在减肥维持试验期间，饮食摄入量与成功减肥和维持体重有关

Journal of The American Dietetic Association Pub Date : 2011-12-01 DOI:10.1016/j.jada.2011.09.014

Catherine M. Champagne PhD, RD, LDN, FADA, Stephanie T. Broyles PhD, Laura D. Moran MS, RD, LD, Katherine C. Cash RD, LDN, Erma J. Levy MPH, RD, Pao-Hwa Lin PhD, Bryan C. Batch MD, Lillian F. Lien MD, Kristine L. Funk MS, RD, Arlene Dalcin RD, LDN, Catherine Loria PhD, MS, MA, Valerie H. Myers PhD

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引用次数: 89

摘要

背景:对维持体重有效的饮食成分还没有得到充分的确认。目的探讨减肥维持临床试验中饮食摄入变化对减肥及维持体重的影响。设计减肥维持是一项随机对照试验。完成第一阶段试验并减重4公斤的成功减肥参与者被随机分配到第二阶段三个维持干预组中的一个，并随访30个月。该多中心试验于2003年至2007年进行。这项亚研究包括828名成功减肥的参与者。方法采用分组食物频率问卷(FFQ)评估营养摄入水平和食物种类。碳水化合物、蛋白质、脂肪、膳食纤维、水果/蔬菜和乳制品被用作预测变量。在研究开始时(第一阶段开始)收集所有参与者的FFQ。随机分配到第二阶段的参与者在三个额外的时间点完成FFQ:随机化(第二阶段开始)，12个月和30个月。干预:主要的干预措施是使用高血压饮食法长期维持体重减轻。这项亚研究考察了特定饮食变量的改变是否与体重减轻和维持有关。统计分析进行了线性回归模型，调整了总能量的变化，检查了每个时间段饮食摄入量和体重变化之间的关系。协变量包括地点、年龄、种族、性别和种族与性别的相互作用。结果:以蛋白质代替脂肪的参与者在第一阶段每6个月平均减少0.33 kg (P<0.0001)，在第二阶段每增加1%的蛋白质每6个月平均减少0.07 kg (P<0.0001)。在第一阶段和第二阶段，增加水果和蔬菜的摄入量与体重减轻有关:每增加一份水果和蔬菜的摄入量分别为每6个月0.29公斤(P= 0.0001)和0.04公斤(P=0.0062)。在这两个阶段，用碳水化合物代替脂肪和用蛋白质代替碳水化合物与体重减轻有关。在第二阶段，增加乳制品的摄入量与体重的显著减轻有关(每增加1份乳制品，每6个月减少0.17公斤，P=0.0002)，但在第一阶段没有明显的发现。结论:多吃水果、蔬菜和低脂乳制品可能有助于减肥和维持体重。

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Dietary Intakes Associated with Successful Weight Loss and Maintenance during the Weight Loss Maintenance Trial

Background

Dietary components effective in weight maintenance efforts have not been adequately identified.

Objective

To determine the effects of changes in dietary consumption on weight loss and maintenance during the Weight Loss Maintenance clinical trial.

Design

Weight Loss Maintenance was a randomized controlled trial. Successful weight loss participants who completed Phase I of the trial and lost 4 kg were randomized to one of three maintenance intervention arms in Phase II and followed for an additional 30 months.

Participants/setting

The multicenter trial was conducted from 2003 through 2007. This substudy included 828 successful weight loss participants.

Methods

The Block Food Frequency Questionnaire (FFQ) was used to assess nutrient intake levels and food group servings. Carbohydrates, proteins, fats, dietary fiber, fruit/vegetable, and dairy servings were utilized as predictor variables. The FFQ was collected on all participants at study entry (beginning of Phase I). Those randomized to Phase II completed the FFQ at three additional time points: randomization (beginning of Phase II), 12 months, and 30 months.

Intervention

The main intervention focused on long-term maintenance of weight loss using the Dietary Approaches to Hypertension diet. This substudy examined if changes to specific dietary variables were associated with weight loss and maintenance.

Statistical analyses performed

Linear regression models that adjusted for change in total energy examined the relationship between changes in dietary intake and weight for each time period. Site, age, race, sex, and a race–sex interaction were included as covariates.

Results

Participants who substituted protein for fat lost, on average, 0.33 kg per 6 months during Phase I (P<0.0001) and 0.07 kg per 6 months during Phase II (P<0.0001) per 1% increase in protein. Increased intake of fruits and vegetables was associated with weight loss in Phases I and II: 0.29 kg per 6 months (P<0.0001) and 0.04 kg per 6 months (P=0.0062), respectively, per 1-serving increase. Substitution of carbohydrates for fat and protein for carbohydrates were associated with weight loss during both phases. Increasing dairy intake was associated with significant weight loss during Phase II (−0.17 kg per 6 months per 1-serving increase, P=0.0002), but not during Phase I. Dietary fiber revealed no significant findings.