Johnstone Alexandra M, Horgan Graham W, Murison Sandra D, Bremner David M, Lobley Gerald E
Division of Obesity and Metabolic Health and Biomathematics and Statistics Scotland, Rowett Research Institute, Aberdeen, United Kingdom.
Am J Clin Nutr. 2008 Jan;87(1):44-55. doi: 10.1093/ajcn/87.1.44.
Altering the macronutrient composition of the diet influences hunger and satiety. Studies have compared high- and low-protein diets, but there are few data on carbohydrate content and ketosis on motivation to eat and ad libitum intake.
We aimed to compare the hunger, appetite, and weight-loss responses to a high-protein, low-carbohydrate [(LC) ketogenic] and those to a high-protein, medium-carbohydrate [(MC) nonketogenic] diet in obese men feeding ad libitum.
Seventeen obese men were studied in a residential trial; food was provided daily. Subjects were offered 2 high-protein (30% of energy) ad libitum diets, each for a 4-wk period-an LC (4% carbohydrate) ketogenic diet and an MC (35% carbohydrate) diet-randomized in a crossover design. Body weight was measured daily, and ketosis was monitored by analysis of plasma and urine samples. Hunger was assessed by using a computerized visual analogue system.
Ad libitum energy intakes were lower with the LC diet than with the MC diet [P=0.02; SE of the difference (SED): 0.27] at 7.25 and 7.95 MJ/d, respectively. Over the 4-wk period, hunger was significantly lower (P=0.014; SED: 1.76) and weight loss was significantly greater (P=0.006; SED: 0.62) with the LC diet (6.34 kg) than with the MC diet (4.35 kg). The LC diet induced ketosis with mean 3-hydroxybutyrate concentrations of 1.52 mmol/L in plasma (P=0.036 from baseline; SED: 0.62) and 2.99 mmol/L in urine (P<0.001 from baseline; SED: 0.36).
In the short term, high-protein, low-carbohydrate ketogenic diets reduce hunger and lower food intake significantly more than do high-protein, medium-carbohydrate nonketogenic diets.
改变饮食中的宏量营养素组成会影响饥饿感和饱腹感。已有研究比较了高蛋白饮食和低蛋白饮食，但关于碳水化合物含量和酮症对进食动机及随意摄入量影响的数据较少。
我们旨在比较在随意进食的肥胖男性中，高蛋白、低碳水化合物（生酮）饮食和高蛋白、中等碳水化合物（非生酮）饮食对饥饿感、食欲及体重减轻的反应。
对17名肥胖男性进行了一项住院试验，每天提供食物。受试者可随意选择两种高蛋白（占能量的30%）饮食，每种饮食持续4周，即低碳水化合物（4%碳水化合物）生酮饮食和中等碳水化合物（35%碳水化合物）饮食，采用交叉设计进行随机分组。每天测量体重，并通过分析血浆和尿液样本监测酮症。使用计算机化视觉模拟系统评估饥饿感。
低碳水化合物饮食的随意能量摄入量低于中等碳水化合物饮食[P = 0.02；差异标准误（SED）：0.27]，分别为每天7.25和7.95兆焦耳。在4周期间，低碳水化合物饮食组的饥饿感显著更低（P = 0.014；SED：1.76），体重减轻显著更多（P = 0.006；SED：0.62），分别为6.34千克和4.35千克。低碳水化合物饮食诱导了酮症，血浆中平均3 - 羟基丁酸浓度为1.52毫摩尔/升（与基线相比P = 0.036；SED：0.62），尿液中为2.99毫摩尔/升（与基线相比P < 0.001；SED：0.36）。
短期内，高蛋白、低碳水化合物生酮饮食比高蛋白、中等碳水化合物非生酮饮食更能显著降低饥饿感并减少食物摄入量。
