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Paul Franks

Paul Franks

Principal investigator

Paul Franks

Predictors of Sustained Reduction in Energy and Fat Intake in the Diabetes Prevention Program Outcomes Study Intensive Lifestyle Intervention

Author

  • Nichola J. Davis
  • Yong Ma
  • Linda M. Delahanty
  • Heather J. Hoffman
  • Elizabeth Mayer-Davis
  • Paul Franks
  • Janet Brown-Friday
  • Mae Isonaga
  • Andrea M. Kriska
  • Elizabeth M. Venditti
  • Judith Wylie-Rosett

Summary, in English

Background Few lifestyle intervention studies examine long-term sustainability of dietary changes. Objective To describe sustainability of dietary changes over 9 years in the Diabetes Prevention Program and its outcomes study, the Diabetes Prevention Program Outcomes Study, among participants receiving the intensive lifestyle intervention. Design One thousand seventy-nine participants were enrolled in the intensive lifeStyle intervention arm of the Diabetes Prevention Program; 910 continued participation in the Diabetes Prevention Program Outcomes Study. Fat and energy intake derived from food frequency questionnaires at baseline and post-randomization Years 1 and 9 were examined. Parsimonious models determined whether baseline characteristics and intensive lifestyle intervention session participation predicted sustainability. Results Self-reported energy intake was reduced from a median of 1,876 kcal/day (interquartile range [IQR]=1,452 to 2,549 kcal/day) at baseline to 1,520 kcal/day (IQR=1,192 to 1,986 kcal/day) at Year 1, and 1,560 kcal/day (IQR=1,223 to 2,026 kcal/ day) at Year 9. Dietary fat was reduced from a median of 70.4 g (IQR=49.3 to 102.5 g) to 45 g (IQR=32.2 to 63.8 g) at Year 1 and increased to 61.0 g (IQR=44.6 to 82.7 g) at Year 9. Percent energy from fat was reduced from a median of 34.4% (IQR=29.6% to 38.5%) to 27.1% (IQR=23.1% to 31.5%) at Year 1 but increased to 35.3% (IQR=29.7% to 40.2%) at Year 9. Lower baseline energy intake and Year 1 dietary reduction predicted lower energy and fat gram intake at Year 9. Higher leisure physical activity predicted lower fat gram intake but not energy intake. Conclusions Intensive lifestyle intervention can result in reductions in total energy intake for up to 9 years. Initial success in achieving reductions in fat and energy intake and success in attaining activity goals appear to predict long-term success at maintaining changes.

Department/s

  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2013

Language

English

Pages

1455-1464

Publication/Series

Journal of the American Dietetic Association

Volume

113

Issue

11

Document type

Journal article

Publisher

Elsevier

Topic

  • Nutrition and Dietetics

Keywords

  • Diet
  • Lifestyle intervention
  • Diabetes prevention
  • Dietary intake
  • Dietary change

Status

Published

Research group

  • Genetic and Molecular Epidemiology

ISBN/ISSN/Other

  • ISSN: 0002-8223