Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men Full Text
New England Journal of Medicine,

Mozaffarian D et al. - Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity.

Methods
  • The authors performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006.
  • The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously.
  • Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance–weighted meta-analysis.

Results
  • Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4).
  • On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P ≤0.005 for each comparison).
  • Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change).
  • Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).

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