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).
Bibliographical noteFunding The LIFEstyle study was supported by a grant from ZonMw
(Prevention program—Health Care Efficiency Research; Project number 50-50110-96-518). This work was funded by the Dutch Heart
Foundation (2013T085) and the European Commission (Horizon2020
project 633595 DynaHealth). Neither ZonMw nor the Dutch Heart
Foundation nor the European Commission had a role in data collection,
analysis, interpretation of data, or writing the report.
cknowledgements We would like to thank the women who participated in this study. We thank all participating hospitals and their
staff for their contribution to this study, and the LIFEstyle coaches
and research nurses, research midwives, and office members of the
Dutch Consortium 2.0 (http://www.studies-obsgyn.nl) for their hard
work and dedication. We would like to acknowledge Mrs. A. Bolster
(University Medical Center Groningen) as senior trainer of the intervention coaches
- Lifestyle intervention