Lim Jonathan Z M, Williams Andrew, Burgess Jamie, O'Connell James, James Michaela, Cross Andy, Hughes David, Cuthbertson Daniel J, Alam Uazman, Wilding John P H
Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK.
Diabetes, Endocrinology, and Metabolism Centre, Manchester Royal Infirmary, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.
Clin Obes. 2025 Feb;15(1):e12703. doi: 10.1111/cob.12703. Epub 2024 Sep 17.
Resting energy expenditure (REE) and metabolic fuel utilization (carbohydrate or fat) proxied by respiratory quotient (RQ) from indirect calorimetry enables more precise measurement of energy needs and fat oxidation capacity. The study compared the effectiveness of providing energy expenditure information during diet and exercise weight intervention versus standard of care (SOC) on weight loss outcomes. Fifty-two participants with obesity were recruited from a specialist weight loss service, randomized 1:1 to intervention (INT) or SOC only. Participants in INT received four-weekly dietetic counselling, using biofeedback from energy expenditure data to recommend caloric restriction and physical activity goals, in addition to SOC. The primary outcome was the mean difference in weight loss between both groups after 24 weeks. Secondary outcomes include participant acceptability and tolerability using indirect calorimetry. Participants in the INT group demonstrated additional weight loss (-2.3 kg [95% CI: -3.1, -1.5]; p <.001), reduced waist circumference (-3.9 cm [95% CI: -5.48, -2.26]; p <.001), and decreased body fat percentage (-1.5% [95% CI:-2.31, -0.72], p <.001), compared to SOC, after adjusting for baseline body mass index, age, and sex. Forty-two percent (10/24) of participants in INT group achieved the minimum clinically significant threshold of 5% weight loss from baseline, compared to 8% (2/26) in the SOC group (p = .007). Participant acceptability and tolerability of indirect calorimetry were high, with mean scores of 4.5 ± 0.6 and 4.2 ± 0.7 (5-point Likert scale). The study establishes the safety and practical integration of biofeedback using indirect calorimetry promoting improved self-regulation and enhancing weight loss.
静息能量消耗（REE）以及通过间接测热法的呼吸商（RQ）来代表的代谢燃料利用（碳水化合物或脂肪），能够更精确地测量能量需求和脂肪氧化能力。该研究比较了在饮食和运动体重干预期间提供能量消耗信息与标准护理（SOC）对体重减轻结果的有效性。从一家专业减肥服务机构招募了52名肥胖参与者，将他们按1:1随机分为干预组（INT）或仅接受标准护理组。INT组的参与者除了接受标准护理外，还每四周接受一次饮食咨询，利用能量消耗数据的生物反馈来推荐热量限制和体育活动目标。主要结局是24周后两组之间体重减轻的平均差异。次要结局包括使用间接测热法的参与者可接受性和耐受性。在调整了基线体重指数、年龄和性别后，与标准护理组相比，INT组的参与者体重进一步减轻（-2.3千克[95%CI：-3.1，-1.5]；p<.001），腰围减小（-3.9厘米[95%CI：-5.48，-2.26]；p<.001），体脂百分比降低（-1.5%[95%CI：-2.31，-0.72]，p<.001）。INT组42%（10/24）的参与者实现了自基线体重减轻至少5%这一具有临床意义的最低阈值，而标准护理组为8%（2/26）（p = .007）。间接测热法的参与者可接受性和耐受性较高，平均评分为4.5±0.6和4.2±0.7（5分李克特量表）。该研究证实了使用间接测热法进行生物反馈的安全性和实际应用价值，其有助于促进自我调节能力的提高并增强体重减轻效果。
