Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility

Matty D.A. Karsten*, Anne M. van Oers, Henk Groen, Meike A.Q. Mutsaerts, Mireille N.M. van Poppel, Anouk Geelen, Cornelieke van de Beek, Rebecca C. Painter, Ben W.J. Mol, Tessa J. Roseboom, Annemieke Hoek, J.M. Burggraaff, W.K.H. Kuchenbecker, D.A.M. Perquin, C.A.M. Koks, R. van Golde, E.M. Kaaijk, J.M. Schierbeek, G.J.E. Oosterhuis, F.J. BroekmansN.E.A. Vogel, C.B. Lambalk, F. van der Veen, N.F. Klijn, P.E.A.M. Mercelina, Y.M. van Kasteren, A.W. Nap, R.J.A.B. Mulder, E.T.C.M. Gondrie, J.P. de Bruin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Purpose: To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention. Methods: The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5–10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion. Results: Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05–1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01–1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p < 0.01). Women with an older partner had an increased energy intake (6 kcal/year older, 95% CI 3–13). A high stage of change towards physical activity was associated with a higher number of daily steps (p = 0.03). A high stage of change towards weight loss was associated with completion of the intervention (p = 0.04). Conclusions: Determinants of lifestyle change and program completion were: higher external eating behavior, not having received previous dietetic support, high stage of change. This knowledge can be used to identify women likely to benefit from lifestyle interventions and develop new interventions for women requiring alternative support. Trial registration: The LIFEstyle study was registered at the Dutch trial registry (NTR 1530; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1530).

Original languageEnglish
Pages (from-to)2463-2475
JournalEuropean Journal of Nutrition
Volume58
Issue number6
Early online date3 Aug 2018
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Determinants
  • Lifestyle intervention
  • Obesity
  • Preconception

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    Karsten, M. D. A., van Oers, A. M., Groen, H., Mutsaerts, M. A. Q., van Poppel, M. N. M., Geelen, A., van de Beek, C., Painter, R. C., Mol, B. W. J., Roseboom, T. J., Hoek, A., Burggraaff, J. M., Kuchenbecker, W. K. H., Perquin, D. A. M., Koks, C. A. M., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J. E., ... de Bruin, J. P. (2019). Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility. European Journal of Nutrition, 58(6), 2463-2475. https://doi.org/10.1007/s00394-018-1798-7