title: Greater Healthful Dietary Variety Is Associated with Greater 2-Year Changes in Weight and Adiposity in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) Trial.
abstract: Greater healthful dietary variety has been inversely associated with body adiposity cross-sectionally; however, it remains unknown whether it can improve long-term weight loss.
  
  
  
  This study prospectively examined associations between healthful dietary variety and short-term (6 mo) and long-term (2 y) changes in adiposity in the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) weight-loss trial completed in 2007.
  
  
  
  Healthful dietary variety was assessed from 24-h recalls with the use of the US Healthy Food Diversity index among participants aged 30-70 y with overweight/obesity (n = 367). Changes in the index between baseline and 6 mo were divided into tertiles representing reduced (T1), stable (T2), or increased variety (T3). Body weight and waist circumference (WC) were measured every 6 mo, and the percentage of body fat and trunk fat were measured at 6 mo and 2 y. Associations between changes in variety and short-term and long-term changes in adiposity were analyzed by use of multivariable-adjusted generalized linear models and repeated-measures ANOVA.
  
  
  
  Regardless of dietary arm, T3 compared with T2 was associated with greater reduction in weight (-8.6 compared with -6.7 kg), WC (-9.1 compared with -6.1 cm), and body fat at 6 mo (β = -4.61 kg, P < 0.05). At 2 y, individuals in T3 compared with those in T2 or T1 maintained greater weight loss [-4.0 (T3) compared with -1.8 kg (T2 and T1), P = 0.02] and WC reduction [-5.4 (T3) compared with -3.0 (T2) and -2.9 cm (T1), P = 0.01]. Total body fat and trunk fat reductions were similarly greater in T3 than in T2.
  
  
  
  Increasing healthful food variety in energy-restricted diets may improve sustained reductions in weight and adiposity among adults with overweight or obesity on weight-loss regimens. This trial is registered at clinicaltrials.gov as NCT00072995.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;
authors.forename: Maya
authors.identifier: 0000-0002-0137-670X
authors.initials: M
authors.lastname: Vadiveloo
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Harvard Medical School, Boston, MA; Department of Medicine, Channing Division of Network Medicine, Brigham & Women's Hospital, Boston, MA; and.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sacks
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Catherine M
authors.identifier: 0000-0001-5424-8245
authors.initials: CM
authors.lastname: Champagne
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; jmattei@hsph.harvard.edu.
authors.forename: Josiemer
authors.initials: J
authors.lastname: Mattei
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D050154:Adiposity; D000068959:Body Weight Maintenance; D031204:Caloric Restriction; D000072001:Diet, Healthy; D004038:Diet, Reducing; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000517:prevention & control; D050177:Overweight; D011446:Prospective Studies; D055105:Waist Circumference; D015431:Weight Loss
keywords: POUNDS Lost; dietary variety/dietary diversity; healthy food diversity; obesity; weight loss; weight maintenance