| dc.description.abstract | Obesity is a public health issue in the United States that impacts men and women of all socioeconomic levels. Obesity is categorized by a body mass index (BMI) of greater than 30 kg/m2. In the United States, 33.7% of men and 36.5% of women are currently classified as obese. A population of increasing concern related to obesity is women of low-income. Presently, 42% of women below 130% of the poverty level are obese, compared to 29% of women above 350% of the poverty level. This ever-increasing gap in obesity prevalence places low-income women at a higher risk for developing chronic diseases in comparison to men and women of higher socioeconomic status. Previous research has drawn attention to the need for interventions aimed toward low-income, overweight and obese women to focus on barriers to food security such as savvy shopping and managing food dollars to make changes in overall diet quality, fruit and vegetable consumption, and to combat obesity. The focus of this thesis is to explore changes in diet quality, meal patterns, and fruit and vegetable consumption in a weight loss intervention customized for low-income, overweight or obese women. This study is a secondary analysis of the $ensible Weigh pilot study at the University of Kansas Medical Center. The study consisted of 3 months of weight loss sessions, followed by 6 months of weight maintenance sessions. These sessions were a modification of the Diabetes Prevention Program, in which some participants received education on barriers to food security such as food dollar budgeting, community resources, meal planning, and basic culinary skills. At baseline, 3 months, and 9 months, sociodemographic information and three 24-hour dietary recalls were collected. Twenty-four hour dietary recalls were entered into NDSR 2014. Diet quality was measured using Healthy Eating Index 2010 (HEI-2010) scores, which were calculated using outputs from NDSR. NDSR outputs were also used to answer questions related to meal and snack consumption as well as fruit and vegetable intake. Results showed that diet quality from baseline to the end of the weight loss period (47.3 to 57.6, p=0.0477) statistically increased, but not during the weight maintenance period (57.6 to 53.4, p=0.3849). Percent of total calories from meals showed no significant changes across the course of the intervention (p=0.9478 from baseline to 3 months, p=0.9903 from 3 months to 9 months, and p=0.9237 from baseline to 9 months). No statistically significant changes were seen in consumption of total fruits (p = 0.072 from baseline to 3 months, p=0.829 from 3 months to 9 months, and p=0.893 from baseline to 9 months), total vegetables (p=0.355 from baseline to 3 months, p=0.515 from 3 months to 9 months, and p=0.811 from baseline to 9 months), or non-starchy vegetables (p=0.353 from baseline to 3 months, p=0.082 from 3 months to 9 months, and p=0.829 from baseline to 9 months). These results show promise that focusing on interventions tailored to one’s socioeconomic status have potential to positively impact diet quality in low-income women who are overweight or obese. | |
