1. ^*Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany;
2. ^†Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
3. ^¶Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
4. ^‡Department of Nutrition, Simmons College, Boston, Massachusetts
5. ^§Division of Preventive Medicine, Boston, Massachusetts
6. ^**Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts

Correspondence: Matthias B. Schulze German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany. E-mail: mschulze@mail.dife.de

^*The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 31 October 2005; Accepted 5 June 2006.

Abstract

Objective: Our objective was to examine the association between adherence to dietary patterns and weight change in women.

Research Methods and Procedures: Women (51,670, 26 to 46 years old) in the Nurses' Health Study II were followed from 1991 to 1999. Dietary intake and body weight were ascertained in 1991, 1995, and 1999. A Western pattern, characterized by high intakes of red and processed meats, refined grains, sweets and desserts, and potatoes, and a prudent pattern, characterized by high intakes of fruits, vegetables, whole grains, fish, poultry, and salad dressing, were identified with principal component analysis, and associations between patterns and change in body weight were estimated.

Results: Women who increased their Western pattern score had greater weight gain (multivariate adjusted means, 4.55 kg for 1991 to 1995 and 2.86 kg for 1995 to 1999) than women who decreased their Western pattern score (2.70 and 1.37 kg for the two time periods), adjusting for baseline lifestyle and dietary confounders and changes in confounders over time (p < 0.001 for both time periods). Furthermore, among women who increased their prudent pattern score, weight gain was smaller (multivariate-adjusted means, 1.93 kg for 1991 to 1995 and 0.66 kg for 1995 to 1999) than among women who decreased their prudent pattern score (4.83 and 3.35 kg for the two time periods) (p < 0.001). The largest weight gain between 1991 and 1995 and between 1995 and 1999 was observed among women who decreased their prudent pattern score while increasing their Western pattern score (multivariate adjusted means, 6.80 and 4.99 kg), whereas it was smallest for the opposite change in patterns (0.87 and - 0.64 kg) (p < 0.001).

Discussion: Adoption of a Western dietary pattern is associated with larger weight gain in women, whereas a prudent dietary pattern may facilitate weight maintenance.