儿童肥胖症治疗的定性和/或定量饮用水建议。
Qualitative and/or quantitative drinking water recommendations for pediatric obesity treatment.
作者信息
Stookey Jodi D, Del Toro Rigoberto, Hamer Janice, Medina Alma, Higa Annie, Ng Vivian, TinajeroDeck Lydia, Juarez Lourdes
机构信息
Children's Hospital Oakland Research Institute, Oakland, CA, USA.
Pediatric Clinical Research Center, Oakland, CA, USA.
出版信息
J Obes Weight Loss Ther. 2014 Oct 11;4(4):232. doi: 10.4172/2165-7904.1000232.
OBJECTIVE
The qualitative recommendation to 'drink water instead of caloric beverages' may facilitate pediatric obesity treatment by lowering total energy intake. The quantitative recommendation to 'drink enough water to dilute urine' might further facilitate weight loss by increasing fat oxidation via cell hydration-mediated changes in insulin.
METHODS
This 8 week randomized intervention tested whether both qualitative-plus-quantitative (QQ) drinking water recommendations result in more weight loss than the qualitative recommendation alone (Q) in 25 children (9-12y) with body mass index at or above the 85 Percentile, given a reduced glycemic diet and usual physical activity. Random urine osmolality, saliva insulin, and body weight were assessed weekly. Mixed models explored if insulin mediated an effect of urine osmolality on weight loss.
RESULTS
In intention-to-treat analyses, QQ and Q participants did not differ significantly with respect to level of urine osmolality, saliva insulin, or weight loss. Only 4 out of 16 QQ participants complied with instruction to drink enough water to dilute urine, however. In completers analyses, the compliant QQ participants, who diluted urine osmolality from 910 ± 161 mmol/kg at baseline to below 500 mmol/kg over time (8 week mean±SE: 450 ± 67 mmol/kg), had significantly lower saliva insulin over time (8 week mean±SE: 13 ± 8 pmol/l vs. 22 ± 4 pmol/l) and greater weight loss (mean ± SE: -3.3 ± 0.7kg vs. -2.0 ± 0.5 kg) than compliant Q participants (7 out of 9 participants) who maintained elevated urine osmolality over time (8- week mean±SE: 888 ± 41 mmol/kg). Urine osmolality below 500 mmol/kg was significantly associated with weight loss. Change in saliva insulin partially explained the association.
CONCLUSIONS
QQ recommendations may increase weight loss for those able to dilute urine. Work is warranted to pursue cell hydration effects of drinking water for pediatric obesity treatment.
目的
“喝水而非饮用含热量饮料”这一定性建议可能通过降低总能量摄入促进儿童肥胖治疗。“喝足够的水以稀释尿液”这一定量建议可能通过细胞水合作用介导的胰岛素变化增加脂肪氧化，从而进一步促进体重减轻。
方法
这项为期8周的随机干预试验，在25名体重指数处于或高于第85百分位的9至12岁儿童中，给予低糖饮食和常规体育活动，测试定性加定量（QQ）饮水建议是否比单独的定性建议（Q）导致更多的体重减轻。每周评估随机尿渗透压、唾液胰岛素和体重。混合模型探讨胰岛素是否介导尿渗透压对体重减轻的影响。
结果
在意向性分析中，QQ组和Q组在尿渗透压水平、唾液胰岛素或体重减轻方面没有显著差异。然而，16名QQ组参与者中只有4人遵守了喝足够的水以稀释尿液的指示。在完成者分析中，那些将尿渗透压从基线时的910±161 mmol/kg随时间（8周平均值±标准误：450±67 mmol/kg）稀释至低于500 mmol/kg的依从性QQ组参与者，随时间推移唾液胰岛素显著降低（8周平均值±标准误：13±8 pmol/l对22±4 pmol/l），且体重减轻幅度更大（平均值±标准误：-3.3±0.7kg对-2.0±0.5 kg），相比那些随时间维持较高尿渗透压（8周平均值±标准误：888±41 mmol/kg）的依从性Q组参与者（9名参与者中的7名）。尿渗透压低于500 mmol/kg与体重减轻显著相关。唾液胰岛素的变化部分解释了这种关联。
结论
QQ建议可能会增加那些能够稀释尿液者的体重减轻。有必要开展工作以探索饮水对细胞水合作用在儿童肥胖治疗中的效果。
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