Frankwich Karen A, Egnatios Jeremy, Kenyon Mandy L, Rutledge Thomas R, Liao Patricia S, Gupta Samir, Herbst Karen L, Zarrinpar Amir
Division of Endocrinology, University of California, San Diego.
School of Medicine, University of California, San Diego.
Clin Gastroenterol Hepatol. 2015 Sep;13(9):1625-1632.e1. doi: 10.1016/j.cgh.2015.02.044. Epub 2015 Mar 10.
BACKGROUND & AIMS: Many companies provide genetic tests for obesity-related polymorphisms (nutrigenetics) and make dietary recommendations for weight loss that are based on the results. We performed a randomized controlled trial to determine whether more participants who followed a nutrigenetic-guided diet lost ≥5% of their body weight than participants on a standard balanced diet for 8 and 24 weeks.
We performed a prospective study of 51 obese or overweight U.S. veterans on an established weight management program at the Veterans Administration San Diego Healthcare System (the MOVE! program). Participants were randomly assigned to groups placed on a nutrigenetic-guided diet (balanced, low-carbohydrate, low-fat, or Mediterranean; n = 30) or a standard balanced diet (n = 21). Nutrigenetic diets were selected on the basis of results from the Pathway FIT test.
There was no significant difference in the percentage of participants on the balanced diet vs the nutrigenetic-guided diet who lost 5% of their body weight at 8 weeks (35.0% ± 20.9% vs 26.9% ± 17.1%, respectively; P = .28) or at 24 weeks. Both groups had difficulty adhering to the diets. However, adherence to the nutrigenetic-guided diet correlated with weight loss (r = 0.74; P = 4.0 × 10(-5)), but not adherence to standard therapy (r = 0.34; P = .23). Participants who had low-risk polymorphisms for obesity lost more weight than all other participants at 8 weeks (5.0% vs 2.9%, respectively; P = .02) and had significantly greater reductions in body mass index (6.4% vs 3.6%, respectively; P = .03) and waist circumference (6.5% vs 2.6%, respectively; P = .02) at 24 weeks.
In a prospective study, a nutrigenetic-based diet did not increase weight loss compared with a standard balanced diet. However, genetic features can identify individuals most likely to benefit from a balanced diet weight loss strategy; these findings require further investigation. ClinicalTrials.gov number: NCT01859403.
许多公司提供与肥胖相关基因多态性的基因检测（营养遗传学），并根据检测结果给出减肥饮食建议。我们进行了一项随机对照试验，以确定在8周和24周时，遵循营养遗传学指导饮食的参与者中体重减轻≥5%的人数是否多于遵循标准均衡饮食的参与者。
我们对圣地亚哥退伍军人事务部医疗保健系统（“行动！”计划）中51名参加既定体重管理计划的肥胖或超重美国退伍军人进行了一项前瞻性研究。参与者被随机分为两组，一组采用营养遗传学指导饮食（均衡、低碳水化合物、低脂肪或地中海饮食；n = 30），另一组采用标准均衡饮食（n = 21）。营养遗传学饮食根据Pathway FIT检测结果选择。
在8周时，遵循均衡饮食与遵循营养遗传学指导饮食的参与者中体重减轻5%的比例无显著差异（分别为35.0%±20.9%和26.9%±17.1%；P = 0.28），在24周时也是如此。两组在坚持饮食方面都有困难。然而，坚持营养遗传学指导饮食与体重减轻相关（r = 0.74；P = 4.0×10⁻⁵），但与坚持标准治疗无关（r = 0.34；P = 0.23）。肥胖低风险基因多态性的参与者在8周时体重减轻比所有其他参与者更多（分别为5.0%和2.9%；P = 0.02），在24周时体重指数显著降低更多（分别为6.4%和3.6%；P = 0.03），腰围也显著降低更多（分别为6.5%和2.6%；P = 0.02）。
在前瞻性研究中，与标准均衡饮食相比，基于营养遗传学的饮食并未增加体重减轻。然而，基因特征可以识别出最有可能从均衡饮食减肥策略中获益的个体；这些发现需要进一步研究。ClinicalTrials.gov编号：NCT01859403。
