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; LIFEstyle study group

doi:10.1007/s00394-018-1798-7

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

Eur J Nutr. 2019 Sep;58(6):2463-2475. doi: 10.1007/s00394-018-1798-7. Epub 2018 Aug 3.

Authors

Matty D A Karsten^{1

2

3}, Anne M van Oers^{4

5}, Henk Groen⁶, Meike A Q Mutsaerts⁴, Mireille N M van Poppel^{7

8}, Anouk Geelen⁹, Cornelieke van de Beek¹⁰, Rebecca C Painter¹⁰, Ben W J Mol^{10

11}, Tessa J Roseboom^{10

12}, Annemieke Hoek⁴; LIFEstyle study group

Collaborators

LIFEstyle study group:
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 Broekmans, N 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

Affiliations

¹ Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. m.d.a.karsten@umcg.nl.
² Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.d.a.karsten@umcg.nl.
³ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.d.a.karsten@umcg.nl.
⁴ Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
⁵ Department of Obstetrics and Gynecology, Medisch Spectrum Twente, Koningsplein 1, 7512 KZ, Enschede, The Netherlands.
⁶ Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
⁷ Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
⁸ Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.
⁹ Division of Human Nutrition, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
¹⁰ Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
¹¹ Department of Obstetrics and Gynecology, School of Medicine, Monash University, Clayton Road, Melbourne, Australia.
¹² Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

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 ).

Keywords: Determinants; Lifestyle intervention; Obesity; Preconception.

Publication types

Multicenter Study
Randomized Controlled Trial

MeSH terms

Adolescent
Adult
Counseling / methods
Exercise
Feeding Behavior / psychology
Female
Health Behavior*
Health Promotion / methods*
Humans
Infertility / psychology
Infertility / therapy*
Life Style*
Male
Obesity / psychology
Obesity / therapy*
Program Evaluation / methods*
Weight Loss
Weight Reduction Programs / methods
Young Adult

Associated data

NTR/NTR 1530

Abstract

Publication types

MeSH terms

Associated data

Grants and funding