Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and MenAbstractBackground---Specific dietary and other lifestyle behaviorsmay 1 (affect) the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain.Methods---We 2 (perform) prospective investigations involving three separate cohorts that 3 (include) 120.877 US women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003,and 1986 to 2006. The relationships between changes in lifestyle factors and weightchange 4 (be evaluate) at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis.Results---Within each 4-year period, participants 5 (gain) an average of 3.35 Ib (5th to 95th percentile,-4.1 to 12.4). On the basis of increased daily servings of individual dietary components,4-year weight change was most strongly associated with the intake of potato chips (1.69 Ib), potatoes(1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats(0.95 lb), and processed meats (0.93 Ib) and was inversely associated with the intake of vegetables (-0.22lb),whole grains (-0.37 lb), fruit"(-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (p≤0.005 for each comparison). Aggregate dietary changes 6 (be associate) with substantial differences in weight change (3.93lb across quintiles of dietary change). Other lifestyle factors 7 (be) also independently associated with weight change (p<0.001), including physical activity (-1.76lb across quintiles); alcohol use (0.4lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).Conclusions---Specific dietary and lifestyle factors 8 (be) independently associated with longterm weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity.(Funded by the National Institutes of Health and others)