两种低脂饮食的比较，在蛋白质和碳水化合物方面存在差异，对肥胖和 2 型糖尿病成人的心理健康的影响：一项随机临床试验。
Comparison of two low-fat diets, differing in protein and carbohydrate, on psychological wellbeing in adults with obesity and type 2 diabetes: a randomised clinical trial.
机构信息
Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
Commonwealth Scientific and Industrial Research Organization - Health and Biosecurity, PO Box 10041, Adelaide, SA, 5000, Australia.
出版信息
Nutr J. 2018 Jun 15;17(1):62. doi: 10.1186/s12937-018-0367-5.
BACKGROUND
Although higher-protein diets (HP) can assist with weight loss and glycemic control, their effect on psychological wellbeing has not been established. The objective of this study was to compare the effects of a HP and a higher-carbohydrate diet (HC), combined with regular exercise, on psychological wellbeing both during weight loss (WL) and weight maintenance phases (WM).
METHODS
In a parallel RCT, 61 adults with T2D (mean ± SD: BMI 34.3 ± 5.1 kg/m, aged 55 ± 8 years) consumed a HP diet (29% protein, 34% carbohydrate, 31% fat) or an isocaloric HC diet (21%:48%:24%), with moderate intensity exercise, for 12 weeks of WL and 12 weeks of WM. Secondary data evaluating psychological wellbeing was assessed using: Problems Areas in Diabetes (PAID); Diabetes-39 Quality of Life (D-39); Short Form Health Survey (SF-36); Perceived Stress Scale-10 (PSS-10) and the Leeds Sleep Evaluation Questionnaire (LSEQ) at Weeks 0, 12 and 24 and evaluated with mixed models analysis.
RESULTS
Independent of diet, improvements for PAID; D-39 diabetes control; D-39 severity of diabetes; SF-36 physical functioning and SF-36 general health were found following WL (d = 0.30 to 0.69, P ≤ 0.04 for all) which remained after 12 weeks of WM. SF-36 vitality improved more in the HP group (group x time interaction P = 0.03). Associations were seen between HbA1c and D-39 severity of diabetes rating (r = 0.30, P = 0.01) and SF-36 mental health (r = - 0.32, P = 0.003) and between weight loss and PAID (r = 0.30, P = 0.01).
CONCLUSION
Several improvements in diabetes-related and general psychological wellbeing were seen similarly for both diets following weight loss and a reduction in HbA1c with most of these improvements remaining when weight loss was sustained for 12 weeks. A HP diet may provide additional increases in vitality.
TRIAL REGISTRATION
The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12613000008729 ) on 4 January 2013.
背景
尽管高蛋白饮食（HP）有助于减肥和控制血糖，但它对心理健康的影响尚未确定。本研究的目的是比较 HP 饮食和高碳水化合物饮食（HC）与规律运动相结合，在减肥（WL）和体重维持（WM）期间对心理健康的影响。
方法
在一项平行 RCT 中，61 名 T2D 成人（平均±SD：BMI 34.3±5.1 kg/m，年龄 55±8 岁）在 WL 期间和 WM 期间分别接受 HP 饮食（29%蛋白质，34%碳水化合物，31%脂肪）或等热量 HC 饮食（21%：48%：24%），并进行中等强度的运动。使用：糖尿病问题领域（PAID）；糖尿病 39 项生活质量（D-39）；健康调查简表（SF-36）；压力感知量表 10 项（PSS-10）和利兹睡眠评估问卷（LSEQ）在第 0、12 和 24 周评估次要数据评估心理健康，使用混合模型分析进行评估。
结果
独立于饮食，WL 后 PAID；D-39 糖尿病控制；D-39 糖尿病严重程度；SF-36 身体机能和 SF-36 一般健康状况均有改善（d=0.30 至 0.69，所有 P 值均≤0.04），WM 12 周后仍保持改善。HP 组 SF-36 活力改善更为明显（组间时间交互 P=0.03）。HbA1c 与 D-39 糖尿病严重程度评分（r=0.30，P=0.01）和 SF-36 心理健康评分（r=-0.32，P=0.003）以及体重减轻与 PAID（r=0.30，P=0.01）之间存在相关性。
结论
两种饮食在减肥后均能显著改善与糖尿病相关和一般心理幸福感，并且在 12 周的减肥维持期内，大多数改善仍然存在。高蛋白饮食可能会增加活力。
试验注册
该试验于 2013 年 1 月 4 日前瞻性地在澳大利亚和新西兰临床试验注册中心（ACTRN 12613000008729）注册。
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