Ard Jamy D, Cook Miranda, Rushing Julia, Frain Annette, Beavers Kristen, Miller Gary, Miller Michael E, Nicklas Barb
Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
Department of Surgery, Weight Management Center, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
Obesity (Silver Spring). 2016 Sep;24(9):1861-6. doi: 10.1002/oby.21569. Epub 2016 Jul 19.
A 6-month pilot trial compared two strategies for weight loss in older adults with body mass indexes (BMIs) ≥35 kg/m(2) to assess weight loss response, safety, and impact on physical function.
Twenty-eight volunteers were randomized to a balanced deficit diet (BDD) (500 kcal/day below estimated energy needs) or an intensive, low-calorie, meal replacement diet (ILCD, 960 kcal/day). Behavioral interventions and physical activity prescriptions were similar for both groups. Primary outcomes were changes in body weight and adverse event frequency; secondary outcomes included measures of physical function and body composition.
ILCD average weight change was -19.1 ± 2.2 kg or 15.9 ± 4.6% of initial body weight compared with -9.1 ± 2.7 kg or 7.2 ± 1.9% for BDD. ILCD lost more fat mass (-7.7 kg, 95% CI [-11.9 to -3.5]) but had similar loss of lean mass (-1.7 kg, 95% CI [-4.1 to 0.6]) compared with BDD. There were no significant differences in change in physical function or adverse event frequency.
Compared with a traditional BDD intervention, older adults who have severe obesity treated with intensive medical weight loss had greater weight loss and decreases in fat mass without a higher frequency of adverse events. In the short term, however, this did not translate into greater improvements in physical function.
一项为期6个月的试点试验比较了体重指数（BMI）≥35kg/m²的老年人的两种减肥策略，以评估减肥反应、安全性及对身体功能的影响。
28名志愿者被随机分为均衡亏空饮食组（BDD，比估计能量需求低500千卡/天）或强化低热量代餐饮食组（ILCD，960千卡/天）。两组的行为干预和体育活动处方相似。主要结局是体重变化和不良事件发生频率；次要结局包括身体功能和身体成分的测量指标。
ILCD组平均体重变化为-19.1±2.2kg，占初始体重的15.9±4.6%，而BDD组为-9.1±2.7kg，占7.2±1.9%。与BDD组相比，ILCD组减少的脂肪量更多（-7.7kg，95%CI[-11.9至-3.5]），但去脂体重减少量相似（-1.7kg，95%CI[-4.1至0.6]）。身体功能变化或不良事件发生频率无显著差异。
与传统的BDD干预相比，接受强化医学减肥治疗的重度肥胖老年人减重更多，脂肪量减少，且不良事件发生频率未增加。然而，短期内这并未转化为身体功能的更大改善。
