Weiss Edward P, Albert Stewart G, Reeds Dominic N, Kress Kathleen S, McDaniel Jennifer L, Klein Samuel, Villareal Dennis T
Department of Nutrition and Dietetics, and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO; and
Division of Endocrinology, School of Medicine, Saint Louis University, St. Louis, MO;
Am J Clin Nutr. 2016 Sep;104(3):576-86. doi: 10.3945/ajcn.116.131391. Epub 2016 Jul 27.
Weight loss from calorie restriction (CR) and/or endurance exercise training (EX) is cardioprotective. However CR and EX also have weight loss-independent benefits.
We tested the hypothesis that weight loss from calorie restriction and exercise combined (CREX) improves cardiovascular disease (CVD) risk factors more so than similar weight loss from CR or EX alone.
Overweight, sedentary men and women (n = 52; aged 45-65 y) were randomly assigned to undergo 6-8% weight loss by using CR, EX, or CREX. Outcomes were measured before and after weight loss and included maximal oxygen consumption (VO2max), resting blood pressure, fasting plasma lipids, glucose, C-reactive protein, and arterial stiffness [carotid-femoral pulse wave velocity (PWV) and carotid augmentation index (AI)]. Values are means ± SEs.
Reductions in body weight (∼7%) were similar in all groups. VO2max changed in proportion to the amount of exercise performed (CR, -1% ± 3%; EX, +22% ± 3%; and CREX, +11% ± 3%). None of the changes in CVD risk factors differed between groups. For all groups combined, decreases were observed for systolic and diastolic blood pressure (-5 ± 1 and -4 ± 1 mm Hg, respectively; both P < 0.0008), total cholesterol (-17 ± 4 mg/dL; P < 0.0001), non-HDL cholesterol (-16 ± 3 mg/dL; P < 0.0001), triglycerides (-18 ± 8 mg/dL; P = 0.03), and glucose (-3 ± 1 mg/dL; P = 0.0003). No changes were observed for HDL cholesterol (P = 0.30), C-reactive protein (P = 0.10), PWV (P = 0.30), or AI (P = 0.84). These changes would be expected to decrease the lifetime risk of CVD from 46% to 36%.
Matched weight losses from CR, EX, and CREX have substantial beneficial effects on CVD risk factors. However, the effects are not additive when weight loss is matched. This trial was registered at clinicaltrials.gov as NCT00777621.
通过热量限制（CR）和/或耐力运动训练（EX）实现的体重减轻具有心脏保护作用。然而，CR和EX也有与体重减轻无关的益处。
我们检验了这样一个假设，即热量限制与运动相结合（CREX）导致的体重减轻比单独通过CR或EX实现的类似体重减轻更能改善心血管疾病（CVD）风险因素。
超重的久坐男性和女性（n = 52；年龄45 - 65岁）被随机分配通过CR、EX或CREX实现6 - 8%的体重减轻。在体重减轻前后测量各项指标，包括最大摄氧量（VO2max）、静息血压、空腹血脂、血糖、C反应蛋白以及动脉僵硬度[颈股脉搏波速度（PWV）和颈动脉增强指数（AI）]。数值为均值±标准误。
所有组的体重减轻幅度（约7%）相似。VO2max 的变化与运动量成正比（CR组，-1% ± 3%；EX组，+22% ± 3%；CREX组，+11% ± 3%）。各CVD风险因素的变化在组间无差异。对于所有组综合来看，收缩压和舒张压均下降（分别为-5 ± 1和-4 ± mmHg；P均< 0.0008），总胆固醇下降（-17 ± 4 mg/dL；P < 0.0001），非高密度脂蛋白胆固醇下降（-16 ± 3 mg/dL；P < 0.0001），甘油三酯下降（-18 ± 8 mg/dL；P = 0.03），血糖下降（-3 ± 1 mg/dL；P = 0.0003）。高密度脂蛋白胆固醇（P = 0.30）、C反应蛋白（P = 0.10）、PWV（P = 0.30）或AI（P = 0.84）无变化。这些变化预计会使CVD的终生风险从46%降至36%。
CR、EX和CREX实现的匹配体重减轻对CVD风险因素有显著有益影响。然而，当体重减轻程度相匹配时，这些影响并非叠加性的。该试验在clinicaltrials.gov上注册，注册号为NCT00777621。
