健康饮食指数饮食质量在随机体重减轻试验中的评价：系统综述。
Healthy Eating Index Diet Quality in Randomized Weight Loss Trials: A Systematic Review.
机构信息
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA.
Health Sciences Library System, University of Pittsburgh, PA.
出版信息
J Acad Nutr Diet. 2023 Jan;123(1):117-143. doi: 10.1016/j.jand.2022.08.114. Epub 2022 Aug 10.
BACKGROUND
Weight loss interventions focus on dietary and physical activity changes to induce weight loss. Both through weight loss and independent of it, diet quality is important for reducing chronic disease risk. However, whether and how diet quality changes over the course of a behavioral intervention is unclear.
OBJECTIVE
To systematically review the evidence from randomized controlled trials on the effect of behavioral interventions on diet quality as defined by the Healthy Eating Index (HEI) among adults with overweight and obesity.
METHODS
PubMed, Ebscohost CINAHL, Embase, OVID APA PsycInfo, Scopus, and Web of Science were searched through May 2021. Inclusion criteria comprised randomized controlled trial design, a primary or secondary aim of weight loss, a sample of US adults with overweight or obesity, measurement using the HEI-2005, 2010, or 2015, and assessment of the time by treatment effect. Interventions must have included behavioral components and lasted at least 3 months. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. The systematic review protocol was published on Open Science Framework.
RESULTS
Of 3,707 citations retrieved, 18 studies met inclusion criteria. A wide array of behavioral interventions were assessed, including in-person and mobile health interventions as well as those prescribing intake of specific foods. Risk of bias in the included studies primarily arose from the measurement of the outcome variable. Sample sizes ranged from 34 to 413 participants. Nine studies used multiple dietary recalls, with few using the recommended method of Healthy Eating Index calculation. Changes in diet quality ranged from no improvement to a 20-point improvement. More often, improvement was in the 4- to 7-point range.
CONCLUSIONS
The evidence for the efficacy of behavioral weight loss interventions for improving diet quality among adults with overweight and obesity is limited. Modest improvements in HEI scores were observed in the reviewed studies.
背景
减肥干预措施侧重于饮食和身体活动的改变，以诱导体重减轻。无论是通过减肥还是独立于减肥，饮食质量对于降低慢性病风险都很重要。然而，在行为干预过程中，饮食质量是否以及如何变化尚不清楚。
目的
系统评价随机对照试验中关于行为干预对超重和肥胖成年人健康饮食指数（HEI）定义的饮食质量的影响的证据。
方法
通过 2021 年 5 月前的 PubMed、Ebscohost CINAHL、Embase、OVID APA PsycInfo、Scopus 和 Web of Science 搜索。纳入标准包括随机对照试验设计、减肥的主要或次要目标、超重或肥胖美国成年人样本、使用 HEI-2005、2010 或 2015 进行测量，以及根据治疗效果评估时间。干预措施必须包括行为成分，且持续时间至少 3 个月。使用 Cochrane 偏倚风险 2 工具评估偏倚风险。系统评价方案在开放科学框架上发表。
结果
在检索到的 3707 条引文中有 18 项研究符合纳入标准。评估了广泛的行为干预措施，包括面对面和移动健康干预以及规定摄入特定食物的干预措施。纳入研究的偏倚风险主要来自于结果变量的测量。样本量范围从 34 到 413 人。9 项研究使用了多次饮食回忆，很少使用健康饮食指数计算的推荐方法。饮食质量的变化范围从没有改善到改善 20 分。更常见的是，改善幅度在 4 到 7 分之间。
结论
行为减肥干预对改善超重和肥胖成年人饮食质量的疗效证据有限。在回顾的研究中观察到 HEI 评分有适度提高。
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