Obesity-Related Eating Behaviors Are Associated with Higher Food Energy Density and Higher Consumption of Sugary and Alcoholic Beverages: A Cross-Sectional Study

Objectives: Obesity-related eating behaviors (OREB) are associated with higher energy intake. Total energy intake can be decomposed into the following constituents: food portion size, food energy density, the number of eating occasions, and the energy intake from energy-rich beverages. To our knowledge this is the first study to examine the association between the OREB and these energy components. Methods: Data were taken from a cross-sectional study conducted in 2008-2010 among 11,546 individuals representative of the Spanish population aged >= 18 years. Information was obtained on the following 8 self-reported OREB: not planning how much to eat before sitting down, eating precooked/canned food or snacks bought at vending machines or at fast-food restaurants, not choosing low-energy foods, not removing visible fat from meat or skin from chicken, and eating while watching TV. Usual diet was assessed with a validated diet history. Analyses were performed with linear regression with adjustment for main confounders. Results: Compared to individuals with <= 1 OREB, those with >= 5 OREB had a higher food energy density (beta 0.10; 95% CI 0.08, 0.12 kcal/g/day; p-trend <0.001) and a higher consumption of sugary drinks (beta 7; 95% CI -7, 20 ml/day; p-trend <0.05) and of alcoholic beverages (beta 24; 95% CI 10, 38 ml/day; p-trend <0.001). Specifically, a higher number of OREB was associated with higher intake of dairy products and red meat, and with lower consumption of fresh fruit, oily fish and white meat. No association was found between the number of OREB and food portion size or the number of eating occasions. Conclusions: OREB were associated with higher food energy density and higher consumption of sugary and alcoholic beverages. Avoiding OREB may prove difficult because they are firmly socially rooted, but these results may nevertheless serve to palliate the undesirable effects of OREB by reducing the associated energy intake.