Increasing Healthful Food Variety is Associated with Reduced Total and Food‐specific Cravings among Men in the POUNDS Lost Weight‐loss Trial

Abstract

Increasing healthful variety may reduce adiposity, but the underlying psychological mechanisms are unknown. We aimed to examine if reducing, maintaining, or increasing healthful food variety affected changes in food cravings among men (n=155) and women (n=195) participating in the POUNDS Lost weight‐loss trial with dietary data at baseline and 6‐months. Healthful dietary variety was quantified with the validated US Healthy Food Diversity (US HFD) index, which measures variety, proportionality, and food quality. Six‐month changes in the US HFD index were divided into tertiles (T); T1=reduced, T2=stable, T3=increased variety. The 33‐item Food Craving Inventory‐II assessed cravings of specific foods from 1 (never) to 5 (always) at 0 and 6‐months. A significant interaction between the US HFD index and food cravings by sex was observed. Generalized linear models were stratified by sex, and adjusted for age, diet arm, and changes in fullness, restraint, hunger, general cravings, and body weight to determine if 6‐month changes in food craving scores varied by tertile of US HFD index change. Increased (T3) versus reduced (T1) variety was associated with reduced cravings for high‐fat foods (‐0.27 vs. 0.07, p=0.007), sweets (‐0.33 vs. ‐0.07, p=0.04), carbohydrates (‐0.17 vs. 0.17, p=0.02), and total cravings (‐0.21 vs. 0.07, p=0.006) in men. Increased variety was not associated with cravings in women, except non‐significantly for fruit and vegetables (0.15 vs. ‐0.17, p=0.07; T3 vs. T1). Our results suggest that increasing healthful variety may help men trying to lose weight reduce food cravings and may be a novel strategy to promote dietary adherence.