Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention
<b>Objective:</b> Stress, sleep, eating behavior and physical activity are associated with weight change and insulin resistance. The aim of the analysis was the assessment of the overall and sex specific association of psychobehavioral variables throughout the 3-y PREVIEW intervention using the Homeostatic Model Assessment of Insulin resistance (HOMA-IR), BMI, and length of time in the study.<b></b> <p><b>Methods</b>: Associations of psychobehavioral variables, including stress, mood, eating behavior physical activity (PA), and sleep with BMI, HOMA-IR and time spent in study were assessed in 2184 participants with pre-diabetes and overweight/ obesity (n=706 men; n=1478 women) during a 3-year lifestyle intervention utilizing linear mixed modelling and general linear modelling.The study was a randomized multicenter trial using a 2x2 diet-by- PA design.</p> <p><b>Results: </b>Overall,<b> </b>cognitive restraint and PA increased during the intervention compared to baseline, while BMI, HOMA-IR, disinhibition, hunger and sleepiness decreased (all p<0.05). Cognitive restraint and PA were negatively, while disinhibition, hunger, stress, total mood-disturbance were positively associated with both BMI and HOMA-IR. Sleep-duration, low sleep quality, total mood-disturbance, disinhibition and hunger scores were positively associated with HOMA-IR for men only. Drop-outs at 6 months had higher stress and total mood-disturbance scores at baseline and throughout their time spent in the study compared to study completers.</p> <p><b>Conclusion: </b>Eating behavior and PA, control of<b> </b>stress, mood-disturbance and sleep characteristics were associated with BMI, HOMA-IR and time spent in study with different effects in men and women during the PREVIEW-lifestyle intervention-study.<b> </b></p>