Valtueña S, Salas-Salvadó J, Lorda P G
Human Nutrition Unit, Facultat de Medicina i Ciències de la Salut, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, Reus, Spain.
Int J Obes Relat Metab Disord. 1997 Sep;21(9):811-7. doi: 10.1038/sj.ijo.0800480.
To investigate the possible metabolic factors predisposing to weight gain subsequent to the cessation of a rapid-weight-loss diet.
Prospective, longitudinal, intervention study of a 2 MJ diet daily for 28 d in a metabolic ward followed by a 12-month outpatient follow-up under a conventional, hypocaloric diet.
Thirty-five females and one male, all with morbid obesity defined by a body mass index > or = 35 kg/m2.
VO2 and VCO2 measured by 30 min indirect calorimetry to calculate resting energy expenditure and resting respiratory quotient at the beginning and end of very-low-calorie diet; body composition assessed by hydrostatic weighing on day 1; weight recorded on days 1 and 28 and at follow-up of 3, 6 and 12 months.
From among all the variables considered, the resting respiratory quotient measured on day 28, even adjusted for weight loss during hospitalisation, was the only one that correlated significantly with the weight changes recorded during follow-up.
Subjects who showed a respiratory quotient on day 28 in the lower range (< 0.72) were more able to maintain the weight-loss achieved with the very-low-calorie diet while those in the higher range (> 0.75) were less able to do so over the follow-up period. Thus, an appropriately measured respiratory quotient could prove useful in clinical practice as a prognostic marker of the long-term effectiveness of low- and very-low-calorie diets used to induce rapid weight loss.
探讨快速减重饮食停止后导致体重增加的可能代谢因素。
在代谢病房进行前瞻性、纵向干预研究，每日摄入2兆焦耳饮食，持续28天，随后在常规低热量饮食下进行12个月的门诊随访。
35名女性和1名男性，均为病态肥胖，体重指数≥35千克/平方米。
在极低热量饮食开始和结束时，通过30分钟间接量热法测量VO2和VCO2，以计算静息能量消耗和静息呼吸商；第1天通过水下称重评估身体成分；在第1天、第28天以及3、6和12个月随访时记录体重。
在所有考虑的变量中，即使对住院期间的体重减轻进行了校正，第28天测量的静息呼吸商仍是唯一与随访期间记录的体重变化显著相关的变量。
第28天呼吸商处于较低范围（<0.72）的受试者更能够维持极低热量饮食所实现的体重减轻，而处于较高范围（>0.75）的受试者在随访期间维持体重减轻的能力较差。因此，适当测量的呼吸商在临床实践中可能作为用于诱导快速减重的低热量和极低热量饮食长期效果的预后标志物有用。
