Champagne Catherine M, Broyles Stephanie T, Moran Laura D, Cash Katherine C, Levy Erma J, Lin Pao-Hwa, Batch Bryan C, Lien Lillian F, Funk Kristine L, Dalcin Arlene, Loria Catherine, Myers Valerie H
Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA.
J Am Diet Assoc. 2011 Dec;111(12):1826-35. doi: 10.1016/j.jada.2011.09.014.
Dietary components effective in weight maintenance efforts have not been adequately identified.
To determine the effects of changes in dietary consumption on weight loss and maintenance during the Weight Loss Maintenance clinical trial.
Weight Loss Maintenance was a randomized controlled trial. Successful weight loss participants who completed Phase I of the trial and lost 4 kg were randomized to one of three maintenance intervention arms in Phase II and followed for an additional 30 months.
PARTICIPANTS/SETTING: The multicenter trial was conducted from 2003 through 2007. This substudy included 828 successful weight loss participants.
The Block Food Frequency Questionnaire (FFQ) was used to assess nutrient intake levels and food group servings. Carbohydrates, proteins, fats, dietary fiber, fruit/vegetable, and dairy servings were utilized as predictor variables. The FFQ was collected on all participants at study entry (beginning of Phase I). Those randomized to Phase II completed the FFQ at three additional time points: randomization (beginning of Phase II), 12 months, and 30 months.
The main intervention focused on long-term maintenance of weight loss using the Dietary Approaches to Hypertension diet. This substudy examined if changes to specific dietary variables were associated with weight loss and maintenance.
Linear regression models that adjusted for change in total energy examined the relationship between changes in dietary intake and weight for each time period. Site, age, race, sex, and a race-sex interaction were included as covariates.
Participants who substituted protein for fat lost, on average, 0.33 kg per 6 months during Phase I (P<0.0001) and 0.07 kg per 6 months during Phase II (P<0.0001) per 1% increase in protein. Increased intake of fruits and vegetables was associated with weight loss in Phases I and II: 0.29 kg per 6 months (P<0.0001) and 0.04 kg per 6 months (P=0.0062), respectively, per 1-serving increase. Substitution of carbohydrates for fat and protein for carbohydrates were associated with weight loss during both phases. Increasing dairy intake was associated with significant weight loss during Phase II (-0.17 kg per 6 months per 1-serving increase, P=0.0002), but not during Phase I. Dietary fiber revealed no significant findings.
Increasing fruits, vegetables, and low-fat dairy may help achieve weight loss and maintenance.
对体重维持有效的饮食成分尚未得到充分确定。
在体重减轻维持临床试验中确定饮食摄入变化对体重减轻和维持的影响。
体重减轻维持是一项随机对照试验。完成试验第一阶段且体重减轻4千克的成功减重参与者被随机分配到第二阶段的三个维持干预组之一，并随访30个月。
参与者/地点：这项多中心试验于2003年至2007年进行。这项子研究纳入了828名成功减重的参与者。
使用Block食物频率问卷（FFQ）评估营养摄入水平和食物组摄入量。碳水化合物、蛋白质、脂肪、膳食纤维、水果/蔬菜和奶制品摄入量被用作预测变量。在研究入组时（第一阶段开始）对所有参与者收集FFQ。随机分配到第二阶段的参与者在另外三个时间点完成FFQ：随机分组时（第二阶段开始）、12个月和30个月。
主要干预措施集中在采用高血压饮食法长期维持体重减轻。这项子研究考察了特定饮食变量的变化是否与体重减轻和维持有关。
调整总能量变化的线性回归模型检验了每个时间段饮食摄入量变化与体重之间的关系。纳入地点、年龄、种族、性别以及种族 - 性别交互作用作为协变量。
在第一阶段，每增加1%的蛋白质，用蛋白质替代脂肪的参与者平均每6个月体重减轻0.33千克（P<0.0001），在第二阶段每6个月体重减轻0.07千克（P<0.0001）。在第一阶段和第二阶段，水果和蔬菜摄入量增加与体重减轻有关：每增加1份，分别为每6个月0.29千克（P<0.0001）和每6个月0.04千克（P = 0.0062）。在两个阶段，用碳水化合物替代脂肪以及用蛋白质替代碳水化合物都与体重减轻有关。增加奶制品摄入量在第二阶段与显著体重减轻有关（每增加1份每6个月减轻0.17千克，P = 0.0002），但在第一阶段没有。膳食纤维未显示出显著结果。
增加水果、蔬菜和低脂奶制品的摄入可能有助于实现体重减轻和维持。
