Department of Psychobiology, Universidade Federal de São Paulo; Department of Nutrition, Universidade Federal de Lavras, Lavras, Brazil.
Department of Biocsciences, Universidade Federal de São Paulo; School of Public Health and School of Arts, Sciences and Humanities, Universidade de São Paulo, São Paulo, Brazil.
Clin Nutr ESPEN. 2021 Apr;42:82-89. doi: 10.1016/j.clnesp.2020.12.028. Epub 2021 Feb 11.
Obstructive Sleep Apnea (OSA) is closely associated with obesity. Weight loss ameliorates OSA and its associated metabolic disorders. A high protein intake may improve weight loss through increased energy expenditure, and fat-free mass maintenance during weight loss.
To evaluate the effects of a low-energy, high-protein diet on OSA severity and metabolic parameters in obese men.
Forty-five OSA obese (BMI ≥ 30 kg/m) males were included in this randomized study and submitted to nocturnal polysomnography, body composition measured by plethysmography, biochemical analyses of blood glucose, insulin and lipids, and food intake evaluations before and after one month of a low-energy diet. Diets were designed to create a 30% deficit in total energy expenditure with 1.6 g of protein/kg/day (High Protein group - HP) or 0.8 g of protein/kg/day (Low Protein group - LP).
Only a time effect of the intervention was observed in body mass (-3.7 ± 2.0% for the LP group and -4.0 ± 1.5% for the HP group; p < 0.001), Body Mass Index (p < 0.001), fat mass in kg (p < 0.01) and fat-free mass in kg (p < 0.01). Significant improvements in Apnea Hypopnea Index were observed in both groups (54.0 ± 25.0 to 33.7 ± 31.7 in LP group; 39.7 ± 24.3 to 21.4 ± 25.9 in HP group; p = 0.06). Improvements of 38% and 46% in the Apnea-Hypopnea Index were observed in the LP and HP groups, respectively. Both interventions provided equivalent metabolic benefits as reductions in glucose (p < 0.001), insulin (p < 0.001), HOMA-IR (p = 0.005), triglycerides (p = 0.002), and in total cholesterol (p = 0.004).
One month of a low-energy diet resulted in significant improvements in OSA severity in obese men. Increased protein intake during a short period of low-energy diet had no further beneficial effects on OSA severity or biochemical parameters than a standard protein diet. Registered under ClinicalTrials.gov Identifier no. NCT01985035.
阻塞性睡眠呼吸暂停（OSA）与肥胖密切相关。减肥可以改善 OSA 及其相关的代谢紊乱。高蛋白饮食可能通过增加能量消耗和减肥期间的去脂体重维持来促进体重减轻。
评估低能量高蛋白饮食对肥胖男性 OSA 严重程度和代谢参数的影响。
45 例 OSA 肥胖（BMI≥30kg/m）男性纳入这项随机研究，并进行夜间多导睡眠图检查、体成分测量、血糖、胰岛素和血脂的生化分析以及低能量饮食前后一个月的饮食摄入评估。饮食设计旨在造成总能量消耗减少 30%，蛋白质摄入量为 1.6g/kg/天（高蛋白组-HP）或 0.8g/kg/天（低蛋白组-LP）。
仅观察到干预的时间效应在体重（LP 组减少-3.7±2.0%，HP 组减少-4.0±1.5%；p<0.001）、体重指数（p<0.001）、kg 脂肪量（p<0.01）和 kg 去脂体重（p<0.01）方面。两组的睡眠呼吸暂停低通气指数均有显著改善（LP 组从 54.0±25.0 降至 33.7±31.7；HP 组从 39.7±24.3 降至 21.4±25.9；p=0.06）。LP 和 HP 组的睡眠呼吸暂停低通气指数分别改善了 38%和 46%。两种干预均提供了等效的代谢益处，包括血糖（p<0.001）、胰岛素（p<0.001）、HOMA-IR（p=0.005）、甘油三酯（p=0.002）和总胆固醇（p=0.004）的降低。
低能量饮食一个月可显著改善肥胖男性的 OSA 严重程度。在短期低能量饮食期间增加蛋白质摄入，对 OSA 严重程度或生化参数的改善作用并不优于标准蛋白质饮食。在 ClinicalTrials.gov 标识符 NCT01985035 下注册。
