Heymsfield S B, Gonzalez M C C, Shen W, Redman L, Thomas D
Pennington Biomedical Research Center, Baton Rouge, USA.
Obes Rev. 2014 Apr;15(4):310-21. doi: 10.1111/obr.12143. Epub 2014 Jan 22.
Maximizing fat loss while preserving lean tissue mass and function is a central goal of modern obesity treatments. A widely cited rule guiding expected loss of lean tissue as fat-free mass (FFM) states that approximately one-fourth of weight loss will be FFM (i.e. ΔFFM/ΔWeight = ∼0.25), with the remaining three-fourths being fat mass. This review examines the dynamic relationships between FFM, fat mass and weight changes that follow induction of negative energy balance with hypocaloric dieting and/or exercise. Historical developments in the field are traced with the 'Quarter FFM Rule' used as a framework to examine evolving concepts on obesity tissue, excess weight and what is often cited as 'Forbes' Rule'. Temporal effects in the fractional contribution of FFM to changes in body weight are examined as are lean tissue moderating effects such as ageing, inactivity and exercise that frequently accompany structured low-calorie diet weight loss protocols. Losses of lean tissue with dieting typically tend to be small, raising questions about study design, power and applied measurement method reliability. Our review elicits important questions related to the fractional loss of lean tissues with dieting and provides a foundation for future research on this topic.
在保留瘦体重及其功能的同时最大化脂肪减少量是现代肥胖症治疗的核心目标。一条被广泛引用的、指导瘦体重（以去脂体重，FFM表示）预期减少量的规则指出，体重减轻量的大约四分之一将是去脂体重（即ΔFFM/Δ体重 ≈ 0.25），其余四分之三为脂肪量。本综述研究了在通过低热量饮食和/或运动诱导负能量平衡后，去脂体重、脂肪量和体重变化之间的动态关系。该领域的历史发展以“四分之一去脂体重规则”为框架进行追溯，以审视关于肥胖组织、超重以及常被称为“福布斯规则”的不断演变的概念。研究了去脂体重对体重变化的贡献率的时间效应，以及诸如衰老、缺乏运动和运动等瘦体重调节效应，这些效应经常伴随有结构化的低热量饮食减肥方案。节食导致的瘦体重损失通常往往较小，这引发了关于研究设计、效能以及应用测量方法可靠性的问题。我们的综述引出了与节食导致的瘦组织分数性损失相关的重要问题，并为该主题的未来研究奠定了基础。
