Weight Loss Maintainers Sustain High Diet Quality in Diverse Residential Retail Food Environments

Sasha Clynes; Alyssa Moran; Michelle Cardel; Gary Foster; Suzanne Phelan

doi:10.1016/j.jand.2024.03.012

Weight Loss Maintainers Sustain High Diet Quality in Diverse Residential Retail Food Environments

J Acad Nutr Diet. 2024 Mar 29:S2212-2672(24)00145-X. doi: 10.1016/j.jand.2024.03.012. Online ahead of print.

Authors

Sasha Clynes¹, Alyssa Moran², Michelle Cardel³, Gary Foster⁴, Suzanne Phelan⁵

Affiliations

¹ Department of Health Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: sclynes1@jh.edu.
² Department of Health Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
³ WeightWatchers, New York, New York; Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida.
⁴ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
⁵ Departments of Kinesiology and Public Health and Center for Health Research, California Polytechnic State University, San Luis Obispo, California.

PMID: 38556111
DOI: 10.1016/j.jand.2024.03.012

Abstract

Background: The relationship between the retail food environment and diet quality has received minimal investigation among weight loss maintainers.

Objective: The aim of this study was to investigate the association between the residential retail food environment and diet quality in weight loss maintainers from WeightWatchers in the United States.

Design: Cross-sectional data were collected between January 2018 and February 2020. The Retail Food Environment Index (RFEI), based on geocoded home addresses, classified the environment as follows: RFEI <1.6 = healthiest; RFEI 1.6 to <2.5 = moderately healthy; RFEI 2.5 to <4.0 = moderately unhealthy; RFEI ≥4.0 = least healthy. Dietary data were obtained using a food frequency questionnaire.

Participants/setting: Adult participants (n = 1,159) who had lost weight using WeightWatchers and maintained ≥9.1-kg weight loss for ≥1 year (mean 24.7-kg loss for 3.4 years).

Main outcome measures: Healthy Eating Index 2015 (HEI-2015) component and total scores (0-100; higher scores indicate better alignment with the 2015-2020 Dietary Guidelines for Americans).

Statistical analyses performed: Regression models included RFEI category, the independent variable, and HEI-2015 and component scores (outcomes) controlling for age, sex, race and ethnicity, educational attainment, and household income.

Results: Compared with individuals living in the healthiest food environments (mean HEI-2015 score = 71.5) those in the unhealthiest environments had a mean HEI-2015 score of 70.1 (95% CI 68.8 to 71.3), those in moderately unhealthy environments had a score of 71.3 (95% CI 70.3 to 73.1) and those in moderately healthy environments had a score of 70.3 (95% CI 68.9 to 71.2), indicating a nonlinear relationship. Compared with those in the healthiest environments, those in the least healthy environments had an approximately 0.47 lower added sugar HEI-2015 component score (95% CI -0.86 to -0.08), indicating approximately 5% higher added sugar intake.

Conclusions: Weight loss maintainers maintained high diet quality in diverse retail food environments. Compared with those in the healthiest food environments, those in the least healthy had a higher consumption of added sugars.

Keywords: Commercial weight loss program; Diet quality; Food stores; Retail food environment; Weight maintenance.