Dietary Satisfaction and its Association with Weight Loss: An Exploratory Analysis
Open Access
- Author:
- Wheeler, Brooke Elaine
- Graduate Program:
- Nutrition
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- June 04, 2013
- Committee Members:
- Sharon M Nickols Richardson, Thesis Advisor/Co-Advisor
- Keywords:
- Diet
Satisfaction
Dietary Satisfaction Questionnaire
Adherence
Weight-Loss - Abstract:
- Weight loss and weight-loss maintenance are undertakings that require physical and mental stamina. Short-term weight loss success has been observed among diverse populations and within a variety of interventions; however, long-term weight-loss maintenance has not been widely evident, likely due to minimal continued adherence and satisfaction with the prescribed intervention. In an attempt to improve long-term adherence to weight-loss interventions, it is critical to realize the facilitators and barriers that may prevent or promote an individual’s compliance. A review of literature was conducted to establish the influences related to satisfaction or adherence to a diet or dietary intervention. The most prominent influences included time, cost, motivation, self-control, family and friend support, like/dislike of foods, and availability or accessibility of foods. From this review, it was established that dietary satisfaction can be defined, at least partially, through the facilitators and barriers to adherence. A 45-item dietary satisfaction questionnaire (D-SAT) was created in 2004 that was consistent with the factors revealed through the aforementioned literature search. The D-SAT was completed in two weight-loss interventions in premenopausal women aged 20-45y with overweight or obesity (n=180; mean ± SD age=34.5 ± 6.9 y; BMI=30.3 ± 3.6 kg/m2). There were no differences between baseline D-SAT scores, thus the results were combined for analysis. A secondary data analysis was completed to evaluate the internal validity of the D-SAT through exploratory factor analysis of the baseline D-SAT scores. This analysis resulted in two versions of the D-SAT suggesting 6-factors (36 items) and 7-factors (38 items). The constructs were labeled: “Benefits of diet, “Preoccupation with diet,” “Eating away from home,” “Diet planning,” “Family impact,” and “Financial cost,” (6-factor D-SAT) and “Personal cost” (7-factor D-SAT). The 6-factor D-SAT and the 7-factor D-SAT were employed in a subsequent secondary analysis to explore the relationship between a prompt change in D-SAT score from baseline to week 2 (jumpstart phase of the intervention) and weight outcomes (body weight [BW] and body mass index [BMI]) during a 12 week intervention phase and 12 week weight-maintenance phase of a study in premenopausal women aged 20-45y that were overweight/obese. Sixty-eight women were included in the analysis whose D-SAT change scores from baseline to week 2 were stratified into 3 groups based on a decrease in score (negative group), no change (neutral group), and increase in score (positive group). A repeated measures ANOVA (4Time x 3Group) and Pearson’s correlation were explored using the 3 groups. Results of the 6-factor D-SAT showed a significant main effect of time on BW [F (1.262, 82.02) = 125.722, p<0.001] and BMI [F (1.305, 123.95) =127.808, p<0.001]. A significant main effect of D-SAT group and time x D-SAT group interaction were not found for BW or BMI. The 7-factor D-SAT results also revealed a significant main effect of time on BW [F (1.243, 82.82) =124.949, p<0.001] and BMI [F (1.284, 83.43) = 127.463, p<0.001]; however, there was not a significant main effect of D-SAT group or time x D-SAT group for BW or BMI. Further, there was not a significant bivariate correlation between D-SAT group and BW and BMI change over the 24-week intervention for the 6-factor D-SAT or the 7-factor D-SAT. Due to the risks associated with overweight and obesity, it is critical to address the factors that influence satisfaction with a diet or dietary intervention, in order to personalize a regimen to the point of satisfaction, adherence, and subsequent improvement in weight, and long-term weight-loss maintenance. Continued analysis of the D-SAT in various populations and interventions is important for refining the questionnaire to confirm that satisfaction is addressed in its entirety and establish its use as a tool for gauging dietary satisfaction and maximizing weight-loss.