Using restrictive messages to limit high-fat foods or nonrestrictive messages to increase fruit and vegetable intake: what works better for postmenopausal women?

Background/Objectives: To compare the effects of two dietary approaches on changes in dietary intakes and body weight: (1) an approach emphasizing nonrestrictive messages directed toward the inclusion of fruits and vegetables (HIFV) and (2) another approach using restrictive messages to limit high-fat foods (LOFAT). Subjects/Methods: A total of 68 overweight-obese postmenopausal women were randomly assigned to one of the two dietary approaches. The 6-month dietary intervention included three group sessions and ten individual sessions with a dietitian. Dietary food intake and anthropometric variables were measured at baseline, at 3 months and at 6 months. Results: Energy density decreased in both groups after the intervention compared with baseline (HIFV, -0.3 +/- 0.2 kcal/g; LOFAT, -0.3 +/- 0.3 kcal/g; P<0.0001). Although body weight decreased significantly in both groups after the intervention compared with baseline (HIFV, -1.6 +/- 2.9 kg; LOFAT, -3.5 +/- 2.9 kg; P<0.0001), women in the LOFAT group lost significantly more body weight than women in the HIFV group (P = 0.01). In the HIFV group, the decrease in energy density was found to be an independent predictor of body weight loss. Conclusions: The LOFAT approach induces more weight loss than does the HIFV approach in our sample of overweight-obese postmenopausal women. European Journal of Clinical Nutrition (2010) 64, 194-202; doi: 10.1038/ejcn.2009.135; published online 25 November 2009