Abstract
Reproductive-aged women are at high risk for obesity development. Limited research exploring weight gain prevention initiatives and associated modifiable risk factors, including diet quality exists. In a secondary analysis of a 12 month, cluster randomized controlled trial for weight gain prevention in reproductive-aged women, we evaluated change in diet quality, macronutrient and micronutrient intake, predictors of change and associations with weight change at follow-up. Forty-one rural towns in Victoria, Australia were randomized to a healthy lifestyle intervention (n = 21) or control (n = 20). Women aged 18–50, of any body mass index and without conditions known to affect weight, were recruited. Diet quality was assessed by the Dietary Guideline Index (DGI) and energy, macronutrient, and micronutrient intake as well as anthropometrics (weight; kg) were measured at baseline and 12 months. Results were adjusted for group (intervention/control), town cluster, and baseline values of interest. Of 409 women with matched data at baseline and follow-up, 220 women were included for final analysis after accounting for plausible energy intake. At 12 months, diet quality had improved by 6.2% following the intervention, compared to no change observed in the controls (p < 0.001). Significant association was found between a change in weight and a change in diet quality score over time β −0.66 (95%CI −1.2, −0.12) p = 0.02. The percentage of energy from protein (%) 0.009 (95%CI 0.002, 0.15) p = 0.01 and glycemic index −1.2 (95%CI −2.1, −0.24) p = 0.02 were also improved following the intervention, compared to the control group. Overall, a low-intensity lifestyle intervention effectively improves diet quality, with associated weight gain preventions, in women of reproductive age.
Highlights
For the first time, the global prevalence of overweight and obesity exceeds that of those who are underweight [1]
The intervention HeLP-her was developed to prevent the progressive weight gain observed in women of reproductive age, by promoting a healthy lifestyle and increasing skills in self-management, problem solving, and goal setting through low-intensity behavior change techniques [30,32]
We explored changes in diet quality, macronutrient and micronutrient intakes, and their association with weight change following a 12 month healthy lifestyle program in reproductive-aged rural dwelling women
Summary
The global prevalence of overweight and obesity exceeds that of those who are underweight [1]. Obesity prevalence is greater in women compared with men 21% of women and 18% of men by 2025, threatening the likelihood of the World Health Organization (WHO) target to halt the rise in obesity [1]. With longitudinal studies demonstrating the highest risk in younger women aged 18 to 40 years, who gain more weight annually than older women (649 versus 494 g/year) [3]. Rural-dwelling women are a vulnerable group who are at further risk, with a higher progressive background weight longitudinally (~730 g/year versus ~600 g/year) [3,4], and a higher prevalence of overweight and obesity, in comparison to urban women [5]. Given the need to improve obesity preventative behaviors in reproductive-aged women including rural women, effective preventive interventions targeting this population are crucial
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