title: Gender differences in the long-term effects of a nutritional intervention program promoting the Mediterranean diet: changes in dietary intakes, eating behaviors, anthropometric and metabolic variables.
abstract: BACKGROUND
  Long-term adherence to principles of the Mediterranean diet (MedDiet) following a nutritional intervention promoting the Mediterranean food pattern in Canadian men and women is not known. Moreover, gender differences in dietary and metabolic profile in such an intervention context has never been addressed. Objective was to determine gender differences in long-term effects of a 12-week nutritional intervention program promoting the adoption of the MedDiet and based on the Self-Determination Theory (SDT) on dietary intakes, eating behaviors, anthropometric and metabolic variables, in men and women presenting cardiovascular risk factors.
  
  
  METHODS
  Sixty-four men and 59 premenopausal women were recruited. The 12-week nutritional program used a motivational interviewing approach and included individual and group sessions. A food frequency questionnaire was administered to evaluate dietary intakes from which a Mediterranean score (Medscore) was derived and the Three-Factor Eating Questionnaire allowed assessment of eating behaviors. Measurements were performed at baseline and after the 12-week nutritional intervention, and then at 3 and 6-month post intervention.
  
  
  RESULTS
  No gender difference was observed in changes in the Medscore during the nutritional intervention and follow-up. However, the Medscore returned towards baseline values during follow-up in men and women (P < 0.0001). Men reported larger decreases in red and processed meat and larger increases in whole fruit intakes than women (P = 0.03 and P = 0.04, respectively). Men showed a greater decrease in habitual susceptibility to disinhibition than women (P = 0.03). A gender by time interaction was found for waist circumference, i.e. men had lower waist circumference at the end of the intervention as well as at follow-up than at baseline while women's waist circumference decreased in response to the intervention only (P = 0.05). As for metabolic variables, changes observed in total-cholesterol (C) to HDL-C ratio, triglyceride levels and triglycerides to HDL-C ratio were more pronounced in men than in women after the intervention as well as at follow-up (P ≤ 0.03).
  
  
  CONCLUSIONS
  Our results indicate that the 12-week nutritional intervention based on the SDT leads to more pronounced beneficial changes in long-term dietary intakes in men than in women and to greater improvements in metabolic profile in men.
  
  
  BACKGROUND
  Current Controlled Trials NCT01852721.
authors.forename: Vicky
authors.initials: V
authors.lastname: Leblanc
authors.forename: Catherine
authors.initials: C
authors.lastname: Bégin
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hudon
authors.forename: Marie-Michelle
authors.initials: MM
authors.lastname: Royer
authors.forename: Louise
authors.initials: L
authors.lastname: Corneau
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dodin
authors.affiliation: Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec G1V 0A6, Canada. Simone.Lemieux@fsaa.ulaval.ca.
authors.forename: Simone
authors.initials: S
authors.lastname: Lemieux
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002170:Canada; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004032:Diet; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017697:Premenopause / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D055105:Waist Circumference