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多学科体重控制项目后长期体重变化的评估。

Evaluation of long-term weight changes after a multidisciplinary weight control program.

作者信息

Fitzwater S L, Weinsier R L, Wooldridge N H, Birch R, Liu C, Bartolucci A A

机构信息

Department of Nutrition Sciences, University of Alabama, Birmingham 35294.

出版信息

J Am Diet Assoc. 1991 Apr;91(4):421-6, 429.

PMID:2016489
Abstract

The American Medical Association Council on Scientific Affairs recently emphasized the importance of nutritionally sound weight reduction diets and changes in life-style to promote long-term weight control. The purpose of this study was to evaluate long-term effectiveness and to identify predictors of success of an intensive multidisciplinary program utilizing the time-calorie displacement diet, a low-fat, high-complex-carbohydrate diet, to promote and maintain reduced body weight. In 213 obese adults consecutively entering the program, including dropouts, weight loss averaged 6.3 kg (0.4 kg/week) and 16% of excess weight over 7 months of treatment. The 78 (37%) completing the recommended 15 visits lost a mean of 10.8 kg and 28% of their excess weight while under treatment. Weight loss was largely predicted by number of visits, which was more important than treatment duration. An increased number of visits was predicted by being married, being female, and reporting a usual diet low in snack foods. Of 147 patients contacted at posttreatment follow-up, 53% maintained their weight loss or continued to lose weight an average of 25 months later and 24% experienced weight rebound but were still below their pretreatment weight; only 23% regained their lost weight. Mean net weight loss from pretreatment to follow-up was 8.0 +/- 1.0 kg (mean +/- standard error of the mean). No factor significantly predicted posttreatment weight rebound. Results suggest that a nutritionally sound diet, prescribed in a multidisciplinary program and emphasizing life-style changes, can result in long-term weight control in a majority of patients treated.

摘要

美国医学协会科学事务委员会最近强调了营养合理的减肥饮食和生活方式改变对于促进长期体重控制的重要性。本研究的目的是评估一项强化多学科项目的长期效果,并确定采用时间-卡路里替代饮食(一种低脂肪、高复合碳水化合物饮食)来促进和维持体重减轻的成功预测因素。在连续进入该项目的213名肥胖成年人中,包括中途退出者,在7个月的治疗期间,体重平均减轻了6.3千克(0.4千克/周),超重体重减轻了16%。78名(37%)完成推荐的15次就诊的患者在治疗期间平均体重减轻了10.8千克,超重体重减轻了28%。就诊次数在很大程度上预测了体重减轻情况,这比治疗持续时间更重要。就诊次数增加的预测因素包括已婚、女性以及报告日常饮食中零食较少。在治疗后随访中联系的147名患者中,53%保持了体重减轻或在平均25个月后继续减重,24%经历了体重反弹但仍低于治疗前体重;只有23%恢复了丢失的体重。从治疗前到随访的平均净体重减轻为8.0±1.0千克(平均值±平均标准误差)。没有因素能显著预测治疗后的体重反弹。结果表明,在多学科项目中规定的、强调生活方式改变的营养合理的饮食,可使大多数接受治疗的患者实现长期体重控制。

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