Buzzard I M, Asp E H, Chlebowski R T, Boyar A P, Jeffery R W, Nixon D W, Blackburn G L, Jochimsen P R, Scanlon E F, Insull W
Division of Human Development and Nutrition, University of Minnesota, School of Public Health, Minneapolis 55414.
J Am Diet Assoc. 1990 Jan;90(1):42-50, 53.
A multicentered pilot study was conducted to test an intervention protocol designed to reduce fat intake to 15% of energy intake. Eligible subjects were postmenopausal women with stage II breast cancer whose baseline fat intake was more than 30% of energy intake. The low-fat diet intervention protocol consisted of bi-weekly individual counseling sessions with emphasis on substitution of lower-fat foods for high-fat foods and maintenance of nutritional adequacy. Nutrient intakes were calculated from 4-day food records collected at baseline and after 3 months of diet intervention. Mean daily fat intake for the 17 patients on the low-fat diet dropped significantly from 38.4 +/- 4.3% of energy intake at baseline to 22.8 +/- 7.8% at 3 months (p less than .001). A 25% reduction in mean energy intake, from 1,840 +/- 419 kcal at baseline to 1,365 +/- 291 kcal at 3 months, was accompanied by significant increases in protein and carbohydrate as percent of energy intake. A mean weight loss of 2.8 kg and a 7.7% reduction in serum cholesterol were observed; both changes were significant at the p less than .01 level. Absolute intakes of zinc and magnesium were significantly reduced. However, mean intake on the low-fat diet for 14 vitamins and minerals, including zinc and magnesium, exceeded two-thirds of the 1989 Recommended Dietary Allowances (RDAs). When expressed as nutrient density (i.e., amount of nutrient per 1,000 kcal), increases were observed for all micronutrients. These results support the hypothesis that a nutritionally adequate low-fat diet can be successfully implemented in a highly motivated, free-living population.
开展了一项多中心试点研究，以测试一项干预方案，该方案旨在将脂肪摄入量降至能量摄入的15%。符合条件的受试者为患有II期乳腺癌的绝经后女性，其基线脂肪摄入量超过能量摄入的30%。低脂饮食干预方案包括每两周进行一次个体咨询，重点是用低脂食物替代高脂食物并维持营养充足。根据在基线和饮食干预3个月后收集的4天食物记录计算营养素摄入量。17名接受低脂饮食的患者的平均每日脂肪摄入量从基线时能量摄入的38.4±4.3%显著降至3个月时的22.8±7.8%（p<0.001）。平均能量摄入量降低了25%，从基线时的1840±419千卡降至3个月时的1365±291千卡，同时蛋白质和碳水化合物占能量摄入的百分比显著增加。观察到平均体重减轻2.8千克，血清胆固醇降低7.7%；这两个变化在p<0.01水平均具有显著性。锌和镁的绝对摄入量显著降低。然而，包括锌和镁在内的14种维生素和矿物质的低脂饮食平均摄入量超过了1989年推荐膳食摄入量（RDA）的三分之二。当以营养素密度表示（即每1000千卡的营养素量）时，所有微量营养素均有增加。这些结果支持了这样一种假设，即在积极性高、自由生活的人群中可以成功实施营养充足的低脂饮食。
