根据昼夜时型预测超重或肥胖女性在接受极低卡路里生酮饮食（VLCKD）时的体重减轻和身体成分改善情况。

Chronotype as a predictor of weight loss and body composition improvements in women with overweight or obesity undergoing a very low-calorie ketogenic diet (VLCKD).

机构信息

Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy; Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Direzionale, isola F2, 80143 Napoli, Italy.

出版信息

Clin Nutr. 2023 Jul;42(7):1106-1114. doi: 10.1016/j.clnu.2023.05.014. Epub 2023 May 19.

DOI:10.1016/j.clnu.2023.05.014

PMID:37236871

Abstract

BACKGROUND & AIM: Recent studies reported that chronotype play a role in the development of metabolic comorbidities and in determining dietary habits in obesity. However, little is known if chronotype could predict the efficacy of nutritional approaches for obesity. The aim of this study was to investigate whether chronotype categories can have a role in determining the efficacy of very low-calorie ketogenic diet (VLCKD) in terms of weight loss and changes of body composition in women with overweight or obesity.

METHODS

In this retrospective study we analyzed data from 248 women (BMI 36.03 ± 5.20 kg/m, aged 38.76 ± 14.05 years) clinically referred for weight loss and who completed a VLCKD program. In all women, we assessed anthropometric parameters (weight, height, and waist circumference), body composition and phase angle (through bioimpedance analysis, Akern BIA 101) at the baseline and after 31 days of active phase of VLCKD. Chronotype score was assessed using Morningness-Eveningness questionnaire (MEQ) at baseline.

RESULTS

After 31 days of active phase of VLCKD all enrolled women experienced significant weight loss (p < 0.001) and reduction of BMI (p < 0.001), waist circumference (p < 0.001), fat mass (kg and %) (p < 0.001), and free fat mass (kg) (p < 0.001). Women with evening chronotype experienced significantly less weight loss (p < 0.001) and reduced fat mass (kg and %) (p < 0.001), increased fat free mass (kg and %) (p < 0.001) and phase angle (p < 0.001) than women with morning chronotype. In addition, chronotype score correlated negatively with percentage changes in weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001) and fat mass (p < 0.001) and positively with fat free mass (p < 0.001) and phase angle (p < 0.001) from baseline to the 31st day of active phase of VLCKD. Using a linear regression model, chronotype score (p < 0.001) was the main predictors of weight loss achieved with VLCKD.

CONCLUSION

Evening chronotype is associated with a lower efficacy in terms of weight loss and improvements of body composition after VLCKD in obesity.

摘要

背景与目的

最近的研究表明，昼夜节律在代谢合并症的发展和肥胖症饮食模式的确定中发挥作用。然而，目前尚不清楚昼夜节律是否可以预测营养方法对肥胖症的疗效。本研究旨在探讨在超重或肥胖女性中，昼夜节律类别是否可以在确定极低卡路里生酮饮食（VLCKD）在减肥和身体成分变化方面的疗效中发挥作用。

方法

在这项回顾性研究中，我们分析了 248 名女性（BMI 36.03±5.20kg/m，年龄 38.76±14.05 岁）的数据，这些女性因减肥而临床就诊，并完成了 VLCKD 计划。在所有女性中，我们在基线和 VLCKD 主动阶段 31 天后评估了人体测量参数（体重、身高和腰围）、身体成分和相位角（通过生物电阻抗分析，Akern BIA 101）。基线时使用晨型-晚型问卷（MEQ）评估昼夜节律评分。

结果

在 VLCKD 主动阶段 31 天后，所有入组女性均经历了显著的体重减轻（p<0.001）和 BMI（p<0.001）、腰围（p<0.001）、脂肪量（kg 和 %）（p<0.001）和游离脂肪量（kg）（p<0.001）的减少。晚型昼夜节律的女性体重减轻（p<0.001）和脂肪量（kg 和 %）（p<0.001）、脂肪游离量（kg 和 %）（p<0.001）和相位角（p<0.001）减少显著增加。此外，昼夜节律评分与体重（p<0.001）、BMI（p<0.001）、腰围（p<0.001）和脂肪量（p<0.001）的百分比变化呈负相关，与脂肪游离量（p<0.001）和相位角（p<0.001）呈正相关从 VLCKD 的主动阶段的第 1 天到第 31 天。使用线性回归模型，昼夜节律评分（p<0.001）是 VLCKD 减肥效果的主要预测因素。