High Fat and Sugar Consumption During Ad Libitum Intake Predicts Weight Gain

OBJECTIVE: To determine how macronutrients accompanying foods with high energy density (EnDen) affect energy intake and weight gain. METHODS: A total of 214 subjects (130 males, BMI: 32 +/- 7 kg/m(2) ) ate ad libitum for 3 days. Food intake was expressed as the mean daily intake (in kilocalories) and the percentage of weight-maintaining energy needs (%WMEN). EnDen was expressed as the ratio of intake (in kilocalories) to food weight (in grams). Food choices were expressed as absolute and percent intake (kilocalories), categorized as high in fat (HF; >/= 45% kcal) or low in fat (LF; < 20% kcal), and further categorized as high in complex carbohydrates (>/= 30% kcal), high in simple sugars (HSS; >/= 30% kcal), or high in protein (HP; >/= 13% kcal). Follow-up weights were available from 99 subjects (65 males, range: 6 months to 11 years). RESULTS: EnDen was associated with BMI (r = 0.28, P < 0.0001), percent body fat (r = 0.18, P = 0.007), and percent intake from HF/HP (r = 0.34, P < 0.0001), HF/HSS (r = 0.31, P < 0.0001), LF/HP (r = -0.37, P < 0.0001) and LF/HSS (r = -0.68, P < 0.0001). The %WMEN was associated with EnDen (r = 0.16, P = 0.01), HF/HSS (r = 0.33, P < 0.0001), and LF/HP intake (r = -0.25, P = 0.0002). In a multivariate model, only HF/HSS intake remained a significant predictor of %WMEN (beta = 1.4% per 1% change, P < 0.0001). The percent intake from HF/HSS (r = 0.23, P = 0.02), not EnDen (P = 0.54), was associated with weight gain, even after adjusting for follow-up time (in years) and covariates. CONCLUSIONS: Relatively greater consumption of HF/HSS foods independently predicted overeating and weight gain. Nutrient compositions of high-EnDen foods may be important for weight management.