Gariballa Salah Eldin Elnagi, Al-Bluwi Ghada, Yasin Javed
Internal Medicine, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates.
Nutrients. 2024 Nov 26;16(23):4044. doi: 10.3390/nu16234044.
The prevalence of obesity and related complications is increasing relentlessly worldwide. The effect of intentional weight loss strategies for obese individuals on fat-free muscle mass (FFMM) and metabolic and general health is not well known. The aim of this research is to measure the effects of dietary intake and physical activity level on FFMM change during intentional weight loss in obese subjects.
Nine hundred and sixty-five overweight and obese community free-living subjects had the effects of physical activity level and dietary intake on FFMM change during intentional weight loss assessed in a prospective longitudinal study. Anthropometric, physical activity, dietary intake, inflammatory markers, and oxidative damage were assessed at baseline and follow-up. Validated questionnaires were used to measure dietary intake and physical activity. We compared FFMM loss or gain between subjects stratified by calorie, protein, and fruit and vegetable intake and physical activity levels. The Cox proportional hazards analysis was used to determine the independent effects of dietary intake and physical activity on FFMM changes.
A total of 965 subjects [(mean (SD) age 39 ± 12 years, 801 (83%)] females] were assessed at baseline with follow-up for a period of 427 ± 223 days. Using the WHO criteria for body mass index (BMI), 284 (30%) subjects were found to be overweight and 584 (62%) were obese. We found significant correlations between fat-muscle mass ratio (FMR) and inflammatory and oxidative damage markers. After adjusting for important prognostic indicators, age, gender, occupation, physical activity, and fruit and vegetable consumption were found to be significantly associated with FFMM at baseline ( < 0.05). We found no statistically significant difference in dietary protein or amino acids intake in subjects who gained FFMM compared to those who lost FFMM both at baseline and follow-up. By contrast, high consumption of fruits and vegetable and increased calorie intake were associated with increased odds of FFMM gain ( < 0.05). Increased physical activity was independently associated with significant FFMM gain after adjusting for other important indicators ([hazard ratio (95% CI): 0.49 (0.25, 0.97); = 0.039].
Increased physical activity and high calorie, fruit and vegetable intake are associated with FFMM preservation or gains during intentional weight loss in obese subjects.
肥胖及相关并发症在全球范围内的患病率正持续上升。针对肥胖个体的有意减肥策略对去脂肌肉量（FFMM）以及代谢和总体健康的影响尚不明确。本研究旨在测量肥胖受试者在有意减肥期间饮食摄入和身体活动水平对FFMM变化的影响。
在一项前瞻性纵向研究中，对965名超重和肥胖的社区自由生活受试者在有意减肥期间身体活动水平和饮食摄入对FFMM变化的影响进行了评估。在基线和随访时评估人体测量学指标、身体活动、饮食摄入、炎症标志物和氧化损伤情况。使用经过验证的问卷来测量饮食摄入和身体活动。我们比较了按卡路里、蛋白质、水果和蔬菜摄入量以及身体活动水平分层的受试者之间FFMM的增减情况。采用Cox比例风险分析来确定饮食摄入和身体活动对FFMM变化的独立影响。
共有965名受试者（平均（标准差）年龄39±12岁，801名（83%）为女性）在基线时接受评估，并随访了427±223天。根据世界卫生组织的体重指数（BMI）标准，发现284名（30%）受试者超重，584名（62%）受试者肥胖。我们发现脂肪 - 肌肉量比（FMR）与炎症和氧化损伤标志物之间存在显著相关性。在调整了重要的预后指标后，发现年龄、性别、职业、身体活动以及水果和蔬菜消费在基线时与FFMM显著相关（<0.05）。我们发现，在基线和随访时，FFMM增加的受试者与FFMM减少的受试者相比，饮食蛋白质或氨基酸摄入量没有统计学上的显著差异。相比之下，高水果和蔬菜消费量以及增加的卡路里摄入量与FFMM增加的几率增加相关（<0.05）。在调整了其他重要指标后，身体活动增加与显著的FFMM增加独立相关（[风险比（95%置信区间）：0.49（0.25，0.97）；P = 0.039]）。
在肥胖受试者有意减肥期间，身体活动增加以及高卡路里、水果和蔬菜摄入量与FFMM的保持或增加相关。
