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极低热量生酮饮食加氨基酸补充剂与极低热量限制饮食在减肥期间保持肌肉量的比较:一项双盲初步研究

Very-low-calorie ketogenic diet with aminoacid supplement versus very low restricted-calorie diet for preserving muscle mass during weight loss: a pilot double-blind study.

作者信息

Merra G, Miranda R, Barrucco S, Gualtieri P, Mazza M, Moriconi E, Marchetti M, Chang T F M, De Lorenzo A, Di Renzo L

机构信息

Emergency Department, "A. Gemelli" General Hospital Foundation, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2016 Jul;20(12):2613-21.

Abstract

OBJECTIVE

Obesity plays a relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional and metabolic factors. We conducted a dietary intervention case-control randomized trial, to compare the effectiveness on body composition of two nutritional protocols: a very-low-carbohydrate ketogenic diet (VLCKD), integrated by an aminoacid supplement with whey protein, and very low restricted-calorie diet (VLCD).

PATIENTS AND METHODS

The clinical study was conducted with a randomized case-control in which twenty-five healthy subjects gave informed consent to participate in the interventional study and were evaluated for their health and nutritional status, by anthropometric, and body composition evaluation.

RESULTS

The results of this pilot study show that a diet low in carbohydrates, associated with a decreased caloric intake, is effective in weight loss. After VLCKD, versus VLCD, no significant differences in body lean of the trunk, body lean distribution (android and gynoid), total body lean were observed (p > 0.05). After VLCKD, no increasing of sarcopenia frequency, according ASSMI, was observed.

DISCUSSION

Many studies have shown the effectiveness of the ketogenic diet on weight loss; even if not know how to work effectively, as some researchers believe that the weight loss is due to reduced calorie intake, satiety could also be induced by the effect of the proteins, rather than the low-carbohydrates.

CONCLUSIONS

Our pilot study showed that a VLCKD was highly effective in terms of body weight reduction without to induce lean body mass loss, preventing the risk of sarcopenia. Further clinical trials are needed on a larger population and long-term body weight maintenance and risk factors management effects of VLCKD. There is no doubt, however, that a proper dietary approach would impact significantly on the reduction of public expenditure costs, in view of prospective data on increasing the percentage of obese people in our nation.

摘要

目的

肥胖在健康问题的发生发展中起着重要的病理生理作用,是遗传、营养和代谢因素复杂相互作用的结果。我们开展了一项饮食干预病例对照随机试验,以比较两种营养方案对身体成分的效果:一种是极低碳水化合物生酮饮食(VLCKD),由含乳清蛋白的氨基酸补充剂组成,另一种是极低热量限制饮食(VLCD)。

患者与方法

本临床研究采用随机病例对照试验,25名健康受试者签署知情同意书参与干预研究,并通过人体测量和身体成分评估对其健康和营养状况进行评估。

结果

这项初步研究的结果表明,低碳水化合物饮食与热量摄入减少相关,对体重减轻有效。与VLCD相比,VLCKD后躯干瘦体重、瘦体重分布(男性型和女性型)、全身瘦体重均无显著差异(p>0.05)。根据亚洲肌肉减少症工作组标准,VLCKD后未观察到肌肉减少症频率增加。

讨论

许多研究表明生酮饮食对体重减轻有效;尽管尚不清楚其具体作用机制,一些研究人员认为体重减轻是由于热量摄入减少,饱腹感也可能是由蛋白质的作用而非低碳水化合物引起的。

结论

我们的初步研究表明,VLCKD在减轻体重方面非常有效,且不会导致瘦体重丢失,可预防肌肉减少症风险。需要对更大规模人群进行进一步临床试验,以研究VLCKD对长期体重维持和危险因素管理的影响。然而,鉴于我国肥胖人群比例上升的前瞻性数据,合理的饮食方法无疑将对降低公共支出成本产生重大影响。

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