超重至肥胖绝经后女性通过节食或运动减重后的生活质量：SHAPE-2随机对照试验
Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial.
作者信息
van Gemert Willemijn A M, van der Palen Job, Monninkhof Evelyn M, Rozeboom Anouk, Peters Roelof, Wittink Harriet, Schuit Albertine J, Peeters Petra H
机构信息
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
Medisch Spectrum Twente Hospital, Department of Epidemiology, P.O. Box 50000, 7500 KA, Enschede, the Netherlands; University of Twente, Department of Research Methodology, Measurement, and Data Analysis, P.O. Box 217, 7500 AE, Enschede, the Netherlands.
出版信息
PLoS One. 2015 Jun 1;10(6):e0127520. doi: 10.1371/journal.pone.0127520. eCollection 2015.
INTRODUCTION
This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss.
METHODS
The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire.
RESULTS
Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other.
CONCLUSION
In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01511276.
引言
本研究调查了通过限制热量饮食或主要通过增加体育锻炼实现适度体重减轻对超重至肥胖且缺乏运动的绝经后女性健康相关生活质量（HRQoL）的影响。我们假设HRQoL会随着体重减轻而改善，并且运动引起的体重减轻对此的效果比饮食引起的体重减轻更有效。
方法
SHAPE-2试验主要旨在评估与饮食导致的同等体重减轻相比，运动导致的体重减轻对与乳腺癌风险相关的生物标志物的任何额外影响。在本分析中，我们关注HRQoL。我们将243名符合条件的女性随机分为饮食组（n = 97）、运动组（n = 98）或对照组（n = 48）。两种干预措施的目标都是减轻5 - 6千克体重。通过SF - 36问卷在基线和16周后测量HRQoL。
结果
214名女性的数据可供分析。饮食组和运动组的体重减轻分别为4.9千克（6.1%）和5.5千克（6.9%）。与对照组相比，SF - 36领域“健康变化”的得分在饮食组显著增加了8.8分（95%置信区间1.6；16.1），在运动组显著增加了20.5分（95%置信区间13.2；27.7）。饮食组和运动组的直接比较显示，运动组的改善在统计学上显著更强。两个干预组在大多数其他领域都有改善的趋势，运动组更为明显，但与对照组或彼此之间没有统计学差异。
结论
在一项针对超重至肥胖且缺乏运动的绝经后女性的随机试验中，仅通过饮食或主要通过运动实现了相当的6% - 7%的体重减轻，并在身体和心理HRQoL领域有所改善，但饮食组或运动组的结果在统计学上均无显著差异。然而，适度的体重减轻确实会导致自我感知健康状况的积极变化。运动引起的体重减轻产生的这种效果比同等的饮食引起的体重减轻显著更大。
试验注册
ClinicalTrials.gov NCT01511276。
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