Dietary energy density and body weight changes after 3 years in the PREDIMED study

Abstract

The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain. ; The PREDIMED trial was supported by the Instituto de Salud Carlos III (ISCIII), the official funding agency for Biomedical Research of the Spanish Government, through grants provided to research networks specifically developed for the trial: RTIC G03/140, CIBERobn and RTIC RD06/0045. The authors also acknowledge grants received from Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, Fondo de Investigación Sanitaria – Fondo Europeo de Desarrollo Regional (PI04-2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI07/0473; PI10/01407, PI11/01647, PI11/02505, PI13/00615; PI13/01090, PI14/01668, PI14/01798, and PI14/01764), Ministerio de Ciencia e Innovación (AGL-2009-13906-C02, AGL2010-22319-C03), Fundación Mapfre 2010, Public Health Division of the Department of Health of the Autonomous Government of Catalonia and Generalitat Valenciana (ACOMP06109, CS2010-AP-111 and CS2011-AP-042; GVACOMP2010-181 and GVACOMP2011-151), and a joint contract (CES09/030) with the ISCIII and the Health Department of the Catalan Government (Generalitat de Catalunya). The roles of the sponsors are as follows: the supplemental foods used in the study were generously donated by Patrimonio Comunal Olivarero and Hojiblanca from Spain (extra-virgin olive oil); the California Walnut Commission from Sacramento, CA (walnuts); and Borges S.A. (almonds) and La Morella Nuts (hazelnuts), both from Reus, Spain. However, the sponsors played no role in the design, collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication. E. Ros received research grants from the California Walnut Commission (Sacramento, CA) and is a non-paid member of its Scientific Advisory Committee. J. Salas-Salvadó received research grants from the International Nut Council (Reus, Spain) and is a non-paid member of its Scientific Advisory Committee. R. Estruch reports serving on the board of and receiving lecture fees from the Research Foundation on Wine and Nutrition (FIVIN); serving on the boards of the Beer and Health Foundation and the European Foundation for Alcohol Research (ERAB); receiving lecture fees from Cerveceros de España. R.M. Lamuela-Raventos reports serving on the board of and receiving lecture fees from FIVIN; receiving lecture fees from Cerveceros de España; and receiving lecture fees and travel support from PepsiCo. L. Serra-Majem reports serving on the boards of the Mediterranean Diet Foundation and the Beer and Health Foundation. X. Pinto´ reports serving on the board of Omegafort; receiving lecture fees from Danone; receiving payment for the development of educational presentations from Menarini; and receiving grant support through his institution from Kowa Life Science Foundation, Unilever, and Karo Bio.