Baseline dietary patterns are a significant consideration in correcting dietary exposure for weight loss

BACKGROUND/OBJECTIVES: Dietary pattern studies are traditionally the domain of epidemiological research. From a clinical perspective, there is a need to explore the effects of changing food and dietary patterns of individuals. The aim was to identify patterns of food choice in the context of a clinical weight loss trial. Cluster analysis based on reported serves of food groups revealed dietary patterns informative for the clinical setting. SUBJECTS/METHODS: Cluster analysis was conducted using diet history data from two clinical trials at baseline, and outcomes at 3 months were reviewed based on these clusters (n = 231). The cluster solution was analysed using defined food groups in serves and with respect to clinical parameters and requirements for selected nutrients. RESULTS: Two distinct dietary patterns were identified from the reported baseline dietary intakes. Subjects in Cluster 1 reported food patterns characterised by higher intakes of low-fat dairy and unsaturated oils and margarine and were generally more closely aligned to food choices encouraged in national dietary guidelines. Subjects in Cluster 2 reported a dietary pattern characterised by non-core foods and drinks, higher-and medium-fat dairy foods, fatty meats and alcohol. At 3 months, Cluster 2 subjects reported greater reductions in energy intake (-5317 kJ; P<0.001) and greater weight loss (-5.6 kg; P<0.05) compared with Cluster 1. CONCLUSIONS: Overweight subjects with reported dietary patterns similar to dietary guidelines at baseline may have more difficulty in reducing energy intake than those with poor dietary patterns. Correcting exposure to non-core foods and drinks was key to successful weight loss. European Journal of Clinical Nutrition (2013) 67, 330-336; doi:10.1038/ejcn.2013.26; published online 13 February 2013