Hall Kevin D, Jordan Peter N
Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892-5621, USA.
Am J Clin Nutr. 2008 Dec;88(6):1495-503. doi: 10.3945/ajcn.2008.26333.
Lifestyle intervention can successfully induce weight loss in obese persons, at least temporarily. However, there currently is no way to quantitatively estimate the changes of diet or physical activity required to prevent weight regain. Such a tool would be helpful for goal-setting, because obese patients and their physicians could assess at the outset of an intervention whether long-term adherence to the calculated lifestyle change is realistic.
We aimed to calculate the expected change of steady-state body weight arising from a given change in dietary energy intake and, conversely, to calculate the modification of energy intake required to maintain a particular body-weight change.
We developed a mathematical model using data from 8 longitudinal weight-loss studies representing 157 subjects with initial body weights ranging from 68 to 160 kg and stable weight losses between 7 and 54 kg.
Model calculations closely matched the change data (R(2) = 0.83, chi(2) = 2.1, P < 0.01 for weight changes; R(2) = 0.91, chi(2) = 0.87, P < 0.0004 for energy intake changes). Our model performed significantly better than the previous models for which chi(2) values were 10-fold those of our model. The model also accurately predicted the proportion of weight change resulting from the loss of body fat (R(2) = 0.90).
Our model provides realistic calculations of body-weight change and of the dietary modifications required for weight-loss maintenance. Because the model was implemented by using standard spreadsheet software, it can be widely used by physicians and weight-management professionals.
生活方式干预能够成功促使肥胖者减重,至少在短期内有效。然而,目前尚无办法定量评估防止体重反弹所需的饮食或体力活动变化。这样一种工具将有助于设定目标,因为肥胖患者及其医生在干预开始时就能评估长期坚持计算得出的生活方式改变是否切实可行。
我们旨在计算因饮食能量摄入的特定变化而导致的稳态体重预期变化,反之,计算维持特定体重变化所需的能量摄入调整。
我们利用来自8项纵向减肥研究的数据开发了一个数学模型,这些研究涉及157名受试者,初始体重在68至160千克之间,稳定减重7至54千克。
模型计算结果与变化数据紧密匹配(体重变化:R² = 0.83,χ² = 2.1,P < 0.01;能量摄入变化:R² = 0.91,χ² = 0.87,P < 0.0004)。我们的模型表现明显优于之前的模型,其χ²值是我们模型的10倍。该模型还准确预测了因体脂减少导致的体重变化比例(R² = 0.90)。
我们的模型提供了体重变化以及维持体重减轻所需饮食调整的实际计算结果。由于该模型是使用标准电子表格软件实现的,医生和体重管理专业人员可以广泛使用。