Erfolgreiche gewichtsreduktion und -stabilisierung durch ernährungsumstellung auf basis der energiedichte veränderung der energieaufnahme bei verschiedenen mahlzeiten

Introduction: Detailed reports of changes of eating habits during obesity treatment are scarce. In the present paper we have analyzed the change of eating habits of 100 obese patients who lost 12.3±0.3kg body weight over a mean follow-up period of 30.5±1.5 months. Methods: Patients recorded food intake over a period of 12 days before and after changes of food intake, respectively. Results: Average daily energy intake of solid food was reduced by 311kcal, food intake by 95g and energy density by 0.16kcal/g, respectively. Liquid calories were reduced by 91kcal/day. Lower daily energy intake was the additive effect of single meal reductions of different magnitude. Food quantity was reduced significantly only at dinner and the afternoon and evening snack, respectively. The number of meals was significantly lower during breakfast and all 3 snacks. Changes of macronutrients comprised substantially lower carbohydrate and fat intake with minimal reduction of protein. The change in energy percent was minimal for carbohydrate while fat was reduced substantially. The contribution of protein to energy intake increased. The individual variation of daily energy and food intake and energy density on a percent basis remained largely unchanged. The absolute range was 1.340kcal before and 1.078kcal after change of eating habits. The inverse relationship between food quantity and energy intake in relation to the energy density of daily ingested food items remained similar on an overall lower plateau. Conclusion: These data demonstrate that an individual change of eating habits on the basis of food energy density is a good option for successful weight loss with fairly small alterations of eating habits. Energy reduction is primarily due to a combination of lower fat and carbohydrate intake. Complex dietary prescriptions such as daily energy intake, ratio of macronutrients and magnitude of dietary fiber intake are not necessary and do not jeopardize long-term weight reduction and maintenance.