Department of Clinical Obesity, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA.
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orlean, LA 70112, USA.
Nutrients. 2024 Jul 20;16(14):2358. doi: 10.3390/nu16142358.
Diets for weight loss have a long history but an ideal one has not yet been clearly identified. To compare low-fat and lower carbohydrate diets, we designed The Preventing Overweight by Novel Dietary Strategies (POUNDS) Lost study. This is a 2 × 2 factorial study with diets of 20% or 40% fat and 15% or 25% protein with a graded carbohydrate intake of 35, 45, 55 and 65%. Weight loss, overall, was modest at nearly 6% with all four diets, and no significant dietary difference. The variability in weight loss in each diet group was significant, ranging from greater than 20% to a small weight gain. Studies of genetic variations in relation to weight loss showed that the diet that was selected could significantly affect weight loss, emphasizing that there is no ideal diet and more than one diet can be used to treat obesity. Weight loss was also influenced by the level of baseline triiodothyronine or thyroxine, and baseline carbohydrate and insulin resistance. Achieving a stable Health Eating Food Diversity Index, eating more protein, eating more fiber, engaging in more physical activity, sleeping better and eating less ultra-processed foods were beneficial strategies for weight loss in this trial. Although there is no "ideal diet", both the DASH diet and the Mediterranean diet have clinical trials showing their significant benefit for cardiovascular risk factors. Finally, the lesson of the "Last Chance Diet", which recommended a diet with protein from gelatin, proved that some diets could be hazardous.
减肥饮食法历史悠久，但仍未明确确定理想的饮食法。为了比较低脂肪和低碳水化合物饮食法，我们设计了通过新型饮食策略预防超重（POUNDS）研究。这是一项 2×2 析因研究，饮食的脂肪含量为 20%或 40%，蛋白质含量为 15%或 25%，碳水化合物摄入量为 35、45、55 和 65%。所有四种饮食的总体减重效果适中，接近 6%，且无明显饮食差异。每种饮食组的体重减轻变异性很大，范围从超过 20%到体重略有增加。与体重减轻相关的遗传变异研究表明，所选的饮食可以显著影响体重减轻，强调没有理想的饮食，并且可以使用多种饮食来治疗肥胖。体重减轻还受到基线三碘甲状腺原氨酸或甲状腺素、基线碳水化合物和胰岛素抵抗水平的影响。在本试验中，实现稳定的健康饮食食物多样性指数、增加蛋白质摄入、增加膳食纤维摄入、增加身体活动、改善睡眠和减少食用超加工食品是有益的减肥策略。尽管没有“理想的饮食”，但 DASH 饮食和地中海饮食都有临床试验表明它们对心血管风险因素有显著益处。最后，“最后机会饮食”（Last Chance Diet）推荐的明胶蛋白饮食法的教训证明，有些饮食可能是危险的。
