Elizabeth M Cespedes Feliciano1, Lesley Tinker2, JoAnn E Manson3, Matthew Allison4, Thomas Rohan5, Oleg Zaslavsky6, Molly E Waring7,8, Keiko Asao9, Lorena Garcia10, Milagros Rosal11, Marian L Neuhouser2. 1. Division of Research, Kaiser Permanente Northern California, Oakland, California, USA. elizabeth.m.cespedes@kp.org. 2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. 3. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. 4. Department of Family and Preventive Medicine, University of San Diego School of Medicine, San Diego, California, USA. 5. Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. 6. Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, Washington, USA. 7. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 8. Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 9. Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. 10. Department of Public Health Sciences, University of California, Davis, Davis, California, USA. 11. Department of Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Abstract
OBJECTIVE: To examine whether changes in diet quality predict changes in central adiposity among postmenopausal women. METHODS: At baseline and 3-year follow-up, Women's Health Initiative Observational Study participants completed food frequency questionnaires, and waist circumference was measured (WC, n = 67,175). In a subset, trunk fat was measured via dual-energy X-ray absorptiometry (DXA, n = 4,254). Using multivariable linear regression, 3-year changes in dietary patterns (Healthy Eating Index-2010, Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension) were examined as predictors of concurrent changes in WC and, secondarily, DXA. RESULTS: Mean (SD) age and 3-year changes in weight and WC were 63 (7) years, 0.52 (4.26) kg, and 0.94 (6.65) cm. A 10% increase in any dietary pattern score, representing improved diet quality, was associated with 0.07 to 0.43 cm smaller increase in WC over 3 years (all P < 0.05). After adjusting for weight change, associations attenuated to 0.02 to 0.10 cm but remained statistically significant for all patterns except Alternate Mediterranean Diet. Results were similar for DXA trunk fat. CONCLUSIONS: Three-year improvements in diet quality are modestly protective against gain in WC and partially explained by lesser weight gain. Achieving and maintaining a healthful diet after menopause may protect against gains in central adiposity.
OBJECTIVE: To examine whether changes in diet quality predict changes in central adiposity among postmenopausal women. METHODS: At baseline and 3-year follow-up, Women's Health Initiative Observational Study participants completed food frequency questionnaires, and waist circumference was measured (WC, n = 67,175). In a subset, trunk fat was measured via dual-energy X-ray absorptiometry (DXA, n = 4,254). Using multivariable linear regression, 3-year changes in dietary patterns (Healthy Eating Index-2010, Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension) were examined as predictors of concurrent changes in WC and, secondarily, DXA. RESULTS: Mean (SD) age and 3-year changes in weight and WC were 63 (7) years, 0.52 (4.26) kg, and 0.94 (6.65) cm. A 10% increase in any dietary pattern score, representing improved diet quality, was associated with 0.07 to 0.43 cm smaller increase in WC over 3 years (all P < 0.05). After adjusting for weight change, associations attenuated to 0.02 to 0.10 cm but remained statistically significant for all patterns except Alternate Mediterranean Diet. Results were similar for DXA trunk fat. CONCLUSIONS: Three-year improvements in diet quality are modestly protective against gain in WC and partially explained by lesser weight gain. Achieving and maintaining a healthful diet after menopause may protect against gains in central adiposity.
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