Role of Eating Behavior and Stress in Maintenance of Dietary Changes During the PREVIEW Intervention

Elli Jalo, Mikael Fogelholm, Margriet Westerterp-Plantenga, Tanja C. Adam, Mathijs Drummen, Maija Huttunen-Lenz, Louise Kjølbæk, José Alfredo Martinez, Teodora Handjieva-Darlenska, Moira A. Taylor, Jennie Brand-Miller, Sally Poppitt, Gareth Stratton, Tony Lam, Santiago Navas-Carretero, Georgi Bogdanov, Liz Simpson, Roslyn Muirhead, Marta P. Silvestre, Nils SwindellAnne Raben, Hanna Konttinen

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Objective: To examine whether eating behavior and perceived stress predict the maintenance of self-reported dietary change and adherence to dietary instructions during an intervention. Design: A secondary analysis of the behavior maintenance stage (6–36 months) of the 3-year PREVIEW intervention (PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World). Participants: Adults (n = 1,311) with overweight and prediabetes at preintervention baseline. Variables Measured: Eating behavior (Three-Factor Eating Questionnaire), stress (Perceived Stress Scale), and dietary intake (4-day food records on 4 occasions) were reported. Analysis: Associations between predictors and dietary outcomes were examined with linear mixed-effects models for repeated measurements. Results: Eating behaviors and stress at 6 months did not predict the subsequent change in dietary outcomes, but higher cognitive restraint predicted lower energy intake, and both higher disinhibition and hunger predicted higher energy intake during the following behavior maintenance stage. In addition, higher disinhibition predicted higher saturated fat intake and lower fiber intake, and higher hunger predicted lower fiber intake. Stress was not associated with energy intake or dietary quality. Eating behaviors and stress were not consistently associated with adherence to dietary instructions. Conclusions and Implications: Higher cognitive restraint predicted lower energy intake (food quantity), but disinhibition and hunger were also associated with dietary quality.

Original languageEnglish
JournalJournal of Nutrition Education and Behavior
Publication statusE-pub ahead of print - 2024


  • behavior change
  • behavior maintenance
  • Eating Inventory
  • eating style
  • food consumption


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