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

Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
New England Journal of Medicine (Impact Factor: 54.42). 06/2011; 364(25):2392-404. DOI: 10.1056/NEJMoa1014296
Source: PubMed

ABSTRACT 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.
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.
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).
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.).

  • Source
    • "However, some epidemiologic studies examining the association between dietary folate intake and leukocyte DNA methylation in healthy subjects reported null associations (Moore et al. 2008; Choi et al. 2009; Zhang et al. 2011a). The Mediterranean diet (MD) is widely recognized to be the optimal diet for disease prevention and for good health, and independently of energy and macronutrient intakes, a better adherence to MD is associated with lower obesity risk (Mozaffarian et al. 2011; Martı`nez-Gonzàlez et al. 2012; Barchitta et al. 2014b). Focusing on dietary patterns, a recent study reported that a high intake of dark green vegetables was associated with LINE-1 hypermethylation in a cancer-free population (Zhang et al. 2011a). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Several dietary agents, such as micronutrient and non-nutrient components, the so-called bioactive food components, have been shown to display anticancer properties and influence genetic processes. The most common epigenetic change is DNA methylation. Hypomethylation of long interspersed elements (LINE-1) has been associated with an increased risk of several cancers, although conflicting findings have also been observed. The aim of the present study was to test the hypothesis that a low adherence to the Mediterranean diet (MD) and folate deficiency may cause LINE-1 hypomethylation in blood leukocytes of healthy women, and thus genomic instability. One hundred and seventy-seven non-pregnant women were enrolled. Mediterranean diet score (MDS) and folate intake were calculated using a food frequency questionnaire. LINE-1 methylation level was measured by pyrosequencing analysis in three CpG sites of LINE-1 promoter. According to MDS, only 9.6 % of subjects achieved a high adherence to MD. Taking into account the use of supplements, there was a high prevalence of folate deficiency (73.4 %). Women whose consumption of fruit was below the median value (i.e., <201 gr/day) were 3.7 times more likely to display LINE-1 hypomethylation than women whose consumption was above the median value (OR 3.7; 95 % CI 1.4-9.5). Similarly, women with folate deficiency were 3.6 times more likely to display LINE-1 hypomethylation than women with no folate deficiency (OR 3.6; 95 % CI 1.1-12.1). A dietary pattern characterized by low fruit consumption and folate deficiency is associated with LINE-1 hypomethylation and with cancer risk.
    Genes & Nutrition 09/2015; 10(5):480. DOI:10.1007/s12263-015-0480-4 · 3.42 Impact Factor
  • Source
    • "Our findings are consistent with studies from high-income countries that have assessed the influence on obesity of foods that could be classified as ultra-processed. In the US, positive associations have been seen between consumption of potato chips, SSBs, and processed meat and long-term weight gain; with protective associations of unprocessed or minimally processed foods such as fruits, vegetables, nuts, and yogurt (Mozaffarian et al., 2011). Also, a 15-year prospective study showed that fast food consumption among young adults was directly associated with changes in body weight and insulin resistance (Pereira et al., 2005). "
    • "The greater and more rapid rises in postprandial blood glucose and insulin induced by high GI and GL diets facilitate weight gain (Ludwig, 2002). Weight change is positively associated with foods higher in GI, especially refined grains, and inversely associated with foods lower in GI, such as whole grains, fruits, and vegetables (Liu et al., 2003; Koh-Banerjee & Rimm, 2003; Koh-Banerjee et al., 2004; Mozaffarian et al., 2011; Fogelholm, Anderssen, Gunnarsdottir , & Lahti-Koski, 2012). Higher protein, lower GI and GL diets also may confer an advantage during weight loss maintenance (Larsen et al., 2010), partly due to higher resting energy expenditure (Ebbeling et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We contend that palates link herbivores and humans with landscapes and consider how these relationships have changed historically. An attuned palate, which enables herbivores to meet needs for nutrients and self-medicate to rectify maladies, evolves from three interrelated processes: flavor-feedback associations, availability of phytochemically rich foods, and learning in utero and early in life to eat nourishing combinations of foods. That occurs when wild or domestic herbivores forage on phytochemically rich landscapes, is less common when domestic herbivores forage on monoculture pastures, is close to zero for herbivores in feedlots, and is increasingly rare for people who forage in modern food outlets. Unlike our ancestors, the palates of many individuals are no longer linked in healthy ways with landscapes. Industrial farming and selection for yield, appearance, and transportability diminished the flavor, phytochemical richness, and nutritive value of fruits and vegetables for humans. Phytochemically impoverished pastures and feedlot diets can adversely affect the health of livestock and the flavor and nutritive value of meat and milk products for humans. While flavors of produce, meat, and dairy have become blander, processed foods have become more desirable as people have learned to link synthetic flavors with feedback from energy-rich compounds that obscure nutritional sameness and diminish health. Thus, the roles plants and animals once played in nutrition have been usurped by processed foods that are altered, fortified, and enriched in ways that can adversely affect appetitive states and food preferences. The need to amend foods, and to take nutrient supplements, could be reduced by creating phytochemically rich plants and herbivores and by creating cultures that know how to combine foods into meals that nourish and satiate. Copyright © 2015. Published by Elsevier Ltd.
    Appetite 08/2015; in press. DOI:10.1016/j.appet.2015.08.004 · 2.69 Impact Factor
Show more


Available from