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Randomized Controlled Trial
. 2019 Sep;58(6):2463-2475.
doi: 10.1007/s00394-018-1798-7. Epub 2018 Aug 3.

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

Matty D A Karsten  1   2   3 , Anne M van Oers  4   5 , Henk Groen  6 , Meike A Q Mutsaerts  4 , Mireille N M van Poppel  7   8 , Anouk Geelen  9 , Cornelieke van de Beek  10 , Rebecca C Painter  10 , Ben W J Mol  10   11 , Tessa J Roseboom  10   12 , Annemieke Hoek  4 ; LIFEstyle study group
Collaborators, Affiliations
Randomized Controlled Trial

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

Matty D A Karsten et al. Eur J Nutr. 2019 Sep.

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.

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Conflict of interest statement

The department of obstetrics and gynecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands. AvO declares a reimbursement for travel expenses from Ferring BV, outside the submitted work. BWJM is a consultant for ObsEva, Geneva. AH received grants from MSD, pharmaceutical company, grants from Ferring BV, pharmaceutical company, outside the submitted work. The remaining authors have nothing to disclose.

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