Comparison of Self‐Reported Weight Status Among Followers of Popular Diets: Data from the ADAPT (Adhering to Dietary Approaches for Personal Taste) Feasibility Survey
Authors: Karlsen Micaela C , Lichtenstein Alice H , Economos Christina D , Folta Sara C , Rogers Gail , Jacques Paul F , Livingston Kara A , McKeown Nicola M 
Published: June 2021

Background

Public interest in nutrition is at the forefront of health and wellness and a major driver of popular diet adoption. Cohort studies lack specific data from followers of popular diets. Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey (FS) assessed the practicality of using web‐based survey methods to capture demographic data and self‐reported body weight from individuals following a range of dietary patterns with wide variation in macronutrient intake.

Objective

To collect preliminary descriptive data on followers of a broad range of popular diets.

Methods

A web‐based FS was conducted in summer 2015, using a convenience sample of self‐identified popular diet followers. Self‐reported data were collected on demographics, height, weight, current and past diets followed, medical history, and physical activity (PA).

Results

A total of 9,536 individuals provided completed responses to demographic questions. Of these, 83% were female, 93% white, 96% non‐Hispanic, and 84% took the survey from within the US. Age distribution was 18–34yrs (22%), 35–54yrs (46%), and ≥55yrs (33%). Current reported diets were collapsed for analysis as follows based on frequency: whole food plant‐based (n=2344; 25%); vegan & raw vegan (n=1763; 19%); Paleo (n=1326; 14%); try to eat healthy (n=1048; 11%); vegetarian & pescatarian (n=883; 9%); whole food (n=754; 8%); Weston A. Price (n=493; 5%); and low‐carb (n=408; 4%). The majority of subjects (98%) reported moderate or high levels of physical activity. A total of 85% took supplements; most commonly single‐nutrients (68%), multi‐nutrients (41%), omega‐3s (33%), and protein supplements (26%). The majority of subjects (76%) reported following their current diet for 1+ yrs; 63% reported following a different diet in the past. Among followers of 1+ yrs, geometric mean BMI of the following diet patterns was significantly lower compared to “try to eat healthy” (geometric mean BMI=29.9 kg/m2; SD=1.2), after adjusting for age, sex, and completion of the survey in the US: whole food 24.6 kg/m2; vegetarian & pescatarian 25.0 kg/m2; vegan & raw vegan 23.3 kg/m2; whole food, plant‐based 23.4 kg/m2; Paleo 24.6 kg/m2; Weston A. Price 23.5 kg/m2. Most common medical conditions reported were overweight/obesity (n=1893), high cholesterol (n=1615), gastrointestinal (n=1092), and high blood pressure (n=991). Many respondents with these diagnoses cited them as a reason for their current diet: overweight/obesity (59%), high cholesterol (50%), gastrointestinal (54%), and high blood pressure (42%).

Conclusion

Data from this FS suggest that BMI is lower among those who made active decisions to adhere to a specific diet compared to those who simply “try to eat healthy.” Data also suggest the decision to follow a specific diet may be linked with diagnosis of a medical condition(s). Future research should prospectively examine the impact of diet choice on BMI and factors that predict successful adherence. Results from the FS will inform future recruitment methods in building a nationally representative, prospective cohort of popular diet followers.

Support or Funding Information

Supported by USDA ARS agreement No. 58‐1950‐7‐707