Luscombe N D, Clifton P M, Noakes M, Farnsworth E, Wittert G
Department of Physiology, University of Adelaide, South Australia.
Int J Obes Relat Metab Disord. 2003 May;27(5):582-90. doi: 10.1038/sj.ijo.0802270.
To determine the effect of replacing some dietary carbohydrate with protein, during energy restriction, on weight loss, total energy expenditure (TEE), resting energy expenditure (REE), respiratory quotient (RQ), and the thermic effect of feeding (TEF) in subjects with hyperinsulinemia.
Parallel, clinical intervention study of 12 weeks energy restriction (6.5 MJ/day) and 4 weeks energy balance (8.2 MJ/day) in two groups of subjects randomly assigned to either a high-protein (HP) diet (27% of energy (%E) as protein, 45%E as carbohydrate) or a lower-protein (LP) diet (16%E as protein, 57%E as carbohydrate).
A total of 36 obese nondiabetic volunteers with hyperinsulinemia (10 males/26 females, aged 34-65 y, BMI 28-43 kg/m(2), fasting insulin 12-45 mU/l).
Body weight and composition, TEE, REE, and RQ were measured at baseline and at week 16. In addition, the TEF to an HP or LP meal was determined for 3 h, at baseline and at week 16.
After 16 weeks, weight loss was similar in response to each diet; the overall decrease was 7.9+/-0.6 kg (P<0.001), of which 6.8+/-0.5 kg was fat (P<0.001). REE fell similarly with each diet; the overall decrease was 719+/-106 kJ/day (P<0.001). The TEF was 2% greater after the HP than after the LP meal at baseline (P<0.01) and 0.8% greater at week 16 (P=0.35). After 16 weeks, the TEF was not reduced in either dietary group. There was no change in TEE after 16 weeks.
In subjects with hyperinsulinemia an energy-restrictive diet containing an increased protein-to-carbohydrate ratio does not enhance weight loss or significantly affect energy expenditure. Caloric restriction, rather than the macronutrient composition of the diet, is the most important determinant of weight loss.
确定在能量限制期间，用蛋白质替代部分膳食碳水化合物，对高胰岛素血症患者体重减轻、总能量消耗（TEE）、静息能量消耗（REE）、呼吸商（RQ）和进食热效应（TEF）的影响。
对两组受试者进行为期12周的能量限制（6.5兆焦/天）和4周的能量平衡（8.2兆焦/天）的平行临床干预研究，受试者随机分为高蛋白（HP）饮食组（蛋白质供能占27%，碳水化合物供能占45%）或低蛋白（LP）饮食组（蛋白质供能占16%，碳水化合物供能占57%）。
共36名患有高胰岛素血症的肥胖非糖尿病志愿者（男性10名/女性26名，年龄34 - 65岁，体重指数28 - 43千克/平方米，空腹胰岛素12 - 45毫国际单位/升）。
在基线和第16周时测量体重和身体成分、TEE、REE和RQ。此外，在基线和第16周时，测定对HP或LP餐食的3小时TEF。
16周后，两种饮食方式导致的体重减轻相似；总体下降7.9±0.6千克（P< .001），其中6.8±0.5千克为脂肪（P< .001）。两种饮食方式下REE下降情况相似；总体下降719±106千焦/天（P< .001）。在基线时，HP餐食后的TEF比LP餐食后高2%（P< .01），在第16周时高0.8%（P = .35）。16周后，两组饮食的TEF均未降低。16周后TEE无变化。
在高胰岛素血症患者中，蛋白质与碳水化合物比例增加的能量限制饮食不会增强体重减轻或显著影响能量消耗。热量限制而非饮食中的宏量营养素组成是体重减轻的最重要决定因素。
