The Relationship Between a High Sugar-Low Fiber Dietary Food Intake and Obesity in a Clinical Setting

Abstract

Diets high in simple sugars and processed foods, and low in whole, fibrous plant foods have been linked to insulin resistance and weight gain. To prevent obesity and cardiometabolic disease, it is recommended that Americans limit intake of sugary beverages, fruit juices, added sugars, and processed carbohydrates, in favor of more fibrous foods such as whole fruits and vegetables, nuts, beans, whole grains, and seeds. PURPOSE: To examine the relationship between frequency of foods consumed high in sugar and low in fiber (HSLF) with BMI. We hypothesized that a HSLF diet would be significantly higher among obese individuals (BMI ≥ 30) than non-obese (BMI < 30). METHODS: A total of 2,703 adults (1,521 females and 1,182 males) from a HealthSnap wellness assessment used in physicians’ offices across the country were evaluated for anthropometric measurements and nutritional behaviors. HSLF consumption was evaluated from patients’ self-reported intake of soda, juices, energy drinks, and other high sugar foods versus selection of whole grains, whole plant foods, nuts, beans, and seeds. To identify the association between HSLF and obesity, a Chi-squared analysis (χ2) was performed using quintiles of HSLF for obese and non-obese subjects. A relative risk (RR) was evaluated across data quintiles. RESULTS: A significant association between obesity and HSLF was observed (χ2 [12, n = 2703] = 178.73, p < 0.001). Patients with HSLF in the highest 20%, Q5, had a 242% higher RR of obesity than those in the lowest 20%, Q1 (RR: 2.42, 95% CI: 1.95-3.03, p < 0.001). CONCLUSION: A diet encompassing foods high in sugar and low in fiber is associated with obesity. This supports the promotion of whole foods, high in fiber while limiting intake of foods high in sugar, as a simple recommendation to protect against obesity in a clinical setting.