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A review of dietary energy density and obesity

The role of dietary energy density (ED) in energy intake regulation and weight management remains controversial. Relationships between ED, energy intake and body weight were determined in a review of pertinent studies examining the effects of ED on energy intake (EI) and/or body weight in non‐elderly adults. Sixty‐nine relevant studies in which effects of ED could be separated from other putative determinants of energy regulation including dietary fiber were identified. Observational studies generally report positive associations between dietary ED and BMI, risk for overweight/obesity or weight gain. Short‐term clinical trials consistently demonstrate that decreasing preload, individual meal or 24‐h dietary ED results in a reduction in EI proportional to the magnitude of the reduction in ED. Longer‐term (>1 mo) randomized clinical trials suggest that reducing the ED of diets consumed ad libitum may promote modest weight loss; however, based on very limited available studies, ED modification may have no additional weight loss benefit when recommended in conjunction with an energy restricted diet. In summary, a substantial body of evidence demonstrates that short‐term decreases in ED promote reductions in EI, but the extent to which low ED diets facilitate weight loss or prevent weight gain remains undetermined. Further studies are needed to elucidate the role of ED in long‐term weight management.