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Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men

Background Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. Methods We performed prospective investigations involving three separate cohorts that included 120,877 U.S. wom... Full description

Journal Title: The New England Journal of Medicine 2011, Vol.364(25), pp.2392-2404
Main Author: Mozaffarian, Dariush
Other Authors: Hao, Tao , Rimm, Eric B , Willett, Walter C , Hu, Frank B
Format: Electronic Article Electronic Article
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ID: ISSN: 0028-4793 ; E-ISSN: 1533-4406 ; DOI: 10.1056/NEJMoa1014296
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recordid: nejm10.1056/NEJMoa1014296
title: Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men
format: Article
creator:
  • Mozaffarian, Dariush
  • Hao, Tao
  • Rimm, Eric B
  • Willett, Walter C
  • Hu, Frank B
subjects:
  • Medicine
ispartof: The New England Journal of Medicine, 2011, Vol.364(25), pp.2392-2404
description: Background Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. Methods We 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
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identifier: ISSN: 0028-4793 ; E-ISSN: 1533-4406 ; DOI: 10.1056/NEJMoa1014296
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  • 0028-4793
  • 00284793
  • 1533-4406
  • 15334406
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titleChanges in Diet and Lifestyle and Long-Term Weight Gain in Women and Men
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descriptionBackground Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. Methods We 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). Conclusions 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. (Funded by the National Institutes of Health and others.) This study followed 120,877 U.S. women and men for 12 to 20 years to examine relationships between diet, lifestyle, and weight change. Participants gained an average of 3.35 lb every 4 years. Specific diet and lifestyle factors were independently associated with weight gain. Because efforts to lose weight pose tremendous challenges, primary prevention of weight gain is a global priority. Since weight stability requires a balance between calories consumed and calories expended, the advice to “eat less and exercise more” would seem to be straightforward. However, weight gain often occurs gradually over decades (about 1 lb per year), making it difficult for most people to perceive the specific causes. Weight-loss trials1–3 have typically enrolled obese or overweight persons who attempted substantial short-term weight loss on specialized diets, thus limiting the generalizability of the findings to nonobese populations and to the factors that . . .
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descriptionBackground Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. Methods We 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). Conclusions 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. (Funded by the National Institutes of Health and others.) This study followed 120,877 U.S. women and men for 12 to 20 years to examine relationships between diet, lifestyle, and weight change. Participants gained an average of 3.35 lb every 4 years. Specific diet and lifestyle factors were independently associated with weight gain. Because efforts to lose weight pose tremendous challenges, primary prevention of weight gain is a global priority. Since weight stability requires a balance between calories consumed and calories expended, the advice to “eat less and exercise more” would seem to be straightforward. However, weight gain often occurs gradually over decades (about 1 lb per year), making it difficult for most people to perceive the specific causes. Weight-loss trials1–3 have typically enrolled obese or overweight persons who attempted substantial short-term weight loss on specialized diets, thus limiting the generalizability of the findings to nonobese populations and to the factors that . . .
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abstractBackground Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. Methods We 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). Conclusions 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. (Funded by the National Institutes of Health and others.) This study followed 120,877 U.S. women and men for 12 to 20 years to examine relationships between diet, lifestyle, and weight change. Participants gained an average of 3.35 lb every 4 years. Specific diet and lifestyle factors were independently associated with weight gain. Because efforts to lose weight pose tremendous challenges, primary prevention of weight gain is a global priority. Since weight stability requires a balance between calories consumed and calories expended, the advice to “eat less and exercise more” would seem to be straightforward. However, weight gain often occurs gradually over decades (about 1 lb per year), making it difficult for most people to perceive the specific causes. Weight-loss trials1–3 have typically enrolled obese or overweight persons who attempted substantial short-term weight loss on specialized diets, thus limiting the generalizability of the findings to nonobese populations and to the factors that . . .
pubMassachusetts Medical Society
doi10.1056/NEJMoa1014296
pages2392-2404
date2011-06-23