Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men

Study Questions:

Do specific dietary and lifestyle behaviors promote or prevent long-term weight gain?


Three separate cohorts, which included men and women residing in the United States who were free of chronic diseases and were not obese at baseline, were used for the present analysis. The cohorts included the Nurses’ Health Study (n = 50,422), the Nurses’ Health Study II (n = 47,898), and the Health Professionals Follow-up Study (n = 22,557). The follow-up periods included years 1986 to 2006, 1991 to 2003, and 1986 to 2006. Relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body mass index for each period, and all lifestyle factors simultaneously.


A total of 120,877 men and women (1,570,808 person-years of follow-up) were included in this prospective study. The average weight gain across the cohorts was 3.35 lb (5th to 95th percentile, −4.1 to 12.4), or 2.4% of body weight (5th to 95th percentile, −3.0 to 8.4), during each 4-year period. This change corresponded to a weight gain of 16.8 lb over a period of 20 years. Weight change during a 4-year period was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb). Weight gain was inversely associated with the intake of vegetables (−0.22 lb), whole grains (−0.37 lb), fruits (−0.49 lb), nuts (−0.57 lb), and yogurt (−0.82 lb) (p ≤ 0.005 for each comparison). Additional lifestyle factors, which were independently associated with weight change (p < 0.001), included physical activity (−1.76 lb across quintiles), alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).


The investigators concluded that specific dietary and lifestyle factors are independently associated with long-term weight gain. Substantial aggregate effect exists, which is associated with significant weight gain.


These data provide clinicians with useful information suggesting that general changes in diet and lifestyle can prevent long-term weight gain. The findings presented in this study can easily be discussed with patients, and may assist in prevention of obesity. Further study is warranted on how best to disseminate such information on a population level.

Clinical Topics: Prevention, Diet

Keywords: Life Style, Follow-Up Studies, Chronic Disease, Beverages, Weight Gain, Solanum tuberosum, Fruit, Body Mass Index, Yogurt, Vegetables, Nuts, Cereals, Motor Activity, Obesity, Diet, United States, Meat

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