Golay A, Eigenheer C, Morel Y, Kujawski P, Lehmann T, de Tonnac N
Department of Internal Medicine, University Hospital Geneva.
Int J Obes Relat Metab Disord. 1996 Dec;20(12):1067-72.
With obesity being recognized as an important cardiovascular risk factor, it is important to determine the optimal hypocaloric diet for decreasing that risk. The goal of this study was to compare the effects of two hypocaloric diets of similar caloric value, but differing in carbohydrate content (25% and 45%).
Sixty-eight out-patients were followed for 12 w.
The patients were assigned to one of two groups that received either a low (25% CHO, n = 31) or a high (45% CHO, n = 37) carbohydrate hypocaloric diet (5.0 MJ/d, 1200 Kcal/d).
After 12 w, the mean weight loss was similar and did not differ significantly between the two groups: 10.2 +/- 0.7 kg (25% CHO) and 8.6 +/- 0.8 kg (45% CHO). Furthermore, loss of adipose tissue was similar, 8.1 +/- 0.5 kg (25% CHO) and 7.1 +/- 0.7 kg (45% CHO). Despite a high protein intake (1.4 g/kg/ideal body weight) there was loss of lean body mass: 2.2 +/- 0.4 kg (25% CHO) and 1.4 +/- 0.3 kg (45% CHO). The waist/hip ratio diminished significantly (P < 0.001) and identically in both groups. The fasting blood glucose (even though normal, along with cholesterol and triglyceride concentrations, were significantly decreased after weight loss. The fasting blood insulin which was mildly elevated before weight loss decreased more markedly with the 25% CHO diet compared to the 45% CHO diet (P < 0.003). The glucose/insulin ratio improved significantly (P < 0.05) after weight loss with both diets (0.17 +/- 0.04 mmol/mU (25% CHO) vs 0.10 +/- 0.03 mmol/mU (45% CHO).
Neither diet offered a significant advantage when comparing weight loss or other, metabolic parameters over a 12 w period. However, considering the greater improvement of fasting blood insulin, the glucose/insulin ratio and blood triglyceride, the low carbohydrate diet (25%) could be more favourable in the long-term. The improvement of fasting blood insulin could be explained by the differences in monounsaturated fat composition in the low carbohydrate diet.
鉴于肥胖被公认为是一个重要的心血管危险因素，确定能降低该风险的最佳低热量饮食很重要。本研究的目的是比较两种热量值相似但碳水化合物含量不同（25%和45%）的低热量饮食的效果。
68名门诊患者接受了为期12周的跟踪研究。
患者被分配到两组中的一组，分别接受低碳水化合物（25%碳水化合物，n = 31）或高碳水化合物（45%碳水化合物，n = 37）的低热量饮食（5.0兆焦耳/天，1200千卡/天）。
12周后，两组的平均体重减轻相似且无显著差异：10.2±0.7千克（25%碳水化合物组）和8.6±0.8千克（45%碳水化合物组）。此外，脂肪组织的减少相似，分别为8.1±0.5千克（25%碳水化合物组）和7.1±0.7千克（45%碳水化合物组）。尽管蛋白质摄入量较高（1.4克/千克/理想体重），但瘦体重仍有减少：2.2±0.4千克（25%碳水化合物组）和1.4±0.3千克（45%碳水化合物组）。两组的腰臀比均显著降低（P < 0.001）且降低程度相同。空腹血糖（尽管正常，但与胆固醇和甘油三酯浓度一样，体重减轻后显著下降）。减肥前轻度升高的空腹血胰岛素，与45%碳水化合物饮食相比，25%碳水化合物饮食使其下降更明显（P < 0.003）。两种饮食减肥后葡萄糖/胰岛素比值均显著改善（P < 0.05）（0.17±0.04毫摩尔/毫单位（25%碳水化合物组）对0.10±0.03毫摩尔/毫单位（45%碳水化合物组））。
在12周期间比较体重减轻或其他代谢参数时，两种饮食均无显著优势。然而，考虑到空腹血胰岛素、葡萄糖/胰岛素比值和血甘油三酯有更大改善，长期来看低碳水化合物饮食（25%）可能更有利。空腹血胰岛素的改善可能由低碳水化合物饮食中单不饱和脂肪组成的差异来解释。
