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一项针对肥胖成年人的体重维持计划的随机对照试验:WLM3P 研究。

A randomized controlled trial of a weight loss maintenance program in adults with obesity: the WLM3P study.

机构信息

NOVA Medical School, Faculty of Medical Sciences, NMS, FMC, Nova University of Lisbon, Lisbon, Portugal.

Nutrition Department Farmodiética, Farmodiética, 2785-723, Lisbon, Portugal.

出版信息

Eur J Clin Nutr. 2024 Aug;78(8):694-702. doi: 10.1038/s41430-024-01454-4. Epub 2024 Jun 6.

Abstract

BACKGROUND/OBJECTIVES: The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD).

SUBJECTS/METHODS: In this two-phase trial, 112 participants targeting initial WL (0-6 months) and subsequent maintenance (7-18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile.

RESULTS

Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported.

CONCLUSION

Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention.

TRIAL REGISTRATION NUMBER

NCT04192357.

摘要

背景/目的:肥胖症的不断加剧需要有效的、可持续的减肥(WL)和维持策略。本研究旨在评估减肥维持 3 阶段方案(WLM3P)在与标准低碳水化合物饮食(LCD)相比,在肥胖成年人中实现长期临床显著减肥(WL)(18 个月时初始 WL 的≥5%)的效果。

受试者/方法:在这项两阶段试验中,112 名参与者旨在实现初始 WL(0-6 个月)和随后的维持(7-18 个月),被随机分配到 WLM3P 或 LCD 组。评估的结果包括体重变化(kg,%)、身体成分和代谢谱的改善。

结果

在 112 名随机参与者中,69%(n=77)完成了研究。在 18 个月时,WLM3P 组(n=40)的 WL 为 15.5±8.3%,而 LCD 组(n=37)为 9.6±8.5%(p<0.001)。WLM3P 组实现 WL≥10%和≥15%的可能性明显更高。完全案例分析显示,WLM3P 组的 BMI、体脂肪量、内脏脂肪面积、腰围、腰臀比、HDL 和甘油三酯/HDL 比值显著改善。未报告严重不良事件。

结论

两种方案均有效地促进了临床相关的 WL 及其维持。然而,在 18 个月的干预后,WLM3P 方案更有助于参与者实现更大的 WL 目标(≥10%和≥15%)和其他临床益处。

试验注册号

NCT04192357。

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