High dietary energy density reduces BP, total cholesterol and prevelance of MetS in obese people

Diet is a modifiable risk factor for chronic diseases. Most research has assessed the relationship between isolate dietary ingredients or the part of dietary patterns and indices in developing metabolic disorders and obesity. Several recent studies have focused on the role of an adequate healthy diet in diet-disease relationships.

Dietary energy density has recently received considerable attention concerning metabolic syndrome (MetS). DED is defined as the energy per unit weight of a beverage or food and is reported as kilocalories/100 g of food. Many previous studies have reported DED's role in developing obesity and related disorders. However, no study has assessed the possible role of DED in triggering cardiometabolic risk factors in people with obesity.

Against the above background, Mahdieh Abbasalizad Farhangi from Tabriz University of Medical Sciences in Tabriz, Iran, and colleagues aimed to assess the association between DED and blood pressure, anthropometric parameters, and MetS parameters (such as blood pressure, lipid profile, and glycemic markers) among obese people in a cross-sectional study.

The researchers included 335 adults with obesity aged 20-50 in Tabriz and Tehran, Iran. Dietary intake was evaluated by a validated semi-quantitative Food Frequency Questionnaire (FFQ) comprising 168 food items; then, DED was calculated. MetS were defined based on the NCEP-ATP III (National Cholesterol Education Program Adult Treatment Panel III) guidelines. A sphygmomanometer measured blood pressure, and body composition was measured by bioelectrical impedance analysis (BIA).

The study led to the following findings:

• People in the higher tertiles of DED had more intake of dietary fat, carbohydrate, saturated fatty acid (SFA), polyunsaturated fatty acid (PUFA), monounsaturated fatty acid (MUFA), and meat, fish, poultry (MFP).
• In both methods, increasing the DED in both ways had no association with fasting blood sugar (FBS), systolic blood pressure (SBP), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), insulin, and HOMA-IR (homeostatic model assessment of insulin resistance) even after adjustment for confounders.
• Diastolic blood pressure (DBP) decreased in the second tertile of DED I (β = 0.921, P = 0.004).
• The quantitative insulin-sensitivity check index (QUICKI) in the second tertile of both DED methods had a significant positive association with DED. In the second tertile of DED II, total cholesterol significantly decreased, whereas high-density lipoprotein cholesterol (HDL-C) increased.
• There were no significant changes in biochemical parameters in the third tertile of DED I and II, even after adjustment for covariates. Also, higher tertiles of DED were associated with reduced prevalence of MetS.

"We observed lower diastolic blood pressure, systolic blood pressure and triglyceride levels in higher tertiles of DED in 335 people with obesity," the authors wrote. "These associations might be due to higher intakes of MUFA, PUFA, and MFP factors in higher DED categories. However, further well-designed studies are warranted to interpret better results."

Reference:

Pour-Abbasi, Mohammad-Sadegh, et al. "Dietary Energy Density, Metabolic Parameters, and Blood Pressure in a Sample of Adults With Obesity." BMC Endocrine Disorders, vol. 23, no. 1, 2023, p. 3.