Bray G A, Ryan D H, Johnson W, Champagne C M, Johnson C M, Rood J, Williamson D A, Sacks F M
Pennington Biomedical Research Center of the University State University System (PBRC), Baton Rouge, LA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health (HCSPH), Boston, MA, USA.
Clin Obes. 2017 Jun;7(3):166-175. doi: 10.1111/cob.12188. Epub 2017 Mar 24.
To assess the association of markers for dietary protein intake, measures of dietary adherence and demographic variables with weight loss in the POUNDS Lost study over the first 6 months and again between 6 and 24 months using data from those who completed each period. This is a secondary analysis of pooled data on completers assigned to one of four diets: 65%C/15%P/20%F (AP/LF), 55%C/25%P/20%F (HP/LF), 45%C/15%P/40%F (AP/HF) or 35%C/25%P40%F (HP/HF) in the POUNDS Lost study. Urinary nitrogen excretion, dietary adherence measured by 24-h recall and attendance at sessions, age (above and below 50 years), gender, race/ethnicity and activity by pedometry were analysed. Increased spread between protein intake at baseline and protein at 6 or 24 months, assessed by urinary nitrogen excretion, was associated with greater weight loss from baseline to 2 years. At 6 and 24 months, older age, male gender, body mass index > 30 kg m and adherence to the fat and protein diets were associated with more weight loss. None of these variables was associated with a regain from 6 to 24 months. Weight regain for women in the highest carbohydrate (65%) group was significantly greater (-4.4 kg [95% CI: -5.9, -3.0]) than for women in the lowest carbohydrate group (-1.8 kg [95% CI: -3.2, -0.4 kg]) (P for interaction = 0.012). An increased spread in the difference between baseline and follow-up protein intake was associated with greater weight loss, consistent with the 'protein spread theory'. Women eating the highest carbohydrate diet regained more weight from 6 to 24 months.
在“减重”研究中，利用完成每个阶段研究对象的数据，评估膳食蛋白质摄入量标志物、膳食依从性指标以及人口统计学变量与前6个月和6至24个月期间体重减轻之间的关联。这是对分配到四种饮食之一的完成者汇总数据的二次分析：“减重”研究中的65%碳水化合物/15%蛋白质/20%脂肪（高碳水化合物/低脂肪）、55%碳水化合物/25%蛋白质/20%脂肪（低碳水化合物/低脂肪）、45%碳水化合物/15%蛋白质/40%脂肪（高碳水化合物/高脂肪）或35%碳水化合物/25%蛋白质/40%脂肪（低碳水化合物/高脂肪）。分析了尿氮排泄、通过24小时回忆法测量的膳食依从性和参加课程情况、年龄（50岁及以上和50岁以下）、性别、种族/族裔以及通过计步器测量的活动量。通过尿氮排泄评估，基线蛋白质摄入量与6个月或24个月时蛋白质摄入量之间的差异增大，与从基线到2年时体重减轻更多相关。在6个月和24个月时，年龄较大、男性、体重指数>30 kg/m²以及对脂肪和蛋白质饮食的依从性与更多的体重减轻相关。这些变量均与6至24个月期间的体重反弹无关。碳水化合物含量最高（65%）组的女性体重反弹（-4.4 kg [95%可信区间：-5.9，-3.0]）显著高于碳水化合物含量最低组的女性（-1.8 kg [95%可信区间：-3.2，-0.4 kg]）（交互作用P值=0.012）。基线和随访蛋白质摄入量之间差异的增大与更多的体重减轻相关，这与“蛋白质差异理论”一致。食用碳水化合物含量最高饮食的女性在6至24个月期间体重反弹更多。
