Abstract TU168: Diet Quality: Magnitude and Predictors of Change in Response to a Six-Month Physical Activity Intervention

Abstract

Introduction: Engaging in health promoting behaviors such as physical activity (PA) may elicit improvements in other healthy behaviors, such as improved dietary choices. Hypothesis: Participants enrolled in a PA intervention group will demonstrate greater improvements in DQ compared to control. Methods: This analysis examined changes in diet quality (DQ) using the Mediterranean Eating Patterns for Americans (MEPA) questionnaire and assessed whether baseline characteristics predicted DQ change. Participants were enrolled in the Active You study, a 6-month weight agnostic RCT that examined the feasibility of using curated exercise videos to promote PA in adults with obesity and self-reported non-adherence to national PA guidelines. Participants were randomized to one of two groups: attention control (AC) or PA for the heart (PATH) intervention. AC group participants received a booklet that provided strategies to integrate PA into daily life and met biweekly with a study coordinator. PATH group participants had access to the PATH platform and met biweekly with an exercise coach for a supervised activity session. All participants received a fitness tracker, digital scale, blood pressure monitor, and a bimonthly newsletter focusing on ways to improve DQ. We calculated change in MEPA score from baseline to 6-months and explored baseline measures and sociodemographic characteristics as predictors of MEPA change using multiple linear regression analysis. Intention-to-treat analysis used multiple imputations for participants with missing 6-month MEPA scores. Results: The sample (N=89) was 46% white, 91% female with a mean age of 48.7±12.2 years and mean baseline BMI of 39.7±6.8 kg/m 2 (AC) and 41.0±7.6 kg/m 2 (PATH). At baseline, there were no significant group differences in sociodemographic or key measurements. At study end, MEPA score significantly increased only in the PATH group (p <0.001) while self-reported PA significantly increased in both groups. Regression analysis revealed higher baseline BMI was modestly associated with MEPA improvement (β = 0.08, p < 0.05). When treatment and baseline MEPA were added to the model, only baseline MEPA score predicted of DQ change (β = –0.34, p < 0.05). Conclusions: Though all participants received bimonthly diet quality newsletters, only those in the PATH intervention group improved their DQ score. Future studies need to examine if the changes in DQ are sustained over time and explore other factors that may influence DQ.