饮食蛋白摄入量对减肥后骨量的影响：系统评价和荟萃分析。
Effects of Dietary Protein Quantity on Bone Quantity following Weight Loss: A Systematic Review and Meta-analysis.
机构信息
Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.
出版信息
Adv Nutr. 2019 Nov 1;10(6):1089-1107. doi: 10.1093/advances/nmz058.
Research supports the hypothesis that higher total protein intake during weight loss promotes retention of lean soft tissue, but the effect of dietary protein quantity on bone mass, a lean hard tissue, is inconsistent. The purpose of this systematic review and meta-analysis was to assess the effect of dietary protein quantity [higher protein (HP): ≥25% of energy from protein or ≥1.0 g · kg body wt-1 · d-1; normal protein (NP): <25% of energy from protein or <1.0 g · kg body wt-1 · d-1] on changes in bone mineral density (BMD) and content (BMC; total body, lumbar spine, total hip, femoral neck) following a prescribed energy restriction. We hypothesized that an HP diet would attenuate the loss of BMD/BMC following weight loss in comparison to an NP diet. Two researchers systematically and independently screened 2366 publications from PubMed, Cochrane, Scopus, CINAHL, and Web of Science Core Collection and extracted data from 34 qualified publications. Inclusion criteria included the following: 1) healthy subjects ≥19 y; 2) a prescribed energy restriction; 3) measurements of total protein intake, BMD, and BMC; and 4) an intervention duration of ≥3 mo. Data from 10 of the 34 publications with 2 groups of different total protein intakes were extracted and used to conduct a random-effects model meta-analysis. A majority of publications (59%) showed a decrease in bone quantity following active weight loss, regardless of total protein intake. Statistically, the loss of total BMD (P = 0.016; weighted mean difference: +0.006 g/cm2; 95% CI: 0, 0.011 g/cm2) and lumbar spine BMD (P = 0.019; weighted mean difference: +0.017 g/cm2; 95% CI: 0.001, 0.033 g/cm2) was attenuated with an HP versus an NP weight-loss diet. However, the clinical significance is questionable given the modest weighted mean difference and study duration. Higher total protein intake does not exacerbate but may attenuate the loss of bone quantity following weight loss.
研究支持这样一种假设，即减肥过程中较高的总蛋白质摄入量可促进瘦体软组织的保留，但饮食蛋白质数量对骨量（一种瘦体硬组织）的影响并不一致。本系统评价和荟萃分析的目的是评估饮食蛋白质数量[高蛋白（HP）：蛋白质提供的能量>25%，或>1.0 g·kg 体重-1·d-1；正常蛋白（NP）：蛋白质提供的能量<25%，或<1.0 g·kg 体重-1·d-1]对规定能量限制后骨矿物质密度（BMD）和骨矿物质含量（BMC；全身、腰椎、总髋、股骨颈）变化的影响。我们假设与 NP 饮食相比，HP 饮食可减轻减肥后 BMD/BMC 的丢失。两名研究人员系统地、独立地从 PubMed、Cochrane、Scopus、CINAHL 和 Web of Science Core Collection 筛选了 2366 篇出版物，并从 34 篇合格出版物中提取数据。纳入标准包括以下内容：1）健康受试者≥19 岁；2）规定的能量限制；3）总蛋白质摄入量、BMD 和 BMC 的测量；4）干预持续时间≥3 个月。从 34 篇出版物中的 10 篇中提取了具有不同总蛋白质摄入量的 2 组的数据，并用于进行随机效应模型荟萃分析。无论总蛋白质摄入量如何，大多数出版物（59%）显示主动减肥后骨量减少。从统计学上讲，总 BMD 的丢失（P=0.016；加权均数差：+0.006 g/cm2；95%CI：0，0.011 g/cm2）和腰椎 BMD 的丢失（P=0.019；加权均数差：+0.017 g/cm2；95%CI：0.001，0.033 g/cm2）在 HP 与 NP 减肥饮食中被减弱。然而，鉴于较小的加权均数差和研究持续时间，临床意义值得怀疑。较高的总蛋白质摄入量不会加重，但可能会减轻减肥后的骨量丢失。
Zotero 插件