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比较一般饮食建议与极低能量饮食对澳大利亚肥胖门诊患者的疗效。

Comparing the effectiveness of general dietary advice versus a very low energy diet in an obese outpatient population in Australia.

机构信息

Discipline of Nutrition and Dietetics, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia.

Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, 2050, Australia.

出版信息

Eat Weight Disord. 2019 Aug;24(4):739-747. doi: 10.1007/s40519-017-0443-4. Epub 2017 Oct 11.

Abstract

PURPOSE

Obesity is a major public health burden. Outpatient clinics are an essential resource for individuals with obesity to access advice for weight loss management. The aim of this study was to compare anthropometric and weight loss outcomes between participants receiving general dietary (GD) advice, and those on a very low energy diet (VLED) under non-trial conditions.

METHODS

Data from 276 adults with obesity attending a multidisciplinary weight management clinic were analysed. Changes in anthropometry, body composition, and blood pressure (BP) over 12 months were analysed using linear mixed-effects models.

RESULTS

Males on the GD demonstrated statistically greater reductions in body weight (BW), BMI, percent fat mass (FM), systolic BP, waist and hip circumference (p < 0.01). Changes in males on a VLED did not reach significance. Females showed statistically significant reductions in BW, BMI, waist and hip circumference regardless of dietary intervention (p < 0.01); those on the GD significantly reduced percent FM (p < 0.001). Females on a VLED had statistically greater reductions in BW, BMI and systolic BP compared to those on the GD. No effect of exercise physiologist was observed in this study. Participants prescribed a GD attended for significantly longer than those on a VLED (p < 0.05), irrespective of gender. At 12 months, 14.3 and 4.5% of males and females on a VLED were still attending, compared to 10.6 and 4.5% on the GD.

CONCLUSIONS

In this retrospective study, females in both dietary intervention groups achieved significant changes across multiple measures. Only men receiving GD advice demonstrated significant changes.

LEVEL OF EVIDENCE

Level II-2.

摘要

目的

肥胖是一个主要的公共卫生负担。门诊诊所是肥胖患者获得减肥管理建议的重要资源。本研究的目的是比较接受一般饮食(GD)建议和极低能量饮食(VLED)的参与者在非试验条件下的人体测量学和减肥效果。

方法

分析了 276 名参加多学科体重管理诊所的肥胖成年人的数据。使用线性混合效应模型分析了 12 个月内人体测量、身体成分和血压(BP)的变化。

结果

接受 GD 的男性在体重(BW)、BMI、体脂肪百分比(FM)、收缩压、腰围和臀围方面的统计学上的降低幅度更大(p < 0.01)。接受 VLED 的男性的变化没有达到统计学意义。女性无论接受何种饮食干预,BW、BMI、腰围和臀围均有统计学显著降低(p < 0.01);接受 GD 的女性体脂肪百分比显著降低(p < 0.001)。与接受 GD 的女性相比,接受 VLED 的女性在 BW、BMI 和收缩压方面的降低幅度统计学上更大。在这项研究中,没有观察到运动生理学家的效果。接受 GD 治疗的参与者就诊时间明显长于接受 VLED 治疗的参与者(p < 0.05),与性别无关。在 12 个月时,接受 VLED 的男性和女性中,仍有 14.3%和 4.5%在就诊,而接受 GD 的男性和女性中,仍有 10.6%和 4.5%在就诊。

结论

在这项回顾性研究中,接受两种饮食干预的女性在多项指标上都有显著的变化。只有接受 GD 建议的男性表现出显著的变化。

证据水平

二级证据,2 级。

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