Banasik Jacquelyn L, Walker Marilee K, Randall Judith M, Netjes Robert B, Foutz Mary S
(Associate Professor), (Family Nurse Practitioner), College of Nursing, Washington State University, Spokane, Washington (Family Nurse Practitioner), Inland Imaging, Spokane, Washington (Family Nurse Practitioner), Veteran's Administration, Spokane, Washington (Family Nurse Practitioner), Cancer Care Northwest, Spokane, Washington.
J Am Assoc Nurse Pract. 2013 Aug;25(8):440-448. doi: 10.1111/j.1745-7599.2012.00808.x. Epub 2012 Nov 20.
To examine potential detrimental long-term effects of acute diet-induced weight loss on visceral adiposity, insulin resistance, cortisol, and adipokines in obese individuals at risk for type-2 diabetes.
Anthropometric measures (height, weight, waist circumference), self-report instruments, abdominal computed tomography (CT) scan, and blood samples (glucose, insulin, interleukin-6, leptin, adiponectin) were obtained from a convenience sample of 20 participants at baseline, after a 28-day low-calorie diet (800 kcal/day) intervention, and again 6 months later.
Fifteen of 20 participants completed the 28-day diet intervention and had a mean weight loss of 15 pounds. Comparison between baseline, postdiet, and 6-month data, demonstrated that although participants had significant improvements after the diet, they regained fat mass, particularly in the visceral area.
Clinicians may need to revise recommendations for using low-calorie diets to achieve weight loss. Diet-induced weight cycling may contribute to dysregulation of metabolism and have long-term detrimental consequences for accumulation of visceral adipose tissue. The likelihood of success is low, with high dropout rates, and those patients who achieve weight loss are very likely to regain it. Thus, the perceived short-term benefits of calorie-restricted diets in this population likely do not outweigh the potential long-term detrimental effects.
研究急性节食导致的体重减轻对有2型糖尿病风险的肥胖个体的内脏脂肪、胰岛素抵抗、皮质醇和脂肪因子的潜在长期有害影响。
从20名参与者的便利样本中获取人体测量指标(身高、体重、腰围)、自我报告工具、腹部计算机断层扫描(CT)以及血液样本(葡萄糖、胰岛素、白细胞介素-6、瘦素、脂联素),数据采集时间点分别为基线期、28天低热量饮食(800千卡/天)干预后以及6个月后。
20名参与者中有15人完成了为期28天的饮食干预,平均体重减轻了15磅。对基线期、节食后和6个月的数据进行比较后发现,尽管参与者在节食后有显著改善,但他们又重新增加了脂肪量,尤其是在内脏区域。
临床医生可能需要修订关于使用低热量饮食来实现体重减轻的建议。节食引起的体重波动可能会导致代谢失调,并对内脏脂肪组织的积累产生长期有害影响。成功的可能性较低,退出率较高,而且那些实现体重减轻的患者很可能会反弹。因此,在这一人群中,热量限制饮食所带来的短期益处可能并不超过潜在的长期有害影响。