Dietary Patterns During Weight Loss Maintenance vs. Weight Regain: A Secondary Analysis of the Look AHEAD Trial
Year: 2026
Type: article
Abstract: Background/Objectives: Limited information exists on how dietary patterns change in adults who experience weight regain vs. those who maintain weight loss after lifestyle interventions. Methods: Five hundred fifty-two adults (60 ± 1.0 years, 33.8 ± 0.4 kg/m2) with type 2 diabetes mellitus from the Look AHEAD Trial achieved ≥ 7% weight loss after Year 1, completed follow-up visits through Year 4, and provided three 134-item food frequency questionnaires. Weight “regain” (WLR) was defined as regaining ≥ 50% of the initial weight lost. Dietary patterns were determined using established DASH diet scores (scale: 0–9) and principal component analysis (PCA; higher scores = more adherent). Repeated measures linear mixed models assessed group and sex differences in dietary patterns. Results: Dietary patterns were similar between groups during weight loss (baseline to Year 1). WLR DASH scores decreased more from Year 1 to Year 4 compared to “maintain” (WLM) (WLR: Y1: 5.66 ± 0.14, Y4: 4.60 ± 0.14; WLM: Y1: 5.49 ± 0.13, Y4: 4.92 ± 0.13; difference-p < 0.01). Of the two PCA-derived dietary patterns, Pattern 1 (vegetable, fruit, and fish) decreased more in WLR (WLR: Y1: 0.12 ± 0.16, Y4: −0.14 ± 0.16, WLM: Y1: 0.06 ± 0.14, Y4: 0.25 ± 0.15; difference-p < 0.01), while Pattern 2 (low-fiber grains and high-fat animal proteins) increased in WLR (WLR: Y1: 0.40 ± 0.11, Y4: 0.61 ± 0.11, WLM: Y1: 0.34 ± 0.10, Y4: 0.21 ± 0.10, difference-p < 0.01). Sex differences showed that only WLR women and WLM men increased sweets from Y1 to Y4 (WLR women Y1: 0.26 ± 0.04, Y4: 0.41 ± 0.04; p < 0.01; WLM men: Y1: 0.23 ± 0.04, Y4: 0.38 ± 0.04; p < 0.01). Conclusions: These data demonstrate that differences in dietary patterns between WLR and WLM emerge after the initial weight loss intervention with some sex differences. This suggests that longer-term shifts in dietary patterns after lifestyle interventions may influence weight loss maintenance.
Source: Nutrients
DOI: 10.3390/nu18020327
Institution: Pennington Biomedical Research Center
Language: English
Topic: Nutritional Studies and Diet
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
Funders: Louisiana Clinical and Translational Science Center, National Institutes of Health, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, National Institute of Diabetes and Digestive and Kidney Diseases, Office of Research on Women's Health, National Institute on Minority Health and Health Disparities
Awards: G3499744149, G357884267
OpenAlex ID: W7124992640