increasing ED (both p < 0.0001). There was a significantly higher mean intake of total protein (grams) (ED2 p < 0.0001), amino acids (ED1 histidine/leucine p < 0.05; ED2 p < 0.0001), and total fat (grams) (ED1 p < 0.0001; ED2 p < 0.0001) with higher ED compared to lower ED. The percent energy from protein (ED1 p < 0.05; ED2 p < 0.0001), total fat (both p < 0.001), and saturated fatty acids (both p < 0.0001) significantly increased and the percent energy from carbohydrate (both p < 0.0001) and sucrose (both p < 0.0001) significantly decreased with increasing ED. This study suggests that ED may influence the ND of the diet depending on whether energy containing beverages are included or excluded in the analysis.