Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?

The association between dietary energy density, increased energy intake and weight gain is supported by experimental evidence, but confirmation of an effect in free-living humans is limited. Experimental evidence supports a role of energy density in obesity through changes in food composition, not d...

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Main Authors: Johnson, L, Wilks, D, Lindroos, A, Jebb, SA
Format: Journal article
Language:English
Published: 2009
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author Johnson, L
Wilks, D
Lindroos, A
Jebb, SA
author_facet Johnson, L
Wilks, D
Lindroos, A
Jebb, SA
author_sort Johnson, L
collection OXFORD
description The association between dietary energy density, increased energy intake and weight gain is supported by experimental evidence, but confirmation of an effect in free-living humans is limited. Experimental evidence supports a role of energy density in obesity through changes in food composition, not drinks consumption. The inclusion of drinks in the calculation creates a variable of questionable validity and has a substantive impact on the estimated energy density of the diet. We posit, based on the experimental evidence, that calculating the energy density of diets by excluding drinks and including calories from drinks as a covariate in the analysis is the most valid and reliable method of testing the relationship between energy density and weight gain in free-living humans. We demonstrate, by systematically reviewing existing observational studies of dietary energy density and weight gain in free-living humans, how current variation in the method for calculating energy density hampers the interpretation of these data. Reaching an a priori decision on the appropriate methodology will reduce the error caused by multiple comparisons and facilitate meaningful interpretation of epidemiological evidence to inform the development of effective obesity prevention strategies.
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spelling oxford-uuid:75a4a4b9-ca85-4747-8e04-a32281b3c5882022-03-26T20:10:39ZReflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:75a4a4b9-ca85-4747-8e04-a32281b3c588EnglishSymplectic Elements at Oxford2009Johnson, LWilks, DLindroos, AJebb, SAThe association between dietary energy density, increased energy intake and weight gain is supported by experimental evidence, but confirmation of an effect in free-living humans is limited. Experimental evidence supports a role of energy density in obesity through changes in food composition, not drinks consumption. The inclusion of drinks in the calculation creates a variable of questionable validity and has a substantive impact on the estimated energy density of the diet. We posit, based on the experimental evidence, that calculating the energy density of diets by excluding drinks and including calories from drinks as a covariate in the analysis is the most valid and reliable method of testing the relationship between energy density and weight gain in free-living humans. We demonstrate, by systematically reviewing existing observational studies of dietary energy density and weight gain in free-living humans, how current variation in the method for calculating energy density hampers the interpretation of these data. Reaching an a priori decision on the appropriate methodology will reduce the error caused by multiple comparisons and facilitate meaningful interpretation of epidemiological evidence to inform the development of effective obesity prevention strategies.
spellingShingle Johnson, L
Wilks, D
Lindroos, A
Jebb, SA
Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title_full Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title_fullStr Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title_full_unstemmed Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title_short Reflections from a systematic review of dietary energy density and weight gain: is the inclusion of drinks valid?
title_sort reflections from a systematic review of dietary energy density and weight gain is the inclusion of drinks valid
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AT wilksd reflectionsfromasystematicreviewofdietaryenergydensityandweightgainistheinclusionofdrinksvalid
AT lindroosa reflectionsfromasystematicreviewofdietaryenergydensityandweightgainistheinclusionofdrinksvalid
AT jebbsa reflectionsfromasystematicreviewofdietaryenergydensityandweightgainistheinclusionofdrinksvalid