Martin Corby K, Bhapkar Manju, Pittas Anastassios G, Pieper Carl F, Das Sai Krupa, Williamson Donald A, Scott Tammy, Redman Leanne M, Stein Richard, Gilhooly Cheryl H, Stewart Tiffany, Robinson Lisa, Roberts Susan B
Pennington Biomedical Research Center, Baton Rouge, Louisiana.
Duke Clinical Research Institute and Duke University School of Medicine, Durham, North Carolina.
JAMA Intern Med. 2016 Jun 1;176(6):743-52. doi: 10.1001/jamainternmed.2016.1189.
Calorie restriction (CR) increases longevity in many species and reduces risk factors for chronic diseases. In humans, CR may improve health span, yet concerns remain about potential negative effects of CR.
To test the effect of CR on mood, quality of life (QOL), sleep, and sexual function in healthy nonobese adults.
DESIGN, SETTING, AND PARTICIPANTS: A multisite randomized clinical trial (Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 [CALERIE 2]) was conducted at 3 academic research institutions. Adult men and women (N = 220) with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 22.0 to 28.0 were randomized to 2 years of 25% CR or an ad libitum (AL) control group in a 2:1 ratio favoring CR. Data were collected at baseline, 12 months, and 24 months and examined using intent-to-treat analysis. The study was conducted from January 22, 2007, to March 6, 2012. Data analysis was performed from July 18, 2012, to October 27, 2015.
Two years of 25% CR or AL.
Self-report questionnaires were administered to measure mood (Beck Depression Inventory-II [BDI-II], score range 0-63, higher scores indicating worse mood, and Profile of Mood States [POMS], with a total mood disturbance score range of -32 to 200 and higher scores indicating higher levels of the constructs measured), QOL (Rand 36-Item Short Form, score range 0-100, higher scores reflecting better QOL, and Perceived Stress Scale, score range 0-40, higher scores indicating higher levels of stress), sleep (Pittsburgh Sleep Quality Index [PSQI], total score range 0-21, higher scores reflecting worse sleep quality), and sexual function (Derogatis Interview for Sexual Function-Self-report, total score range 24-188, higher scores indicating better sexual functioning).
In all, 218 participants (152 women [69.7%]; mean [SD] age, 37.9 (7.2) years; mean [SD] BMI, 25.1 [1.6]) were included in the analyses. The CR and AL groups lost a mean (SE) of 7.6 (0.3) kg and 0.4 (0.5) kg, respectively, at month 24 (P < .001). Compared with the AL group, the CR group had significantly improved mood (BDI-II: between-group difference [BGD], -0.76; 95% CI, -1.41 to -0.11; effect size [ES], -0.35), reduced tension (POMS: BGD, -0.79; 95% CI, -1.38 to -0.19; ES, -0.39), and improved general health (BGD, 6.45; 95% CI, 3.93 to 8.98; ES, 0.75) and sexual drive and relationship (BGD, 1.06; 95% CI, 0.11 to 2.01; ES, 0.35) at month 24 as well as improved sleep duration at month 12 (BGD, -0.26; 95% CI, -0.49 to -0.02; ES, -0.32) (all P < .05). Greater percent weight loss in the CR group at month 24 was associated with increased vigor (Spearman correlation coefficient, ρ = -0.30) and less mood disturbance (ρ = 0.27) measured with the POMS, improved general health (ρ = -0.27) measured with the SF-36, and better sleep quality per the PSQI total score (ρ = 0.28) (all P < .01).
In nonobese adults, CR had some positive effects and no negative effects on health-related QOL.
clinicaltrials.gov Identifier: NCT00427193.
热量限制（CR）可延长多种物种的寿命，并降低慢性病的风险因素。在人类中，CR可能会改善健康寿命，但人们仍对CR的潜在负面影响存在担忧。
测试CR对健康非肥胖成年人的情绪、生活质量（QOL）、睡眠和性功能的影响。
设计、地点和参与者：在3个学术研究机构进行了一项多中心随机临床试验（减少能量摄入长期效应综合评估第二阶段 [CALERIE 2]）。体重指数（BMI；按千克体重除以身高米数的平方计算）为22.0至28.0的成年男性和女性（N = 220）以2:1的比例随机分为2年25%热量限制组或随意饮食（AL）对照组，倾向于热量限制组。在基线、12个月和24个月收集数据，并使用意向性分析进行检查。该研究于2007年1月22日至2012年3月6日进行。数据分析于2012年7月18日至2015年10月27日进行。
2年25%的热量限制或随意饮食。
采用自我报告问卷来测量情绪（贝克抑郁量表-II [BDI-II]，评分范围0 - 63，分数越高表明情绪越差，以及情绪状态量表 [POMS]，总情绪困扰评分范围为 - 32至200，分数越高表明所测量的构念水平越高）、生活质量（兰德36项简表，评分范围0 - 100，分数越高反映生活质量越好，以及感知压力量表，评分范围0 - 40，分数越高表明压力水平越高）、睡眠（匹兹堡睡眠质量指数 [PSQI]，总分范围0 - 21，分数越高反映睡眠质量越差）和性功能（性功能自我报告德罗加蒂斯访谈，总分范围24 - 188，分数越高表明性功能越好）。
总共218名参与者（152名女性 [69.7%]；平均 [标准差] 年龄，37.9（7.2）岁；平均 [标准差] BMI，25.1 [1.6]）纳入分析。在第24个月时，热量限制组和随意饮食组平均（标准误）分别减重7.6（0.3）kg和0.4（0.5）kg（P <.001）。与随意饮食组相比，热量限制组在第24个月时情绪显著改善（BDI-II：组间差异 [BGD]， - 0.76；95%置信区间， - 1.41至 - 0.11；效应量 [ES]， - 0.35），紧张感降低（POMS：BGD， - 0.79；95%置信区间， - 1.38至 - 0.19；ES， - 0.39），总体健康状况改善（BGD，6.45；95%置信区间，3.93至8.98；ES，0.75）以及性驱力和性关系改善（BGD，1.06；95%置信区间，0.11至2.01；ES，0.35），并且在第12个月时睡眠时间也有所改善（BGD， - 0.26；95%置信区间， - 0.49至 - 0.02；ES， - 0.32）（所有P <.05）。热量限制组在第24个月时更大的体重减轻百分比与用POMS测量的活力增加（斯皮尔曼相关系数，ρ = - 0.30）和情绪困扰减少（ρ = 0.27）、用SF - 36测量的总体健康状况改善（ρ = - 0.27）以及根据PSQI总分得出的更好睡眠质量（ρ = 0.28）相关（所有P <.01）。
在非肥胖成年人中，热量限制对与健康相关的生活质量有一些积极影响且无负面影响。
clinicaltrials.gov标识符：NCT00427193。
