Dietary energy density as an independent predictor of obesity, elevated fasting insulin, and metabolic syndrome in US adults

Fiber content, energy density and/or water content affect the satietogenic properties of foods. High-density palatable foods are potentially associated with lesser satiety and/or increased daily caloric intake. A cross-sectional study using representative data of US adults aged =20 years from the National Health and Nutrition Examination Survey (n=9688) was conducted to assess whether dietary energy density of foods was associated with obesity and related disorders including insulin resistance and metabolic syndrome (NECP-ATP III criteria). Multivariate linear regression models revealed that dietary energy density calculated on food intake only was independently and significantly associated with higher BMI in women (beta*=0.44, 95% CI: 0.14, 0.73), trending to be associated with higher BMI in men (beta=0.37, 95% CI: -0.007, 0.74). Furthermore, dietary energy density was associated with higher waist circumference in both women (beta=1.11, 95% CI: 0.42, 1.80) and men (beta=1.33, 95% CI: 0.46, 2.19), with elevated fasting insulin (beta=0.65, 95% CI: 0.18, 1.12), and with metabolic syndrome (prevalence ratio=1.10, 95% CI: 1.03, 1.17). Intervention studies to reduce dietary energy density may thus be warranted to tackle rising obesity rates worldwide. (*Beta represents absolute mean increase or decrease.)

Abstract