Dwyer Johanna T, Allison David B, Coates Paul M
Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland 20892, USA.
J Am Diet Assoc. 2005 May;105(5 Suppl 1):S80-6. doi: 10.1016/j.jada.2005.02.028.
We summarize evidence on the role of dietary supplements in weight reduction, with particular attention to their safety and benefits. Dietary supplements are used for two purposes in weight reduction: (a) providing nutrients that may be inadequate in calorie-restricted diets and (b) for their potential benefits in stimulating weight loss. The goal in planning weight-reduction diets is that total intake from food and supplements should meet recommended dietary allowance/adequate intake levels without greatly exceeding them for all nutrients, except energy. If nutrient amounts from food sources in the reducing diet fall short, dietary supplements containing a single nutrient/element or a multivitamin-mineral combination may be helpful. On hypocaloric diets, the addition of dietary supplements providing nutrients at a level equal to or below recommended dietary allowance/adequate intake levels or 100% daily value, as stated in a supplement's facts box on the label, may help dieters to achieve nutrient adequacy and maintain electrolyte balance while avoiding the risk of excessive nutrient intakes. Many botanical and other types of dietary supplements are purported to be useful for stimulating or enhancing weight loss. Evidence of their efficacy in stimulating weight loss is inconclusive at present. Although there are few examples of safety concerns related to products that are legal and on the market for this purpose, there is also a paucity of evidence on safety for this intended use. Ephedra and ephedrine-containing supplements, with or without caffeine, have been singled out in recent alerts from the Food and Drug Administration because of safety concerns, and use of products containing these substances cannot be recommended. Dietitians should periodically check the Food and Drug Administration Web site ( www.cfsan.fda.gov ) for updates and warnings and alert patients/clients to safety concerns. Dietetics professionals should also consult authoritative sources for new data on efficacy as it becomes available ( ods.od.nih.gov ).
我们总结了膳食补充剂在减肥中的作用的证据，尤其关注其安全性和益处。膳食补充剂在减肥中有两个用途：（a）提供热量限制饮食中可能不足的营养素，以及（b）因其在促进减肥方面的潜在益处。制定减肥饮食计划的目标是，食物和补充剂的总摄入量应满足推荐膳食摄入量/适宜摄入量水平，除能量外，所有营养素的摄入量都不会大幅超过该水平。如果减肥饮食中食物来源的营养素含量不足，含有单一营养素/元素或多种维生素-矿物质组合的膳食补充剂可能会有所帮助。在低热量饮食中，添加膳食补充剂，其提供的营养素水平等于或低于推荐膳食摄入量/适宜摄入量水平或标签上补充剂成分表中所述的每日值的100%，可能有助于节食者实现营养充足并维持电解质平衡，同时避免营养素摄入过量的风险。许多植物性和其他类型的膳食补充剂据称对促进或增强减肥有用。目前它们在促进减肥方面的功效证据尚无定论。虽然很少有与合法且用于此目的的市场上的产品相关的安全问题实例，但关于此预期用途的安全性证据也很少。由于安全问题，含有麻黄和麻黄碱的补充剂，无论是否含有咖啡因，已在食品药品监督管理局最近的警报中被特别指出，不建议使用含有这些物质的产品。营养师应定期查看食品药品监督管理局网站（www.cfsan.fda.gov）以获取更新和警告，并提醒患者/客户注意安全问题。营养专业人员还应在有新的功效数据时（ods.od.nih.gov）参考权威资料。
