Dietary Intake and Weight Gain Among Adolescents on Depot Medroxyprogesterone Acetate

Study Objective: To examine the relationship between dietary intake and weight gain among adolescent females initiating depot medroxyprogesterone acetate (DMPA). Design: Prospective observational study. Setting: Two urban Adolescent Medicine clinics. Participants: 45 postmenarchal females, age 12 to 21, enrolled after self-selecting to initiate DMPA. Intervention: Participants received 150 mg DMPA intramuscularly every 12 weeks. Height, weight, and 24-hour dietary recall were collected at baseline, 3, 6, and 12 months. Main Outcome Measure: Body mass index (BMI) over time calculated as weight (kg)/height (m(2)). Associations between dietary variables and BMI were evaluated with repeated measures analysis of variance modeling. Results: Mean chronological and gynecologic ages were 16.2 +/- 1.5 and 4.2 +/- 1.8 years, respectively. Mean BMI increased from 23.7 +/- 5.3 to 25.3 +/- 5.7 over 12 months. Average dietary intake included: 1781.4 +/- 554.1 total kilocalories, 228.5 g +/- 69.8 carbohydrates, 71.0 g +/- 27.3 fat, and 61.0 g +/- 20.2 protein. These diet measures were not associated with BMI over time. Dietary fiber, magnesium, and linoleic acid were inversely associated with increased BMI over time (P < .05) Conclusion: We found no evidence that general measures of diet (energy, carbohydrates, fat, and protein), as assessed by 24-hour recall, were predictive of weight gain on DMPA. Several nutrients abundant in foods that benefit overall health were inversely associated with increased BMI over time, suggesting that diet quality, rather than quantity, is a more important predictor of DMPA-associated weight gain.