LONGITUDINAL CHANGES IN FOOD PATTERNS PREDICT CHANGES IN WEIGHT AND BODY MASS INDEX AND THE EFFECTS ARE GREATEST IN OBESE WOMEN

Authors: NEWBY, PHYLLIS - TUFTS/HNRCA; WEISMAYER, CHRISTOPH - KAROLINSKA INST, SWEDEN; AKESSON, AGNETA - KAROLINSKA INST, SWEDEN; Tucker, Katherine; WOLK, ALICJA - KAROLINSKA INST, SWEDEN

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/14/2006
Publication Date: 10/1/2006
Citation: Newby, P.K., Weismayer, C., Akesson, A., Tucker, K., Wolk, A. 2006. Longitudinal changes in food patterns predict changes in weight and body mass index and the effects are greatest in obese women. Journal of Nutrition. 136:2580-2587.

Interpretive Summary: The prevalence of obesity is increasing in most parts of the world. The objective of this study was to examine whether changes in food patterns were associated with changes in BMI over 9 y among Swedish women. Data analyzed in this study were from 33,840 women participating in the Swedish Mammography Cohort in 1987 and 1997. Diet was assessed with a food frequency questionnaire (FFQ) at both time points and food patterns were derived using confirmatory factor analysis. Our main exposure variable was defined as change in factor score for each food pattern from 1987 to 1997. Our outcome variable was defined as change in BMI during the same period, and we also examined change in weight. We observed a significant interaction between change in food patterns and baseline BMI. In a multivariate adjusted model, obese subjects who increased their score for the Healthy pattern had the largest decrease in BMI, compared to normal weight women and for overweight women. Greater positive changes in the healthy pattern score predicted smaller weight gains among normal weight and overweight women and weight loss among obese women. Increasing consumption of foods included in the Healthy pattern, which included vegetables and fruit, may be helpful for weight maintenance among normal weight women and weight loss among obese women.

Technical Abstract: The prevalence of obesity is increasing in most parts of the world. The objective of this study was to examine whether changes in food patterns were associated with changes in BMI over 9 y among women. Data analyzed in this study were from 33,840 women participating in the Swedish Mammography Cohort (SMC) in 1987 and 1997. Diet was assessed with a food frequency questionnaire (FFQ) at both time points and food patterns were derived using confirmatory factor analysis. Our main exposure variable was defined as change in factor score for each food pattern from 1987 to 1997. Our outcome variable was defined as change in BMI during the same period, and we also examined change in weight. We observed a significant interaction between change in food patterns and baseline BMI. In a multivariate adjusted model, obese subjects who increased their score for the Healthy pattern had the largest decrease in BMI (ß = -0.18 kg/m2 for a 1 unit increase in SD score; 95% CI: -0.26 to –0.10; P < 0.0001), compared to -0.05 kg/m2 (95% CI: -0.07 to –0.03; P < 0.0001) for normal weight women and -0.11 kg/m2 (95% CI: -0.15 to –0.07; P < 0.0001) for overweight women. Greater positive changes in the healthy pattern score predicted smaller weight gains among normal weight and overweight women and weight loss among obese women. Increasing consumption of foods included in the Healthy pattern, which included vegetables and fruit, may be helpful for weight maintenance among normal weight women and weight loss among obese women.