Weight Loss
Weight loss strategies: Association with consumption of sugary beverages, snacks and values about food purchases

https://doi.org/10.1016/j.pec.2014.04.008Get rights and content

Abstract

Objective

To examine whether weight loss strategies are associated with consumption of sugar-sweetened beverages (SSBs), snacks or food values.

Methods

Cross-sectional analysis of 24-h dietary recall data obtained from the National Health and Nutrition Examination Survey 2007–2010 (N = 9440).

Results

Adults trying to lose weight consumed roughly 2000 total calories, 250 calories from SSBs, 225 calories from salty snacks, and 350 calories from sweet snacks. Adults not trying to lose weight consumed roughly 2300 total calories, 300 calories from SSBs, 250 calories from salty snacks, and 380 calories from sweet snacks. While overweight and obese adults trying to lose weight consumed fewer calories than those who were not, heavier adults trying to lose weight using dietary strategies or a combination of diet and physical activity consumed more calories than healthy weight adults using that same weight loss strategy (p < 0.05). Price (>70%) and nutrition (>50%) were most when making food choices (p < 0.05) for all groups.

Conclusion

Consumption of discretionary calories is high regardless of body weight or weight loss intention.

Practice implications

Promoting reduced SSB and snack consumption in the clinical setting may be important for weight loss, particularly among heavier individuals. Clinicians should consider values related to food purchasing to identify concrete behavioral targets.

Introduction

The obesity epidemic, which is associated with an increased burden of chronic conditions [1], [2], [3], affects a tenth of adults worldwide [4] and one third of American adults [5]. In the United States alone obesity costs $147 billion in healthcare spending annually [6]. Even modest weight loss can have a significant impact on the elimination or reduction of adverse health conditions associated with obesity [7], [8], and recommendations for weight loss include both reduced caloric intake and increased physical activity [9].

Despite strong interest in weight loss programs in the United States – American adults spend tens of billions of dollars on commercial weight loss programs annually – the quality of the American diet is generally poor [10]. In particular, consumption of sugar-sweetened beverages (SSBs) and snacks – which are typically high in calories, fat, and sugar [11], [12] – is high. Two-thirds of adults (63%) drink SSBs, averaging 28 ounces per day, and 293 calories daily (15% of recommended 2000 kcal/day diet) [13]. From 1977 to 2001, energy intake from soft drinks and fruit drinks increased by 135% [14] and the prevalence of adult obesity doubled [15]. Over the past four decades, rates of snacking have increased from 59% to 90%, making snacking a quarter of total energy intake [16], [17], [18].

There is a consensus in the literature that a reduction in excess calories is helpful in preventing or delaying the onset of excess weight gain. Moreover, the consumption of a relatively small number of excess daily calories can lead to weight gain [19], [20]. While patterns of SSB [13], [14], [21], [22] and snack [16], [17], [18] consumption are well described along with effective intervention strategies to reduce their consumption [23], [24], [11], there has been little research looking focused on whether consumption of these discretionary calories differs by weight loss strategies (i.e., diet, exercise, or diet and exercise combined). No research has examined whether the patterns of SSB and snack consumption associated with weight loss strategies differ by body weight status. While there is a knowledge base describing the motives underlying food selection [25], [26], missing from the literature is evidence about whether individual values related to food purchasing differ by weight loss strategy or body weight status. Available studies focus on the overall population and find that values such as price, convenience and taste are key drivers of food consumption patterns [27]. Taken together, understanding the association between weight loss strategies, consumption of discretionary calories and food values is an important area of inquiry as it may help identify modifiable behavioral targets, particularly among overweight and obese adults.

The primary purpose of this study was to describe patterns of SSB and snack consumption by weight loss strategies among U.S. adults overall and by body weight category. The secondary purpose was to examine whether values related to food consumption (e.g., price, taste) were associated with weight loss strategies and body weight. This analysis does not attempt to estimate the impact of SSB or snack intake on obesity incidence given our reliance on cross-sectional data.

Section snippets

Data and design

Data was obtained from the nationally representative continuous National Health and Nutrition Examination Survey (NHANES). The NHANES is a population-based survey designed to collect information on the health and nutrition of the U.S. population. Participants were selected based on a multi-stage, clustered, probability sampling strategy. Our analysis combined the continuous NHANES data collection (2007–2010) to look at overall patterns during that time period. We selected 2007 as the start date

Results

The characteristics of the NHANES 2007–2010 sample are presented in Table 1, overall and by body weight category. The categories of body weight had comparable distributions of employment status, income, and the day of the week the respondents completed the survey. The obese category had more women, non-Hispanic Blacks and Mexican Americans, middle age (45–64), less educated (high school education or less), married and lower income adults (p < 0.05).

Discussion

The elimination of discretionary calories from the diet may help reduce the energy imbalance and promote weight loss or weight maintenance, particularly among heavier individuals, who require a relatively larger decrease in calories in order to lose weight [20]. Our results indicate that, on a typical day, roughly half of American adults consume sugary beverages and sweet snacks, regardless of their weight loss efforts or body weight and about one third consume sweet snacks. We found that the

Competing interests

The authors have no competing interests.

Funding

This work was supported by a grant from the National Heart, Lung, and Blood Institute (1K01HL096409).

Contributor statement

SNB conceived the study and developed the hypotheses. JAW analyzed the data. All authors contributed to the interpretation of study findings. SNB drafted the manuscript and all authors contributed to the final draft. SNB is the guarantor.

Human participant protection

The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.

Acknowledgements

We thank Seanna Vine for her help preparing the dataset for analysis.

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