Changes in diet and lifestyle and long-term weight gain in women and men.
Changes in diet and lifestyle and long-term weight gain in women and men.
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DOI：
10.1056/nejmoa1014296
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发表时间：
2011-06-23
期刊：
影响因子：
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通讯作者：
Hu FB
中科院分区：
文献类型：
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作者：
Mozaffarian D;Hao T;Rimm EB;Willett WC;Hu FB
特定的饮食和其他生活方式行为可能会影响预防长期体重增加的听起来直截了当的策略“少吃多运动”的成功。我们进行了前瞻性研究，涉及三个独立的队列，其中包括120，877名美国女性和男性，他们在基线时没有慢性疾病并且不肥胖，随访期为1986年至2006年，1991年至2003年和1986年至2006年。每4年评估一次生活方式因素变化与体重变化之间的关系，同时对年龄、每个阶段的基线体重指数和所有生活方式因素进行多变量调整。队列特异性和性别特异性结果相似，并使用逆方差加权荟萃分析进行汇总。在每4年期间，参与者平均增加3.35磅（第5至第95百分位数，-4.1至12.4）。根据每日增加的个别膳食成分，4年的体重变化与薯片的摄入量最密切相关（1.69磅），土豆（1.28磅），含糖饮料（1.00磅），未加工红肉（0.95磅）和加工肉类（0.93磅），与蔬菜摄入量呈负相关（-0.22磅），全谷物（-0.37磅），水果（-0.49磅），坚果（-0.57磅）和酸奶（-0.82磅）（每次比较P≤0.005）。总体饮食变化与体重变化的实质性差异相关（饮食变化的五分位数为3.93磅）。其他生活方式因素也与体重变化独立相关（P<0.001），包括体力活动（五分位数为-1.76磅）;饮酒（每天每杯饮料0.41磅），吸烟（新戒烟者，5.17磅;前吸烟者，0.14磅），睡眠（8小时睡眠体重增加更多<6 or >）和看电视（每天每小时0.31磅）。特定的饮食和生活方式因素与长期体重增加独立相关，具有显著的综合效应，并对预防肥胖的策略产生影响。（由美国国立卫生研究院和其他机构资助。
Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance–weighted meta-analysis. Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, −4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (−0.22 lb), whole grains (−0.37 lb), fruits (−0.49 lb), nuts (−0.57 lb), and yogurt (−0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (−1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day). Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.)