Presentation on theme: "Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men Dariush Mozaffarian, M.D., Dr.P.H., Tao Hao, M.P.H., Eric B. Rimm, Sc.D., Walter."— Presentation transcript:
1Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men Dariush Mozaffarian, M.D., Dr.P.H., Tao Hao, M.P.H., Eric B. Rimm, Sc.D., Walter C. Willett, M.D., Dr.P.H., and Frank B. Hu, M.D., Ph.D. N Engl J Med 2011; 364:Alicia Williams2012 PharmD CandidateMercer University COPHSJuly 7, 2011
2Funding Supported by grants from: The National Institute of HealthThe Searle Scholars ProgramThe funders of this study had no role in its design or conduct.
3Study ObjectiveTo investigate the relationship between multiple lifestyle changes, both independently and jointly, and long-term weight gain in non-obese women and men
4Study Design Three separate cohorts were prospectively investigated. Participants were evaluated biennially and at 4-year intervals using validated questionnaires concerning medical history, lifestyle, and health practices.
5Patient Demographics The Nurses’ Health Study (NHS) 50,422 female registered nurses from 11 U.S. States who were enrolled in 1976The Nurses’ Health Study II (NHS II)47,898 younger female registered nurses from 14 states who were enrolled in 1989The Health Professionals Follow-Up Study (HPFS)22,557 male health professionals from all 50 states, enrolled in 1986Data was based on:20 yrs of follow-up ( ) in the NHS12 yrs of follow-up ( ) in the NHS II20 yrs of follow-up ( ) in the HPFS
6Exclusion Criteria Obesity Diabetes Cancer Cardiovascular, pulmonary, renal, or liver disease at baselineThose for whom baseline data on lifestyle habits were missingThose with an implausible energy intake (<900 or >3500 kcal/day)Those with more than nine blank responses on the diet questionnaireThose who were newly pregnant during follow-upThose who were over 65 years of age
7Inclusion Criteria Those free of obesity and chronic disease Those for whom data on weight and lifestyle habits at baseline were complete
8InterventionMultivariable adjustments were made for age, baseline body-mass index for each 4-year period, and all lifestyle factors simultaneously.Findings across cohorts were pooled by means of inverse-variance-weighted, random-effects meta-analyses.Analyses were carried out with the use of SAS software, version 9.1 (SAS Institute), at a two-tailed alpha level of 0.05.
9Primary Endpoint Lifestyle habits of interest were: physical activity television watchingalcohol usesleep durationdietIntake of refined or processed foods vs. unprocessed foods
10ResultsWithin each 4-yr period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4)This change corresponds to a weight gain of 16.8 lb over a period of 20 yrs.Lifestyle factors independently associated with weight change (P<0.001):physical activity: lb across quintilesalcohol use: lbs per drink per daysleep: more weight gained with <6 or >8 hrstelevision watching: lb per hr per day
11Results diet Based on increased daily serving of individual components P≤0.005 for each comparisonpotato chips: lbpotatoes: lbsugar-sweetened beverages: lbunprocessed red meats: lbprocessed meat: lbvegetables: lbwhole grains: lbfruits: lbnuts: lbyogurt: lb
12ConclusionChanges in consumption of refined or processed foods and liquid carbohydrates or alcohol were positively associated with weight gain.Changes in the consumption of unprocessed foods such as whole grains, fruit, nuts, and vegetables were inversely associated with weight gain.Weight gain is lowest among persons who sleep 6 to 8 hrs a night.The duration of television viewing and changes in the duration of viewing influence weight gain in adults.
13Comments Limitations: Although dietary questionnaires specified portion sizes, residual, unmeasured differences in portion sizes among participants might account for additional independent effects on energy balance.The cohorts studied here was largely comprised of white, educated U.S. adults, which potentially limits the generalizability of the findings.