Trial reportThe journal of nutrition, health & aging2025
Sex moderates diet quality differences in integrated collaborative care for comorbid obesity and depression: Post-hoc analysis of the RAINBOW RCT.
Trial report in The journal of nutrition, health & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02246413 (RCT on Co-management of Obesity, Depression, and Elevated CVD Risk in Primary Care-- Engaging Self-regulation Targets to Understand the Mechanisms of Behavior Change and Improve Mood and Weight Outcomes), which is not on this map. Not yet cited in PubMed.
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RCT on Co-management of Obesity, Depression, and Elevated CVD Risk in Primary Care-- Engaging Self-regulation Targets to Understand the Mechanisms of Behavior Change and Improve Mood and Weight Outcomes
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo investigate (1) whether an evidence-based behavioral weight loss intervention was associated with improved diet quality in adults with obesity and depression compared with usual care; and (2) whether the associations were modified by sex.
designIn the RAINBOW RCT, 409 participants were randomized in 1:1 ratio to receive a 12-month intervention integrating a Diabetes Prevention Program-based behavioral weight loss treatment with problem-solving therapy for depression (n = 204) or usual care (n = 205). Participants completed 24-h dietary recalls at baseline, 6, 12, 18, and 24 months. Dietary outcomes included the DASH score as the composite measure of diet quality and its components. Between-group differences in dietary outcomes were examined among all participants and by sex, using repeated-measures mixed-effects linear models.
resultsIntervention group had mean age 50.9 (SD 12.2) years and 71% women, while control had 51.0 (11.9) years and 70% women. Changes in DASH scores did not differ between the intervention and usual care control groups through 24 months in both females and males. Compared with controls, males in the intervention group had decreased nut, seed, and legume intake at 6 (mean difference, -1.1; 95% CI, -1.9, -0.3 servings/day; P = 0.01; P
conclusionDiet quality not only did not improve in an effective behavioral weight loss intervention but deteriorated in females, in particular. These post-hoc findings warrant confirmation and may suggest sex-tailored behavior change techniques specifically targeting diet quality are needed in behavioral weight loss interventions aside from caloric reductions.
trial registrationClinicalTrials.gov#NCT02246413 (https://clinicaltrials.gov/ct2/show/NCT02246413).
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