Longitudinal Examination of Diet, Physical Activity and Weight Changes in Rural and Non-rural Populations

Obesity is a major public health problem that impacts many individuals in the United States. Research has indicated that the prevalence of obesity is higher in rural populations compared to non-rural populations. This may be attributable to differences in diet, physical activity or other lifestyle factors. In order properly design interventions targeted at weight management and obesity reduction, information about the behaviors of populations must be known. Therefore, the purpose of this research was to examine diet and physical activity patterns in rural and non-rural populations -- where rural is defined based on lifestyle -- and their relationship to changes in body composition over time, as well as to examine changes in physical activity and body weight and composition after marriage. In general, rural populations are understudied and differ from their non-rural counterparts in terms of sociodemographic factors and access to food and physical activity opportunities. The following analyses utilize data from the South Dakota Rural Bone Health Study and advance the knowledge of how behaviors and body composition change over time and provide novel information about how body composition, weight and physical activity levels are affected by marriage. Dietary patterns, captured using a food frequency questionnaire, were examined for differences in rates of change over time among Hutterite, non-rural and rural individuals. Likewise, physical activity patterns and body composition, captured with a 7-day physical activity recall and dual-energy x-ray absorptiometry, were examined for rates of change over time among Hutterite, non-rural and rural individuals. Finally, the transition to marriage and its impact on anthropometric measurements and physical activity in young men was examined. Taken together, the findings in this dissertation can be used not only for understanding more about how lifestyle impacts the behaviors of non-rural and rural adults, but also for determining how to move forward for designing appropriate interventions targeted at reducing obesity in these populations