Decreases in High-Fat and/or High-Added-Sugar Food Group Intake Occur when a Hypocaloric, Low-Fat Diet Is Prescribed Within a Lifestyle Intervention: A Secondary Cohort Analysis.

BACKGROUND
When a hypocaloric, low-fat diet is prescribed, intake of currently consumed foods can decrease, foods naturally low in fat and/or added sugar may increase, or fat- or sugar-modified foods may increase.

OBJECTIVE
To examine food group intake change and its relation to reductions in energy and fat intake and weight during a lifestyle intervention.

DESIGN
Secondary cohort analysis.

PARTICIPANTS
One hundred sixty-nine participants (aged 52.0±8.6 years, body mass index 34.9±4.5, 92% white, 97.6% non-Hispanic, and 56.8% women) with complete data at 0 and 6 months collected in a research setting.

MAIN OUTCOME MEASURES
From three 24-hour telephone dietary recalls, 165 food groups from Nutrition Data System for Research software were coded into 25 larger food groups assessing intake of higher-fat and/or added-sugar food groups vs naturally lower-fat and/or added-sugar food groups and into 17 larger food groups assessing intake of nonmodified vs fat- and/or sugar-modified food groups.

STATISTICAL ANALYSES PERFORMED
Repeated measures analyses of covariance (intervention group: covariate) assessed changes from 0 to 6 months. Hierarchical regressions examined changes in food group intake and changes in energy intake, percent energy from fat intake, and weight from 0 to 6 months.

RESULTS
Significant reductions (P<0.05) in intake of high-fat and/or high-added-sugar food groups (Higher-Fat Dairy; Higher-Fat Eggs; Higher-Fat Fats; Higher-Fat Fruit; Higher-Fat Meat; Nonmodified Higher-Fat Fats, Oils, and Sweets; Nonmodified Higher-Fat Sugar-Sweetened Fats, Oils, and Sweets; Nonmodified Regular-Fat Dairy; and Nonmodified Regular-Fat Sugar-Sweetened Dairy) occurred. Decreases in the Higher-Fat Meat group were significantly (P<0.05) related to decreases in energy intake, percent energy from fat intake, and weight.

CONCLUSIONS
When a hypocaloric, low-fat diet is prescribed, reductions in high-fat and/or high-added-sugar food groups occur. Targeting reductions in high-fat meats may improve outcomes.