Pekkarinen T, Takala I, Mustajoki P
Department of Medicine, Helsinki University Hospital, Finland.
Int J Obes Relat Metab Disord. 1998 Jul;22(7):661-6. doi: 10.1038/sj.ijo.0800644.
The beneficial effects of weight loss with a very-low-calorie diet (VLCD) on cardiovascular risk factors have been reported at the end of energy restriction. As the effects, especially on blood pressure, may not remain constant during weight maintenance, we studied the longer-term effects of weight loss on 24h ambulatory blood pressure (ABP), lipids, glucose and insulin.
Prospective study of a 17-week weight loss programme containing an eight-week VLCD period and follow-up visit at one-year.
Twenty-nine moderately obese, normotensive or mildly hypertensive women. The mean +/- s.d. body mass index (BMI) was 36.0 +/- 2.6 kg/m2 and mean age 40.3 +/- 8.3 y.
In the last week of the VLCD, the mean (s.d.) weight loss was 12.4 +/- 3.3 kg (P < 0.001), at the end of the programme 15.1 +/- 4.4 kg (P < 0.001 vs baseline), and at one-year follow-up 10.7 +/- 7.6 kg (P < 0.001 vs baseline). Mean 24 h ABP decreased 8.0/4.6 mmHg (P < 0.001 for both) on the last week of the VLCD, at the end of the programme, the systolic ABP decrease was 4.7 mmHg (P < 0.01 vs baseline) and diastolic 2.1 mmHg (not statistically significant (NS) vs baseline). At one-year follow-up, the mean systolic ABP decrease was 4.1 mmHg (P < 0.01 vs baseline) and mean diastolic 3.0 mmHg (P < 0.05 vs baseline). Sodium excretion decreased 55 mmol/24 h in the last VLCD week (P < 0.01) and returned to baseline after that. At the one-year follow-up, beneficial changes, compared with baseline, were observed in mean serum glucose (-0.28 mmol/l, P < 0.05), triglyceride (-0.35 mmol/l, P < 0.01) and HDL cholesterol (+0.16 mmol/l, P < 0.001).
This weight loss programme with a VLCD enabled obese subjects to lose weight and decrease cardiovascular risks. Despite some regain in weight during follow-up, the beneficial effects were overall maintained over the year. Sodium intake tended to increase during follow-up. Information on sodium restriction should be included in weight loss programmes.
有报道称极低热量饮食（VLCD）减肥对心血管危险因素的有益影响在能量限制结束时显现。由于这些影响，尤其是对血压的影响，在体重维持期间可能不会保持不变，我们研究了减肥对24小时动态血压（ABP）、血脂、血糖和胰岛素的长期影响。
一项为期17周的减肥计划的前瞻性研究，该计划包括为期8周的VLCD阶段，并在一年后进行随访。
29名中度肥胖、血压正常或轻度高血压的女性。平均±标准差体重指数（BMI）为36.0±2.6kg/m²，平均年龄40.3±8.3岁。
在VLCD的最后一周，平均（标准差）体重减轻12.4±3.3kg（P<0.001），在计划结束时体重减轻15.1±4.4kg（与基线相比P<0.001），在一年随访时体重减轻10.7±7.6kg（与基线相比P<0.001）。在VLCD的最后一周，平均24小时ABP下降8.0/4.6mmHg（两者P<0.001），在计划结束时，收缩压ABP下降4.7mmHg（与基线相比P<0.01），舒张压下降2.1mmHg（与基线相比无统计学意义（NS））。在一年随访时，平均收缩压ABP下降4.1mmHg（与基线相比P<0.01），平均舒张压下降3.0mmHg（与基线相比P<0.05）。在VLCD的最后一周，钠排泄量减少55mmol/24小时（P<0.01），之后恢复到基线水平。在一年随访时，与基线相比，平均血清葡萄糖（-0.28mmol/L，P<0.05）、甘油三酯（-0.35mmol/L，P<0.01）和高密度脂蛋白胆固醇（+0.16mmol/L，P<0.001）出现有益变化。
这个采用VLCD的减肥计划使肥胖受试者能够减轻体重并降低心血管风险。尽管随访期间体重有所反弹，但有益影响在一年中总体上得以维持。随访期间钠摄入量有增加趋势。减肥计划应包含有关钠限制的信息。
