Abstract P217: Dietary Habits Associated With 6- and 24-month Weight Loss Maintenance in Primary Care Patients

Abstract

Introduction: Though weight loss can improve health, weight regain is common. Primary care physicians are uniquely positioned to provide counseling for weight loss maintenance given their longitudinal care of patients, yet evidence of simple lifestyle recommendations for maintaining weight loss in primary care patients is lacking. Our objective was to characterize longitudinal associations between diet habits and weight change among primary care patients with recent, intentional weight loss of at least 5%. Methods: This was a secondary analysis of data from a weight loss maintenance clinical trial in a primary care setting that compared two interventions delivered through the electronic health record: continued coaching vs. tracking only. Dietary habits [fried foods, desserts, fruits and vegetables (F&V), and sugar-sweetened beverages (SSB)] were measured by the Connor Diet Habits Survey. Linear regression models were used to evaluate associations (overall and by randomized group) between changes in dietary habits and weight separately at 6- and 24-month follow-up, adjusted for baseline diet habit, age, gender and clinic location. Results: Participants (n=192) were 74% female, 87% white and had baseline mean (SD) age of 53 (12) years, body mass index of 30.4 (5.9) kg/m 2 , and recent weight loss of 11 (8) percent. Overall, participants had mean (SD) weight loss of 0.18 (5.04) kg at 6 months (n=169) and weight gain of 3.26 (7.60) kg at 24 months (n=140). At 6 months, a 1 serving per week increase in dessert intake was associated with 0.53 kg (p=0.030) greater weight gain. Fried foods, F&V, and SSB were not associated with 6-month weight changes. However, by 24 months, an increase of 1 serving per week was associated with greater weight gain of 0.54 kg (p=0.043) for fried foods, 0.80 kg (p=0.031) for desserts, and 2.01 kg (p=0.002) for SSB. A decrease of 1 F&V serving per day was associated with a 0.82 kg (p=0.008) greater weight gain at 24 months. When stratified by randomized group, associations were stronger in the continued coaching vs. tracking only arm. Conclusions: Increased consumption of desserts was associated with weight regain at 6 and 24 months, while increased fried foods and SSB, and decreased F&V were associated with weight regain at 24 months. These data suggest that simple strategies such as improving or at least maintaining dietary intake of fried foods, desserts, F&V, and SSB could help facilitate long-term weight loss maintenance in primary care patients.