Change in Dietary Patterns and Change in Waist Circumference and DXA Trunk Fat Among Postmenopausal Women

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.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

© 2016 The Obesity Society.

Figures

Figure 1

Three Year Changes in Diet Quality Scores and Changes in Waist Circumference: With and Without Adjustment for Changes in Weight1, 2 1 All models adjust for age at enrollment, baseline waist circumference, education, race/ethnicity, smoking status, family history of diabetes, HRT status, total energy intake, and physical activity; where indicated (Figure 1B) models adjust for 3-year change in weight. 2 “Consistent high” indicates always being in the top two quartiles for diet quality, whereas “consistent low” indicates always being in the bottom two. “Low to high” is moving from one of the lower quartiles to one of the higher quartiles, whereas “high to low” is moving from one of the upper quartiles to one of the lower quartiles. The median baseline value for each dietary pattern scores were as follows: AHEI-2010 (51); DASH (24); HEI-2010 (68); and aMED (4). The “n; median change” for the “consistent high” category was n=25,040; 1 point for AHEI-2010; n=23,013; 0 points for DASH; n=24,493; 1 point for HEI-2010 n=19,444; 0 points for aMED. These values for the “low to high” category were n=8,548; 11 points for AHEI-2010; n=23,013; 0 points for DASH; n=9,095; 11 points for HEI-2010 n=9,382; 2 points for aMED. For the “high to low” category the values were n=8,548; −10 points for AHEI-2010; n=8,196; −4 points for DASH; n=9,095; −9 points for HEI-2010 n=10,158; −2 points for aMED, and for the “consistent low” category the n=25039; 1 point for AHEI-2010; n=27,682; 0 points for DASH; n=24,492; 1 points for HEI-2010 n=28,191; 0 points for aMED.