Adherence and Success in Long-Term Weight Loss Diets: The Dietary Intervention Randomized Controlled Trial (DIRECT)
Adherence and Success in Long-Term Weight Loss Diets: The Dietary Intervention Randomized Controlled Trial (DIRECT)
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DOI：
10.1080/07315724.2009.10719767
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发表时间：
2009-04-01
影响因子：
3.5
通讯作者：
Shai, Iris
中科院分区：
文献类型：
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作者：
Greenberg, Ilana;Stampfer, Meir J.;Shai, Iris
背景资料：关于饮食试验参与者是否真正坚持指定的饮食以及影响他们坚持的因素的数据有限。方法：我们在一项为期两年的饮食干预随机对照试验（DIRECT）中评估了成功和坚持，其中322名中度肥胖参与者（平均年龄52岁，平均体重指数（BMI）31 kg/m2，86%为男性）被随机分为三组：低脂、地中海或低碳水化合物饮食。第24个月的总体依从性为85%，低脂饮食为90%，地中海饮食为85%，低碳水化合物饮食为78%（两组间p = 0.042）。女性（29% vs. 14%男性，p = 0.001）和当前吸烟者（25% vs. 14%维护者，p = 0.04）的吸烟率较高。在多变量模型中，脱落的独立预测因素为：基线BMI较高（OR = 1.11; CI：1.03-1.21）和6个月时体重减轻较少（OR = 1.20; CI：1.1-1.3）。在多变量模型中，在第6个月时实现更大的体重减轻是与2年内体重减轻成功（> 5%）相关的主要预测因素（OR = 1.5; CI：1.35-1.67）。低碳水化合物饮食组自我报告的饮食完全依从性评分更高（p
Background: Data are limited as to whether participants in diet trials truly adhere to their assigned diet and the factors that affect their adherence.Methods: We evaluated success and adherence in a two-year dietary intervention randomized controlled trial (DIRECT) in which 322 moderately obese participants (mean age 52 yrs, mean body-mass-index (BMI) 31 kg/m(2), 86% men) were randomized to one of three groups: low-fat, Mediterranean, or low-carbohydrate diets.Results: Overall compliance at month-24 was 85%, with 90% in low-fat, 85% in Mediterranean, and 78% in low-carbohydrate diet (p = .042 between groups). Attrition was higher in women (29% vs. 14% men, p = .001) and current smokers (25% vs. 14% among maintainers, p = 0.04). In a multivariate model, independent predictors of dropping-out were: higher baseline BMI (OR = 1.11; CI: 1.03-1.21) and less weight loss at month-6 (OR = 1.20; CI: 1.1-1.3). In a multivariate model, greater weight loss achieved at month-6 was the main predictor associated with success in weight loss (> 5%) over 2 years (OR = 1.5; CI: 1.35-1.67). Self-reported complete adherence score to diet was greater on low-carbohydrate diet (p