一项为期12个月的减肥随机对照试验期间饮食质量的变化。
Changes in diet quality during a 12 month weight loss randomised controlled trial.
作者信息
Wibisono Cinthya, Probst Yasmine, Neale Elizabeth, Tapsell Linda
机构信息
1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522 Australia.
2Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales 2522 Australia.
出版信息
BMC Nutr. 2017 Apr 17;3:38. doi: 10.1186/s40795-017-0157-z. eCollection 2017.
BACKGROUND
Reductions in energy intake are seen in weight loss trials, but whether this occurs with improvements to diet quality (DQ) is less established. The aim of this study was to evaluate changes in diet quality in a sample of volunteers in a weight loss trial.
METHODS
This was a secondary analysis of dietary data from a lifestyle intervention trial (the HealthTrack study) which advised on dietary guidelines. The trial ran for 12 months with three treatment groups: control (general advice ), intervention (individualised advice, ), and intervention plus a supplement of walnuts (). Both the published (APDQS, maximum score 164) and a study specific Diet Quality Tracker (DQT, maximum score 44) indicated compliance to dietary advice. DQ scores calculated at 0, 3months and 12months were evaluated using two-way RMANOVA, one-way ANOVA and one-way RMANOVA. Changes in intakes of food groups and nutrients were analysed using Kruskal-Wallis and Friedman's tests.
RESULTS
There were no differences between groups at baseline, but at 3months recorded higher DQ scores (APDQS:96 ± 10; DQT:22 ± 5, < 1 × 10 for both) compared to (APDQS:91 ± 13, < 1 × 10; DQT:21 ± 4, < 1 × 10) and (APDQS:87 ± 12, < 5 × 10; DQT:19 ± 4, > 5 × 10), and a higher consumption of nuts at 3 months ( < 1 × 10), and 12months ( < 1 × 10). All groups reported decreased intakes of discretionary foods/beverages assessed by the DQT ( < 1 × 10 for and ; < 1 × 10 for ). The APDQS showed this as reduced intakes of grain based desserts ( < 1 × 10 at 3 and 12months), and salty snacks at 12months ( < 1 × 10 for and ; < 5 × 10 for ). Intakes of monounsaturated and saturated fatty acids were lowest, and polyunsaturated fatty acids highest for ( < 1 × 10), resulting in a higher dietary polyunsaturated:saturated fat ratio ( < 1 × 10).
CONCLUSIONS
Lifestyle intervention addressing dietary guidelines can lead to significant reductions in consumption of discretionary foods and saturated fat, but individualised advice may have a greater impact on improving overall DQ regardless of DQI used. Providing a healthy food supplement may help assure higher DQ and where the food is walnuts, produce commensurate differences in dietary fatty acid profiles.
TRIAL REGISTRATION
ANZCTRN 12614000581662. Date of registration: 30th May 2014.
背景
在减肥试验中可观察到能量摄入减少，但能量摄入减少是否伴随着饮食质量（DQ）的改善尚不明确。本研究的目的是评估减肥试验中一组志愿者的饮食质量变化。
方法
这是一项对来自生活方式干预试验（健康追踪研究）的饮食数据进行的二次分析，该试验提供饮食指南建议。试验为期12个月，有三个治疗组：对照组（一般建议）、干预组（个性化建议）和干预加核桃补充剂组。已发表的澳大利亚饮食质量评分系统（APDQS，最高分164）和一项特定研究的饮食质量追踪器（DQT，最高分44）均表明符合饮食建议。使用双向重复测量方差分析、单向方差分析和单向重复测量方差分析评估在0、3个月和12个月时计算的DQ分数。使用Kruskal-Wallis检验和Friedman检验分析食物组和营养素摄入量的变化。
结果
各组在基线时无差异，但在3个月时，干预加核桃补充剂组的DQ分数（APDQS：96±10；DQT：22±5，两者均P<1×10⁻⁴）高于干预组（APDQS：91±13，P<1×10⁻⁴；DQT：21±4，P<1×10⁻⁴）和对照组（APDQS：87±12，P<5×10⁻⁴；DQT：19±4，P>5×10⁻⁴），且在3个月（P<1×10⁻⁴）和12个月（P<1×10⁻⁴）时坚果摄入量更高。所有组报告称，根据DQT评估的 discretionary 食物/饮料摄入量减少（干预组和对照组P<1×10⁻⁴；干预加核桃补充剂组P<1×10⁻⁴）。APDQS显示这表现为谷物类甜点摄入量减少（3个月和12个月时P<1×10⁻⁴），以及12个月时咸味小吃摄入量减少（干预组和对照组P<1×10⁻⁴；干预加核桃补充剂组P<5×10⁻⁴）。干预加核桃补充剂组的单不饱和脂肪酸和饱和脂肪酸摄入量最低，多不饱和脂肪酸摄入量最高（P<1×10⁻⁴），导致饮食中多不饱和脂肪与饱和脂肪的比例更高（P<1×10⁻⁴）。
结论
遵循饮食指南的生活方式干预可导致 discretionary 食物和饱和脂肪的摄入量显著减少，但无论使用何种饮食质量指标，个性化建议可能对改善整体饮食质量有更大影响。提供健康的食物补充剂可能有助于确保更高的饮食质量，如果食物是核桃，则会在饮食脂肪酸谱方面产生相应差异。
试验注册
澳大利亚和新西兰临床试验注册号ANZCTRN 12614000581662。注册日期：2014年5月30日。
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