The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes
The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes
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DOI：
10.2337/diacare.21.1.2
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发表时间：
1998-01-01
期刊：
影响因子：
16.2
通讯作者：
Wing, RR
中科院分区：
文献类型：
--
作者：
Williams, KV;Mullen, ML;Wing, RR
谨慎，以确定是否间歇性极低热量饮食（VLCD）改善体重减轻和血糖控制超过适度的热量restriction.Research设计和方法-个人与2型糖尿病（n = 54）谁是大于或等于20%超过理想体重参加了20周的行为体重控制计划。受试者被随机分配到标准行为治疗（SBT）组或两个VLCD组之一。SET受试者全程接受1，500 - 1，800千卡/天的饮食。两个VLCD组在第2周期间连续5天进行VLCD治疗，然后进行间歇性VLCD治疗，每周1天，持续15周（1天）或每5周连续5天（5天），其他时间饮食为1，500 - 1，800 kcal/d。尽管两组在20周时空腹血糖（FPG）变化方面没有差异，但与SBT组相比，5天组中更多的受试者达到正常HbA（1c）（P = 0.04）。这种益处与体重减轻的影响无关。FPG和HbA（1c）总体变化的最佳预测因子是在该计划的前3周内的FPG反应。结论-周期性VLCDs改善糖尿病受试者的体重减轻。间歇性5天VLCD治疗方案似乎特别有希望，因为该组中更多受试者达到正常HbA（1c）。此外，对3周饮食治疗的血糖反应预测了20周的血糖反应，并且它比初始或总体体重减轻更能预测20周的反应。
OBJECTIVE-To determine whether an intermittent very-low-calorie diet (VLCD) improves weight loss and glycemic control more than moderate caloric restriction alone.RESEARCH DESIGN AND METHODS - Individuals with type 2 diabetes (n = 54) who were greater than or equal to 20% over ideal body weight participated in a 20-week behavioral weight control program. Subjects were randomized to either a standard behavioral therapy (SBT) group or to one of two VLCD groups. SET subjects received a 1,500-1,800 kcal/day diet throughout. Both VLCD groups followed a VLCD for 5 consecutive days during week 2, followed by either intermittent VLCD therapy for 1 day/week for 15 weeks (1-day) or for 5 consecutive days every 5 weeks (5-day), with a 1,500-1,800 kcal/day diet at other times.RESULTS - Both VLCD groups lost more weight than the SBT group over the 20 weeks (P = 0.04). Although the groups did not differ in fasting plasma glucose (FPG) changes at 20 weeks, more subjects in the 5-day group attained a normal HbA(1c) when compared with the SBT group (P = 0.04). This benefit was independent of the effects of weight loss. The best predictor of overall change in FPG and HbA(1c) was the FPG response during the first 3 weeks of the program.CONCLUSIONS - Periodic VLCDs improved weight loss in diabetic subjects. A regimen with intermittent 5-day VLCD therapy seemed particularly promising, because more subjects in this group attained a normal HbA(1c). Moreover, thr glucose response to a 3-week period of diet therapy predicted glycemic response at 20 weeks, and it was a better predictor of the 20-week response than initial or overall weight loss.