Objective: This study’s purpose was to examine dietary quality, macronutrient intake, and micronutrient adequacy among long term weight loss maintainers (WLM) in a commercial weight management program. Methods: Participants were 1,207 WLM in WW (formerly Weight Watchers) who had maintained a 9.1 kg or greater weight loss (29.7 kg on average) for 3.4 years, and had an average BMI of 28.3 kg/m2. A control group of weight stable adults with obesity (Controls; N=102) had a BMI of 41.1 kg/m2 and 2.3 kg or less weight change over the previous five years. Results: WLM vs. Controls had a 10.1 point higher HEI-2015 score (70.2 [69.7 - 70.7] vs 60.1 [58.4 - 61.8], respectively; p=0.0001) in analyses that adjusted for group difference in demographic factors. WLM versus Controls had a significantly higher average percentage of calories from carbohydrates (50.3% [49.7 - 50.8] vs 46.7% [44.8 - 48.7], respectively; p=0.0001) and protein (18.2% [18.0-18.5] vs 15.9% [15.1-16.6], respectively; p=0.0001) and lower percentage of calories from fat (32.3% [31.9-32.8] vs 37.4% [35.8-38.9], respectively; p=0.0001). Examining micronutrients, WLM had significantly higher odds for meeting the EAR for copper (OR=5.8 [2.6-13.1]; p=0.0001), magnesium (OR=2.9 [1.8-4.7]; p=0.0001), potassium (OR=4.7 [1.4-16.5]; p=0.015), vitamin A (OR=2.8 [1.7-4.8]; p=0.0001), thiamin (OR=2.3 [1.3-4.1]; p=0.003), riboflavin (OR=6.5 [2.2-19.3]; p=0.001), vitamin B6 (OR=2.91 [1.6-5.2]; p=0.0001), vitamin C (OR=5.0 [2.8-8.8]; p=0.0001), folate (OR=2.2 [1.3-3.7]; p=0.003), and vitamin E (OR=1.8 [1.1-2.8]; p=0.014) and didn’t differ in calcium (OR=1.15 [0.7-1.7]; p=0.823), iron (OR=1.9 [0.8-4.6]; p=0.151), phosphorus (OR=2.0 [0.9-4.5]; p=0.101), selenium (OR=1.6 [0.6-3.8]; p=0.332), zinc (OR=1.7 [0.9-3.0]; p=0.095), niacin (B3) (OR=1.9 [0.8-4.1]; p=0.136), vitamin B12 (OR=1.2 [0.5-2.8]; p=0.625), and vitamin D (OR=1.5 [0.9-2.4]; p=0.09). Conclusions In a widely available commercial program, WLM consumed a healthier and more micronutrient rich diet than adults who were weight stable with obesity. Future research is needed to examine whether improved micronutrient status among WLM reduces risk of chronic disease.

Osteoporosis, a major public health problem, likely has its origins in childhood. During periods of rapid skeletal growth, diet may influence accrual of bone mineral density (BMD) and adult bone health. This study used novel approaches in bone imaging to further characterize optimal skeletal development and enhance our understanding of key dietary components that influence attainment of peak bone mass (PBM) and contribute to determinants of peak bone strength in peri-pubertal females. The use of a validated food-frequency questionnaire (FFQ) enabled the influence of usual dietary intake on bone parameters to be examined.This study examined the relationship of dietary intake of micronutrients and bone macro-architectural structure in peri-pubertal girls. This study suggested that vitamin C and zinc intake are associated with objective measures of bone status in 4th, but not 6th grade girls. This indicates potential differences in micronutrient and bone associations at various age-associated stages of bone maturation.The impact of dietary fat on peri-pubertal skeletal growth is not well characterized. This study examined relationships of select dietary fatty acid (FA) intakes and measures of bone status in peri-pubertal girls. This study suggested that MUFA, total PUFA, n-6 and linoleic acid (LA) are inversely associated with bone status prior to menarche, but composition of dietary fat may be more important during the early-pubertal years. Decreased intakes of n-6 PUFA may benefit bone health in young girls.The impact of a dietary protein on volumetric bone mineral density (vBMD), bone mineral content (BMC) and bone strength throughout maturation remains controversial. Given evidence of both anabolic and catabolic affects of protein on bone health, this study examined relations of dietary protein from different sources with bone parameters in peri-pubertal girls. This study showed that dietary protein intake is related to higher trabecular but not cortical vBMD, BMC and BSI, and accounts for 2-4% of their variability in peri-pubertal girls. The relationship seems to vary by the source of dietary protein and calcium intake. However, a negative impact of animal protein on bone health is not supported. Large scale observational and intervention studies are needed to establish causality.