Zhang Hanyue, Vasileiou Aikaterina, Searle Dominique, Larsen Sofus C, Senior Alistair M, Magkos Faidon, Ward Leigh C, Horgan Graham, Santos Inês, Palmeira António L, Simpson Stephen J, Raubenheimer David, Stubbs R James, Heitmann Berit L
Research Unit for Diet and Health, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.
Department of Food Science, University of Copenhagen, Copenhagen, Denmark.
Obesity (Silver Spring). 2025 Oct;33(10):1995-2004. doi: 10.1002/oby.24370. Epub 2025 Aug 7.
To examine the association between dietary macronutrient composition and 12-month weight loss maintenance (WLM) in adults who achieved initial weight loss (≥ 5%).
This prospective cohort analysis used 12-month follow-up data from the Navigating to a Healthy Weight trial. Macronutrient composition (%) was assessed using a 4-day, 24-h dietary recall. Food sources were categorized as discretionary foods, lean meat, vegetables, fruit, grains, and dairy. Primary outcomes included 12-month changes in body weight, fat mass index (FMI), waist-to-height ratio (WHtR), and hip-to-height ratio (HHtR). A nutritional geometry approach was used to examine individual and interactive associations of macronutrient intake, visualizing as response surfaces.
Among 1518 participants (69.8% women; mean age 45 ± 12 years), mean macronutrient composition was 20.6% protein, 33.8% fat, and 43.1% carbohydrate. Protein energy percentage was inversely associated with energy intake (β: -0.33; 95% CI: -0.39, -0.27). Response surfaces revealed that lower proportional energy from protein, diluted by high fat and/or carbohydrate, was associated with higher total energy intake and greater 12-month increases in body weight, WHtR, and HHtR, but not FMI. Consumption of discretionary food, not other food sources, increased energy intake by reducing proportional energy from protein.
Maintaining dietary proportional energy from protein, particularly by limiting discretionary food consumption, was associated with reduced energy intake and improved WLM.
探讨在实现初始体重减轻（≥5%）的成年人中，膳食常量营养素组成与12个月体重维持（WLM）之间的关联。
这项前瞻性队列分析使用了“迈向健康体重”试验的12个月随访数据。使用4天24小时膳食回顾法评估常量营养素组成（%）。食物来源分为 discretionary foods、瘦肉、蔬菜、水果、谷物和乳制品。主要结局包括体重、脂肪质量指数（FMI）、腰高比（WHtR）和臀高比（HHtR）的12个月变化。采用营养几何学方法来研究常量营养素摄入量的个体和交互关联，并将其可视化为响应面。
在1518名参与者中（69.8%为女性；平均年龄45±12岁），平均常量营养素组成为蛋白质20.6%、脂肪33.8%和碳水化合物43.1%。蛋白质能量百分比与能量摄入呈负相关（β：-0.33；95%置信区间：-0.39，-0.27）。响应面显示，较低比例的蛋白质能量被高脂肪和/或高碳水化合物稀释，与较高的总能量摄入以及12个月内体重、WHtR和HHtR的更大增加相关，但与FMI无关。食用 discretionary food，而非其他食物来源，通过降低蛋白质的比例能量增加了能量摄入。
维持蛋白质的膳食比例能量，尤其是通过限制 discretionary food 的消费，与减少能量摄入和改善WLM相关。
