Adherence and compliance rates across post-dieting strategies: a preliminary analysis

Background There are a variety of post-diet strategies implemented to limit fat regain and maintain fat-free mass. This study investigated the adherence and attrition rates across three different post-diet strategies: a reverse diet (REV), an immediate return to maintenance (NIH), or an ad-libitum a...

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Main Authors: Valentina Rodriguez Da Silva, John Holtje, Ashlyn Bratton, Jakob Paz, Zia Rahaman, Eric T. Trexler, Vladyslava Martynovska, Sara Hobbes, Cassandra Resler, Sydney Monahan, Valeria V. Silva Ramirez, Bill I. Campbell
Format: Article
Language:English
Published: Taylor & Francis Group 2025-09-01
Series:Journal of the International Society of Sports Nutrition
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Online Access:https://www.tandfonline.com/doi/10.1080/15502783.2025.2550186
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Summary:Background There are a variety of post-diet strategies implemented to limit fat regain and maintain fat-free mass. This study investigated the adherence and attrition rates across three different post-diet strategies: a reverse diet (REV), an immediate return to maintenance (NIH), or an ad-libitum approach (CON).Methods Resistance-trained subjects [75 total, 10 (13.3%) males, 65 (86.7%) females; 36.5 ± 6 years; 71.1 ± 13.9 kgs] underwent a 30% caloric deficit from a pre-determined maintenance. After achieving 5% bodyweight loss, subjects initiated their randomized post-diet strategy, which they followed for 15 weeks. The REV group underwent a gradual weekly caloric increase from the deficit (8.5% for males and 11.7% for females). The NIH group returned immediately to a newly calculated maintenance utilizing the NIH Bodyweight Planner. The CON group followed an ad-libitum diet. A chi-square test was used to compare the proportion of withdrawals among groups.Results Seventy-five participants entered the post-diet phase and either withdrew or completed their assigned phase. Average prescribed calories differed significantly between REV and NIH (REV = 2423, NIH = 2179, p = 0.03367). Both groups under-consumed their prescribed calories by 259 and 177 calories, respectively, with no significant difference between groups (p = 0.2686). REV had a withdrawal rate of 45.2%, NIH of 30.4%, and CON of 23.8% with no significant differences between groups (p = 0.2488).Conclusion It is believed that having a prescribed post-diet strategy may improve adherence and/or compliance in the post-diet period, but the present data challenges this assumption. Although caloric intake differed between REV and NIH by the end of the study, both groups under-consumed their prescribed intake, suggesting similar difficulties with adherence. Additionally, subject withdrawals were categorized into five categories: health-related causes, inability to follow study requirements, loss of contact with subject, personal reasons, and self-withdrawal. Given that there were no significant differences in withdrawal rates between the three groups, specific post-dieting strategies may not be directly predictive of compliance and, rather, other external variables may play a bigger role in determining post-dieting success. Further research may be needed to determine what these variables are, and whether there are additional benefits or detriments to these post-dieting strategies beyond adherence and compliance.
ISSN:1550-2783