Low-Energy-Density Diets Are Associated with High Diet Quality in Adults in the United States



      This study investigated food choices made by individuals consuming diets differing in energy density and explores relationships between energy density and diet quality.


      Cross-sectional, nationally representative survey.


      7,500 adults (older than 19 years) in the 1994-1996 Continuing Survey of Food Intakes by Individuals.

      Statistical Analysis

      Energy density values were calculated from reported food intake. Subjects were classified as consuming a low-energy-density diet, medium-energy-density diet, or high-energy-density diet using tertile cutoffs. For each group, the percentage consuming various foods/beverages and the mean amount of foods/beverages they consumed was determined along with mean nutrient intakes.


      Compared with participants consuming a high-energy-density diet, those with a low-energy-density diet had a lower energy intake but consumed more food, by weight, from most food groups. A low-energy-density diet included a relatively high proportion of foods high in micronutrients and water and low in fat, such as fruits and vegetables. Subjects with a low-energy-density diet consumed fewer (nonwater) beverages such as caloric carbonated beverages. They also consumed less fat and had higher intakes of several important micronutrients, including vitamins A, C, and B-6, folate, iron, calcium, and potassium.


      These analyses further demonstrate the beneficial effects of a low-energy-density diet, which was associated with lower energy intakes, higher food intakes, and higher diet quality than a high-energy-density diet. To achieve a low-energy-density diet, individuals should be encouraged to eat a variety of fruits and vegetables as well as low-fat/reduced-fat, nutrient-dense, and/or water-rich grains, dairy products, and meats/meat alternatives.
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      B. J. Rolls is professor and Guthrie Chair, Department of Nutritional Sciences, The Pennsylvania State University, State College, PA.


      H. M. Blanck, J. D Seymour, and B. C. Tohill are epidemiologists, L. K. Khan is deputy chief, M. K. Serdula is chief medical officer, and J. H. Ledikwe is a postdoctoral fellow, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Public Health Promotion, Division of Nutrition and Physical Activity, Atlanta, GA.