Predictors of dietary change among those who successfully lost weight in phase I of the Weight Loss Maintenance Trial

Authors

  • Megan A. McVay,

    Corresponding author
    1. Duke University Medical Center, Division of General Internal Medicine, Duke University, Durham, North Carolina, USA
    2. Department of Veteran Affairs, Center of Excellence for Health Services Research in Primary Care, Durham, North Carolina, USA
    • Correspondence: M. A. McVay, Center for Health Services Research, Durham Veterans Health Administration, 508 Fulton St. (152), Durham, NC 27705, USA. Email: megan.mcvay@duke.edu

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    • M.A. McVay, PhD, Postdoctoral Fellow
  • Valerie H. Myers,

    1. Klein Buendel, Inc., Golden, Colorado, USA
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    • V.H. Myers, PhD, Scientist II
  • William M. Vollmer,

    1. Center for Health Research, Kaiser Permanente, Portland, Oregon, USA
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    • W.M. Vollmer, PhD, Senior Investigator
  • Janelle W. Coughlin,

    1. School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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    • J.W. Coughlin, PhD, Assistant Professor
  • Catherine M. Champagne,

    1. Louisiana State University System, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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    • C.M. Champagne, PhD, RD, Professor
  • Arlene T. Dalcin,

    1. School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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    • A.T. Dalcin, RD, Research Associate
  • Kristine L. Funk,

    1. Center for Health Research, Kaiser Permanente, Portland, Oregon, USA
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    • K.L. Funk, MS, RD, Research Associate III
  • Jack F. Hollis,

    1. Center for Health Research, Kaiser Permanente, Portland, Oregon, USA
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    • J.F. Hollis, PhD, Senior Investigator
  • Gerald J. Jerome,

    1. Towson University, Towson, Maryland, USA
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    • G.J. Jerome, PhD, Associate Professor
  • Carmen D. Samuel-Hodge,

    1. Gillings School of Public Health, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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    • C.D. Samuel-Hodge, PhD, RD, Assistant Professor
  • Victor J. Stevens,

    1. Center for Health Research, Kaiser Permanente, Portland, Oregon, USA
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    • V.J. Stevens, PhD, Senior Investigator
  • Laura P. Svetkey,

    1. Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA
    2. Duke Hypertension Center, Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
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    • L.P. Svetkey, MD, Professor
  • Phillip J. Brantley

    1. Louisiana State University System, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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    • P.J. Brantley, PhD, Professor

Abstract

Aim

Dietary changes occurring during weight loss interventions can vary. The present study tested if pretreatment psychosocial, dietary and demographic factors were associated with changes in fat intake and fruit and vegetable intake during a weight loss intervention.

Methods

This analysis includes participants who lost at least four kilograms during the initial six month weight loss phase (phase I) of the Weight Loss Maintenance Trial, a group format behavioural intervention emphasising a low-fat diet and increased physical activity. Multiple linear regression was used to determine associations between pretreatment psychosocial, dietary, physical activity, and demographic variables and changes from pretreatment to six months in fat intake and fruit and vegetable intake.

Results

Participants (n = 1032) were 63.4% female, 62.4% non-African American, and had a mean age of 55.6 and BMI of 34.1 kg/m2. Being African American (P < 0.0001) and higher baseline kilojoule intake (P < 0.01) were associated with smaller reductions in fat intake. Being African American (p < 0.001) and older age (P = 0.02) were associated with smaller increases in fruit and vegetable intake, whereas a history of 10 or more past weight loss episodes of at least 10 lb (4.5 kg; P < 0.01) was associated with greater increases.

Conclusions

Few psychosocial factors examined contributed to variability in dietary change. Even when achieving meaningful weight losses during a behavioural weight loss intervention, African Americans may make fewer beneficial changes in fat and fruit and vegetable intake than non-African Americans.

Ancillary