Participant characteristics and self-reported weight status in a cross-sectional pilot survey of self-identified followers of popular diets: Adhering to dietary approaches for personal taste (ADAPT) feasibility survey

Authors: KARLSEN, MICAELA - University Of New England; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ECONOMOS, CHRISTINA - Tufts University; FOLTA, SARA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; CHANG, REMCO - Tufts University; ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LIVINGSTON, KARA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MCKEOWN, NICOLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/6/2020
Publication Date: 7/27/2020
Citation: Karlsen, M.C., Lichtenstein, A.H., Economos, C., Folta, S., Chang, R., Rogers, G., Jacques, P.F., Livingston, K., McKeown, N.M. 2020. Participant characteristics and self-reported weight status in a cross-sectional pilot survey of self-identified followers of popular diets: Adhering to dietary approaches for personal taste (ADAPT) feasibility survey. Public Health Nutrition. 23(15):2717-2727. https://doi.org/10.1017/S1368980020001330.
DOI: https://doi.org/10.1017/S1368980020001330

Interpretive Summary: The typical American diet is associated with high prevalence of overweight and obesity. In contrast, a variety of alternative eating patterns, such as plant-based, Mediterranean, and Paleo patterns, are linked to weight loss and better cardiometabolic outcomes. Our study analyzed data on over 9,000 popular diet followers, and results suggest that BMI is lower among individuals who made active decisions to adhere to a specific diet, particularly more plant-based diets and/or diets limiting highly processed foods, compared with those who simply "try to eat healthy" but do not report adhering to a defined dietary pattern. Such data are relevant for dietitians and other health professionals who may encounter patients following popular, alternative diets, and they should be prepared to engage in evidence-based discussion with respect to these healthier eating patterns.

Technical Abstract: Objective: To describe characteristics of self-identified popular diet followers and compare mean BMI across these diets, stratified by time following diet. Design: Cross-sectional, web-based survey administered in 2015. Setting: Non-localised, international survey. Participants: Self-selected followers of popular diets (n 9019) were recruited to the survey via social media and email nnouncements by diet community leaders, categorised into eight major diet groups. Results: General linear models were used to compare mean BMI among (1) short-term (<1 year) and long-term (>=1 year) followers within diet groups and (2) those identifying as 'try to eat healthy' (TTEH) to all other diet groups, stratified by time following the specific diet. Participants were 82 % female, 93 % White and 96 % non-Hispanic. Geometric mean BMI was lower (P < 0.05 for all) among longer-term followers (>=1 year) of whole food, plant-based (WFPB), vegan, whole food and low-carb diets compared with shorter-term followers. Among those following their diet for 1-5 years (n 4067), geometric mean BMI (kg/m2)were lower (P < 0.05 for all) for all groups compared with TTEH (26.4 kg/m2): WFPB (23.2 kg/m2), vegan (23.5 kg/m2), Paleo (24.6 kg/m2), vegetarian (25.0 kg/m2), whole food (24.6 kg/m2), Weston A. Price (23.5 kg/m2) and low-carb (24.7 kg/m2). Conclusion: Our findings suggest that BMI is lower among individuals who made active decisions to adhere to a specific diet, particularly more plant-based diets and/or diets limiting highly processed foods, compared with those who simply TTEH. BMI is also lower among individuals who follow intentional eating plans for longer time periods.