间歇性能量限制对有妊娠糖尿病史的女性体重减轻和糖尿病风险标志物的影响：一项为期 12 个月的随机对照试验。

The effect of intermittent energy restriction on weight loss and diabetes risk markers in women with a history of gestational diabetes: a 12-month randomized control trial.

机构信息

University of South Australia, Clinical and Health Sciences, Adelaide, Australia.

Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.

出版信息

Am J Clin Nutr. 2021 Aug 2;114(2):794-803. doi: 10.1093/ajcn/nqab058.

DOI:10.1093/ajcn/nqab058

PMID:33831950

Abstract

BACKGROUND

Weight loss after gestational diabetes (GDM) can prevent or delay the onset of type 2 diabetes. Intermittent energy restriction (IER) may offer an alternative to continuous energy restriction (CER) for weight loss.

OBJECTIVES

We compared the effects of IER (2 days per week) to daily CER over 12 mo on weight loss and diabetes risk markers in overweight women with previous GDM.

METHODS

Overweight females (n = 121) ≥18 y were randomized 1:1 to either IER [2-d 500 kcal (2100 kJ); n = 61] or CER [1500 kcal (6000 kJ); n = 60] in this 12-mo noninferiority trial.

RESULTS

The trial was completed by 62 participants with a median age of 39.6 y [Quartile (Q) 1 to Quartile 3, 34.9 to 43.9 y] with a median BMI of 32.6 kg/m2 (Q1 to Q3, 28.5 to 37.9 kg/m2) at a median of 2.9 y after GDM (Q1 to Q3, 2.1 to 6.4 y; 49% attrition; IER n = 29; CER n = 30; P = 0.8). The mean ± SD weight loss was significant over time (P < 0.001) but not by diet group (IER -4.8 ± 5.0 kg; CER -3.2 ± 5.0; P = 0.2). The mean between-group difference was -1.6 kg (95% CI: -4.2 to 1.0 kg; P = 0.2). There were no significant between-group differences in change in HbA1c, fasting plasma glucose, fasting serum insulin, HOMA-IR or 2-h oral glucose tolerance at 12 mo (p>0.05). The trial was registered at https://www.anzctr.org.au/ (ACTRN12617001476325).

CONCLUSIONS

IER produces comparable weight loss to CER over 12 mo in overweight women with previous GDM. The high dropout rate in this study is a limitation in the interpretation of these results. Larger studies are needed to confirm noninferiority of IER compared to CER.

摘要

背景

妊娠糖尿病（GDM）后减肥可以预防或延迟 2 型糖尿病的发生。间歇性能量限制（IER）可能是连续能量限制（CER）的替代方法，有助于减肥。

目的

我们比较了 IER（每周 2 天）与 CER（每天 1500 千卡[6000 千焦]）在超重且患有既往 GDM 的女性中持续 12 个月的减肥和糖尿病风险标志物的效果。

方法

12 个月的非劣效性试验中，121 名超重女性（年龄≥18 岁）按 1:1 随机分为 IER 组[2 天 500 千卡（2100 千焦）；n=61]或 CER 组[1500 千卡（6000 千焦）；n=60]。

结果

共有 62 名参与者完成了试验，中位年龄 39.6 岁[四分位数（Q）1 到 Q3，34.9 到 43.9 岁]，中位 BMI 为 32.6kg/m2（Q1 到 Q3，28.5 到 37.9kg/m2），GDM 后中位数为 2.9 年（Q1 到 Q3，2.1 到 6.4 年；49%的参与者退出；IER n=29；CER n=30；P=0.8）。体重随时间明显减轻（P<0.001），但与饮食组无关（IER-4.8±5.0kg；CER-3.2±5.0kg；P=0.2）。两组间的平均差异为-1.6kg（95%CI：-4.2 至 1.0kg；P=0.2）。12 个月时，HbA1c、空腹血糖、空腹血清胰岛素、HOMA-IR 或 2 小时口服葡萄糖耐量试验的组间变化无显著差异（p>0.05）。该试验在 https://www.anzctr.org.au/ 注册（ACTRN12617001476325）。