Abstract
Background
Standard behavioral obesity treatment produces poor long-term results. Focusing on
healthy eating behaviors rather than energy intake may be an alternative strategy.
In addition, important behaviors might differ for short- vs long-term weight control.
Objective
Our aim was to describe and compare associations between changes in eating behaviors
and weight after 6 and 48 months.
Design
We performed secondary analysis of data collected during a randomized weight-loss
intervention trial with 48-month follow-up.
Participants
We studied 481 overweight and obese postmenopausal women enrolled in the Women on
the Move through Activity and Nutrition (WOMAN) Study.
Main outcome measures
We measured changes in weight from baseline to 6 and 48 months.
Statistical analyses performed
Linear regression models were used to examine the associations between 6- and 48-month
changes in eating habits assessed by the Conner Diet Habit Survey and changes in weight.
Analyses were conducted in the combined study population and stratified by randomization
group.
Results
At 6 months in the combined population, weight loss was independently associated with
decreased desserts (P<0.001), restaurant eating (P=0.042), sugar-sweetened beverages (P=0.009), and fried foods (P<0.001), and increased fish consumption (P=0.003). Results were similar in intervention participants; only reduced desserts
and fried foods associated with weight loss in controls. At 48 months in the combined
population, weight loss was again associated with decreased desserts (P=0.003) and sugar-sweetened beverages (P=0.011), but also decreased meats/cheeses (P=0.024) and increased fruits/vegetables (P<0.001). Decreased meats/cheeses predicted weight loss in intervention participants;
desserts, sugar-sweetened beverages, and fruits/vegetables were independently associated
in controls.
Conclusions
Changes in eating behaviors were associated with weight change, although important
behaviors differed for short- and long-term weight change and by randomization group.
Future studies should determine whether interventions targeting these behaviors could
improve long-term obesity treatment outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence and trends in obesity among US adults, 1999-2008.JAMA. 2010; 303: 235-241
- Health risks associated with overweight and obesity.Obes Rev. 2007; 8: 13-17
- Excess deaths associated with underweight, overweight, and obesity.JAMA. 2005; 293: 1861-1867
- Overweight and obesity in the United States: Prevalence and trends, 1960-1994.Int J Obes Relat Metab Disord. 1998; 22: 39-47
- Progress toward the healthy people 2010 goals and objectives.Annu Rev Public Health. 2010; 31 (274): 271-281
- Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up.J Am Diet Assoc. 2007; 107: 1755-1767
- Comparison of strategies for sustaining weight loss: The weight loss maintenance randomized controlled trial.JAMA. 2008; 299: 1139-1148
- Weight regain prevention.Clin Diabetes. 2008; 26: 100-113
- Consistent self-monitoring of weight: A key component of successful weight loss maintenance.Obesity (Silver Spring). 2007; 15: 3091-3096
- Behavioral transitions and weight change patterns within the PREMIER Trial.Obesity (Silver Spring). 2011; 19: 1609-1615
- STOP regain: Are there negative effects of daily weighing?.J Consult Clin Psychol. 2007; 75: 652-656
- The weight loss experience: A descriptive analysis.Ann Behav Med. 2004; 27: 100-106
- Updated recommendations put focus on obesity.Mayo Clin Womens Healthsource. 2010; 14: 1-2
- Dietary practices, dining out behavior, and physical activity correlates of weight loss maintenance.Prev Chronic Dis. 2008; 5: A11
- Who succeeds in maintaining weight loss?.Obes Rev. 2005; 6: 67-85
- Dietary energy density and successful weight loss maintenance.Eat Behav. 2011; 12: 119-125
- Predictors of weight change over two years among a population of working adults: The Healthy Worker Project.Int J Obes Relat Metab Disord. 1994; 18: 145-154
- Long-term follow-up of patients attending a combination very-low calorie diet and behaviour therapy weight loss programme.Int J Obes Relat Metab Disord. 1992; 16: 605-613
- Dietary patterns and 14-y weight gain in African American women.Am J Clin Nutr. 2011; 94: 86-94
- What distinguishes weight-loss maintainers from the treatment-seeking obese?.Ann Behav Med. 2009; 38: 94-104
- Practices associated with weight loss versus weight-loss maintenance results of a national survey.Am J Prev Med. 2011; 41: 159-166
- The Women on the Move Through Activity and Nutrition (WOMAN) study: Final 48-month results.Obesity (Silver Spring). 2012; 20: 636-643
- The clinical trial of Women On the Move Through Activity and Nutrition (WOMAN) study.Contemp Clin Trials. 2007; 28: 370-381
- Physical Activity and Health: A Report of the Surgeon General.Office of the Surgeon General, Washington, DC1996
- The Diet Habit Survey: A new method of dietary assessment that relates to plasma cholesterol changes.J Am Diet Assoc. 1992; 92: 41-47
- The Nutrition Attitude Survey: Associations with dietary habits, psychological and physical well-being, and coronary risk factors.Health Psychol. 1986; 5: 359-374
- A collection of physical activity questionnaires for health-related research.Med Sci Sports Exerc. 1997; 29: S1-S205
- Discontinuing hormone replacement therapy: Attenuating the effect on CVD risk with lifestyle changes.Am J Prev Med. 2007; 32: 483-489
- Compendium of physical activities: An update of activity codes and MET intensities.Med Sci Sports Exerc. 2000; 32: S498-S504
- Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians.Diabetes Care. 1990; 13: 401-411
- The definition of weight maintenance.Int J Obes (Lond). 2006; 30: 391-399
- Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis.Lancet. 2005; 365: 36-42
- Fast food restaurant use among women in the Pound of Prevention study: Dietary, behavioral and demographic correlates.Int J Obes Relat Metab Disord. 2000; 24: 1353-1359
- Dietary energy density predicts women's weight change over 6 y.Am J Clin Nutr. 2008; 88: 677-684
- Prospective study of dietary energy density and weight gain in women.Am J Clin Nutr. 2008; 88: 769-777
- Energy density and weight change in a long-term weight-loss trial.Int J Behav Nutr Phys Act. 2009; 6: 57
- Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial.Am J Clin Nutr. 2007; 85: 1212-1221
- A low-energy-dense diet adding fruit reduces weight and energy intake in women.Appetite. 2008; 51: 291-295
- Dietary energy density in the treatment of obesity: A year-long trial comparing 2 weight-loss diets.Am J Clin Nutr. 2007; 85: 1465-1477
- Provision of foods differing in energy density affects long-term weight loss.Obes Res. 2005; 13: 1052-1060
Biography
B. Barone Gibbs is an assistant professor, Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
Biography
L. S. Kinzel is a senior research nutritionist, Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
Biography
L. H. Kuller is a distinguished university professor of Public Health, Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.
Biography
K. Pettee Gabriel is an assistant professor, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Austin.
Biography
Y.-F. Chang is a research assistant professor, School of Medicine, Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA.
Article info
Publication history
Published online: August 28, 2012
Accepted:
May 29,
2012
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was funded by National Heart, Lung and Blood Institute contract R01-HL-66846.
Meets Learning Need Codes 5000, 5370, 6000, and 6010. To take the Continuing Professional Education quiz for this article, log in to www.eatright.org, click the “myAcademy” link under your name at the top of the homepage, select “Journal Quiz” from the menu on your myAcademy page, click “Journal Article Quiz” on the next page, and then click the “Additional Journal CPE Articles” button to view a list of available quizzes, from which you may select the quiz for this article.
Identification
Copyright
© 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
