肥胖与体重控制的能量学:饮食构成重要吗?

Energetics of obesity and weight control: does diet composition matter?

作者信息

Schoeller Dale A, Buchholz Andrea C

机构信息

Department of Nutritional Sciences, University of Wisconsin-Madison, 53706, USA.

出版信息

J Am Diet Assoc. 2005 May;105(5 Suppl 1):S24-8. doi: 10.1016/j.jada.2005.02.025.

Abstract

Greater average weight losses (2.5 kg over 12 weeks) have been reported for low-carbohydrate diets (<90 g/day) compared with traditional low-fat (<25% of energy), hypocaloric diets, implying a 233 kcal/day greater energy deficit. It has therefore been suggested that a low-carbohydrate diet may provide a metabolic advantage (an increase in energy expenditure), resulting in a positive effect on weight loss and maintenance. However, a review of studies in which 24-hour energy expenditure was measured did not provide evidence to support a metabolic advantage of low-carbohydrate diets and showed little evidence of a metabolic advantage of high-protein (>25% of energy) diets. Nonetheless, diets high in protein, but either low or modest in carbohydrate, have resulted in greater weight losses than traditional low-fat diets. We speculate that it is the protein, and not carbohydrate, content that is important in promoting short-term weight loss and that this effect is likely due to increased satiety caused by increased dietary protein. It has been suggested that the increased satiety might help persons to be more compliant with a hypocaloric diet and achieve greater weight loss. The current evidence, combined with the need to meet all nutrient requirements, suggests that hypocaloric weight-loss diets should be moderate in carbohydrate (35% to 50% of energy), moderate in fat (25% to 35% of energy), and protein should contribute 25% to 30% of energy intake. More studies of the efficacy of weight-loss and weight-maintenance diets that address protein content are needed. In addition, controlled studies of total energy expenditure or physical activity measured under free-living conditions that directly compare high-protein diets with those containing low and moderate carbohydrate content should also be performed.

摘要

据报道,与传统的低脂肪(能量的<25%)低热量饮食相比,低碳水化合物饮食(<90克/天)的平均体重减轻幅度更大(12周内减轻2.5千克),这意味着每天的能量赤字多233千卡。因此,有人提出低碳水化合物饮食可能具有代谢优势(能量消耗增加),从而对体重减轻和维持产生积极影响。然而,一项对测量24小时能量消耗的研究的综述并未提供证据支持低碳水化合物饮食的代谢优势,也几乎没有证据表明高蛋白(>能量的25%)饮食具有代谢优势。尽管如此,高蛋白但碳水化合物含量低或适中的饮食比传统的低脂肪饮食导致的体重减轻更多。我们推测,在促进短期体重减轻方面,重要的是蛋白质含量而非碳水化合物含量,这种影响可能是由于饮食蛋白质增加导致饱腹感增强所致。有人提出,饱腹感增强可能有助于人们更好地遵守低热量饮食并实现更大程度的体重减轻。目前的证据,加上满足所有营养需求的必要性,表明低热量减肥饮食的碳水化合物含量应适中(占能量的35%至50%),脂肪含量适中(占能量的25%至35%),蛋白质应占能量摄入的25%至30%。需要更多关于考虑蛋白质含量的减肥和维持体重饮食功效的研究。此外,还应进行在自由生活条件下测量总能量消耗或身体活动的对照研究,直接比较高蛋白饮食与碳水化合物含量低和适中的饮食。

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