膳食纤维能否在能量限制饮食之外独立影响体重？一项随机对照试验的系统评价和荟萃分析。

Can dietary viscous fiber affect body weight independently of an energy-restrictive diet? A systematic review and meta-analysis of randomized controlled trials.

机构信息

Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

Am J Clin Nutr. 2020 Feb 1;111(2):471-485. doi: 10.1093/ajcn/nqz292.

DOI:10.1093/ajcn/nqz292

PMID:31897475

Abstract

BACKGROUND

The role of dietary fiber in obesity management remains debatable. Evidence suggests that intake of viscous fiber may have the potential to facilitate weight loss.

OBJECTIVE

We aimed to summarize and quantify the effects of viscous fiber on body weight, BMI, waist circumference, and body fat, independent of calorie restriction, through a systematic review and meta-analysis of randomized controlled trials.

METHODS

Trials ≥4 wk in duration that assessed the effect of viscous fiber supplemented to an ad libitum diet along with comparator diets were included. MEDLINE, EMBASE, and the Cochrane library were searched through 24 July, 2019. Two independent reviewers extracted relevant data. Data were pooled using the generic inverse variance method and random-effects models and expressed as mean differences with 95% CIs. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The overall certainty of evidence was explored using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

RESULTS

Findings from 62 trials (n = 3877) showed that viscous fiber reduced mean body weight (-0.33 kg; 95% CI: -0.51, -0.14 kg; P = 0.004), BMI (in kg/m2) (-0.28; 95% CI: -0.42, -0.14; P = 0.0001), and waist circumference (-0.63 cm; 95% CI: -1.11, -0.16 cm; P = 0.008), with no change in body fat (-0.78%; 95% CI: -1.56%, 0.00%; P = 0.05) when consumed with an ad libitum diet. Greater reductions in body weight were observed in overweight individuals and those with diabetes and metabolic syndrome. The certainty of evidence was graded moderate for body weight, high for waist circumference and body fat, and low for BMI.

CONCLUSIONS

Dietary viscous fiber modestly yet significantly improved body weight and other parameters of adiposity independently of calorie restriction. Future trials are warranted to address the inconsistency and imprecision identified through GRADE and to determine long-term weight-loss sustainability.This systematic review and meta-analysis was registered at clinicaltrials.gov as NCT03257449.

摘要

背景

膳食纤维在肥胖管理中的作用仍存在争议。有证据表明，摄入粘性纤维可能有助于减肥。

目的

我们旨在通过对随机对照试验进行系统评价和荟萃分析，总结和量化粘性纤维在独立于热量限制的情况下对体重、BMI、腰围和体脂肪的影响。

方法

纳入持续时间≥4 周的试验，评估补充粘性纤维对随意饮食加对照饮食的影响。通过 2019 年 7 月 24 日检索 MEDLINE、EMBASE 和 Cochrane 图书馆。两名独立审查员提取相关数据。使用通用倒数方差法和随机效应模型对数据进行汇总，并以均值差和 95%CI 表示。评估了研究间异质性（Cochran Q 统计量）并进行了量化（I2 统计量）。使用推荐评估、制定与评价（GRADE）方法探讨证据的总体确定性。

结果

来自 62 项试验（n=3877）的结果表明，粘性纤维可降低平均体重（-0.33kg；95%CI：-0.51，-0.14kg；P=0.004）、BMI（kg/m2）（-0.28；95%CI：-0.42，-0.14；P=0.0001）和腰围（-0.63cm；95%CI：-1.11，-0.16cm；P=0.008），但对体脂肪无影响（-0.78%；95%CI：-1.56%，0.00%；P=0.05），当与随意饮食一起摄入时。在超重者和糖尿病及代谢综合征患者中，体重下降更为明显。体重的证据确定性为中等，腰围和体脂肪的证据确定性为高，BMI 的证据确定性为低。