Effect of Calorie Restriction on Mood, Quality of Life, Sleep, and Sexual Function in Healthy Nonobese Adults: The CALERIE 2 Randomized Clinical Trial.
Effect of Calorie Restriction on Mood, Quality of Life, Sleep, and Sexual Function in Healthy Nonobese Adults: The CALERIE 2 Randomized Clinical Trial.
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DOI：
10.1001/jamainternmed.2016.1189
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发表时间：
2016-06-01
影响因子：
39
通讯作者：
Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) Phase 2 Study Group
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文献类型：
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作者：
Martin CK;Bhapkar M;Pittas AG;Pieper CF;Das SK;Williamson DA;Scott T;Redman LM;Stein R;Gilhooly CH;Stewart T;Robinson L;Roberts SB;Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) Phase 2 Study Group
热量限制（CR）增加了许多物种的寿命，并减少了慢性疾病的风险因素。在人类中，CR可以改善健康寿命，但人们仍然担心CR的潜在负面影响。测试CR对健康非肥胖成年人的情绪、生活质量（QOL）、睡眠和性功能的影响。在3个学术研究机构进行了一项多中心随机临床试验（减少能量摄入长期效应的综合评估2期[CALERIE 2]）。将体重指数（BMI;计算方法为体重（kg）除以身高（m）的平方）为22.0 - 28.0的成年男性和女性（N = 220）以有利于CR的2：1比例随机分配至2年25% CR组或随意（AL）对照组。在基线、12个月和24个月时收集数据，并使用意向治疗分析进行检查。该研究于2007年1月22日至2012年3月6日进行。从2012年7月18日至2015年10月27日进行数据分析。两年的25%CR或AL。自我报告问卷调查，以衡量情绪（贝克抑郁量表-II [BDI-II]，评分范围0-63，评分越高表示情绪越差，情绪状态量表[POMS]，总情绪障碍评分范围为-32至200，评分越高表示测量的结构水平越高），QOL（兰德36项简表，评分范围0-100，评分越高反映QOL越好，感知压力量表，评分范围0-40，评分越高表明压力水平越高），睡眠（匹兹堡睡眠质量指数[PSQI]，总分范围0-21，分数越高反映睡眠质量越差），和性功能（Derogatis性功能访谈-自我报告，总分范围24-188，分数越高表明性功能越好）。共有218名参与者（152名女性[69.7%];平均[SD]年龄，37.9（7.2）岁;平均[SD] BMI，25.1 [1.6]）被纳入分析。CR组和AL组在第24个月时的平均体重减轻（SE）分别为7.6（0.3）kg和0.4（0.5）kg（P <0.001）。与AL组相比，CR组患者的情绪有明显改善（BDI-II：组间差异[BGD]，−0.76; 95% CI，−1.41至−0.11;效应量[ES]，−0.35），张力降低（POMS：BGD，-0.79; 95%CI，-1.38至-0.19; ES，-0.39），以及总体健康状况改善（BGD，6.45; 95% CI，3.93至8.98; ES，0.75）和性驱动力和关系（BGD，1.06; 95% CI，0.11 - 2.01; ES，0.35）以及12个月时睡眠持续时间改善（BGD，-0.26; 95%CI，-0.49至-0.02; ES，-0.32）（所有P <0.05）。CR组在第24个月时体重减轻的百分比越大，POMS测量的活力（斯皮尔曼相关系数，ρ =-0.30）和情绪障碍（ρ = 0.27）越少，SF-36测量的总体健康状况（ρ =-0.27）越好，PSQI总分的睡眠质量（ρ = 0.28）越好（所有P <0.01）。在非肥胖成人中，CR对健康相关QOL有一些积极影响，没有负面影响。
Calorie restriction (CR) increases longevity in many species and reduces risk factors for chronic diseases. In humans, CR may improve health span, yet concerns remain about potential negative effects of CR. To test the effect of CR on mood, quality of life (QOL), sleep, and sexual function in healthy nonobese adults. A multisite randomized clinical trial (Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 [CALERIE 2]) was conducted at 3 academic research institutions. Adult men and women (N = 220) with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 22.0 to 28.0 were randomized to 2 years of 25% CR or an ad libitum (AL) control group in a 2:1 ratio favoring CR. Data were collected at baseline, 12 months, and 24 months and examined using intent-to-treat analysis. The study was conducted from January 22,2007, to March 6, 2012. Data analysis was performed from July 18, 2012, to October 27, 2015. Two years of 25% CR or AL. Self-report questionnaires were administered to measure mood (Beck Depression Inventory-II [BDI-II], score range 0–63, higher scores indicating worse mood, and Profile of Mood States [POMS], with a total mood disturbance score range of −32 to 200 and higher scores indicating higher levels of the constructs measured), QOL (Rand 36-Item Short Form, score range 0–100, higher scores reflecting better QOL, and Perceived Stress Scale, score range 0–40, higher scores indicating higher levels of stress), sleep (Pittsburgh Sleep Quality Index [PSQI], total score range 0–21, higher scores reflecting worse sleep quality), and sexual function (Derogatis Interview for Sexual Function–Self–report, total score range 24–188, higher scores indicating better sexual functioning). In all, 218 participants (152 women [69.7%]; mean [SD] age, 37.9 (7.2) years; mean [SD] BMI, 25.1 [1.6]) were included in the analyses. The CR and AL groups lost a mean (SE) of 7.6 (0.3) kg and 0.4 (0.5) kg, respectively, at month 24 (P < .001). Compared with the AL group, the CR group had significantly improved mood (BDI-II: between-group difference [BGD], −0.76; 95% CI, −1.41 to −0.11; effect size [ES], −0.35), reduced tension (POMS: BGD, −0.79; 95% CI, −1.38 to −0.19; ES, −0.39), and improved general health (BGD, 6.45; 95% CI, 3.93 to 8.98; ES, 0.75) and sexual drive and relationship (BGD, 1.06; 95% CI, 0.11 to 2.01; ES, 0.35) at month 24 as well as improved sleep duration at month 12 (BGD, −0.26; 95% CI, −0.49 to −0.02; ES, −0.32) (all P < .05). Greater percent weight loss in the CR group at month 24 was associated with increased vigor (Spearman correlation coefficient, ρ = −0.30) and less mood disturbance (ρ = 0.27) measured with the POMS, improved general health (ρ = −0.27) measured with the SF-36, and better sleep quality per the PSQI total score (ρ = 0.28) (all P < .01). In nonobese adults, CR had some positive effects and no negative effects on health-related QOL.