Predictors of Dietary Change and Maintenance in the Women's Health Initiative Dietary Modification Trial

Lesley F. Tinker, Milagros C. Rosal, Anne F. Young, Michael G. Perri, Ruth E. Patterson, Linda Van Horn, Annlouise R. Assaf, Deborah J. Bowen, Judith Ockene, Jennifer Hays-Grudo, Lieling Wu

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Abstract

Objective: To identify predictors of dietary change to and maintenance of a low-fat eating pattern (<20% energy from fat, ≥5 servings fruits/vegetables daily, and ≥6 servings grains daily) among a cohort of postmenopausal women. Candidate predictors included intrapersonal, interpersonal, intervention program characteristics, and clinical center. Design: Longitudinal study within the Women's Health Initiative Dietary Modification Trial. Dietary change was evaluated after 1 year of participation in the Women's Health Initiative Dietary Modification Trial, and dietary maintenance after 3 years. Subjects: Postmenopausal women aged 50 to 79 years at baseline who were randomized to the intervention arm of the Women's Health Initiative Dietary Modification Trial (n=19,541). Statistical analysis: Univariate and multivariate linear regression analysis was performed and associations evaluated between candidate predictors and each of the three dietary goals: percent energy from fat, fruit/vegetable servings, and grain servings. Results: Year 1 (change) predictors of percent energy from fat (P<0.005) included being younger (β=2.12; 70 to 79 years vs 50 to 59 years), more educated (β=-.69; college vs high school), more optimistic (β=-.07), attending more sessions (β=-.69), and submitting more self-monitoring records (β=-.74). At year 3 (maintenance), the predictors of percent energy from fat (P<0.005) included attending more sessions (β=-.65) and submitting more self-monitoring scores (β=-.71). The analytic model predicted 22% of the variance in fat intake at year 1 and 27% at year 3 (P<0.01). Conclusions: The strongest predictors of dietary change and maintenance were attending intervention sessions and self-monitoring dietary intake. Novel was the finding that optimism predicted dietary change.

Original languageEnglish
Pages (from-to)1155-1165
Number of pages11
JournalJournal of the American Dietetic Association
Volume107
Issue number7
DOIs
Publication statusPublished - 1 Jul 2007

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Tinker, L. F., Rosal, M. C., Young, A. F., Perri, M. G., Patterson, R. E., Van Horn, L., ... Wu, L. (2007). Predictors of Dietary Change and Maintenance in the Women's Health Initiative Dietary Modification Trial. Journal of the American Dietetic Association, 107(7), 1155-1165. https://doi.org/10.1016/j.jada.2007.04.010