Eating Behavior Traits and Success in Dietary Changes in Men with Prediabetes - the T2D-GENE Intervention

Sustained dietary change is essential for type 2 diabetes prevention, yet most Finnish men do not follow dietary recommendations. Eating behavior traits such as cognitive restraint, uncontrolled eating, and emotional eating may influence dietary success; however, their role in long-term adherence remains unclear. Moreover, men are underrepresented in eating behavior research. This study investigated whether baseline eating behavior traits predicted dietary goal achievement and changes in food intake during a 3-year lifestyle intervention among 370 older (50-75 years) men with prediabetes. The intervention promoted increased intake of vegetables, fruit, fiber, and unsaturated fats, while reducing saturated fat and sucrose. Diet was assessed with 4-day food records and eating behavior traits with the Three-Factor Eating Questionnaire-R18. Participants improved their diet quality, particularly fiber intake and fat quality. Although eating behavior traits did not predict overall success in reaching dietary goals, they were linked to specific food choices: Higher cognitive restraint predicted increased consumption of wholegrains, higher uncontrolled eating was linked to reduced intake of fatty pastries, and higher emotional eating was associated with increased nut and seed intake and decreased sugar-sweetened beverage consumption. Interestingly, traits typically associated with poorer eating habits were linked to healthier dietary changes. These results suggest that eating behavior traits may not determine overall adherence but can shape specific dietary patterns. Assessing these traits before intervention may support the design of tailored behavioral strategies. This study offers new insights into behavioral predictors of dietary change in older men with prediabetes, a group requiring personalized prevention strategies.