Dietary adaptation for weight loss maintenance at Yale (DAWLY): Protocol and predictions for a randomized controlled trial.
Dietary adaptation for weight loss maintenance at Yale (DAWLY): Protocol and predictions for a randomized controlled trial.
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耶鲁大学维持减肥的饮食适应：一项随机对照试验的方案和预测。
DOI：
10.3389/fnut.2022.940064
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发表时间：
2022
影响因子：
5
通讯作者：
Small, Dana M.
中科院分区：
文献类型：
--
作者：
Fang, Xi;Davis, Xue;Flack, Kyle D.;Duncan, Chavonn;Li, Fangyong;White, Marney;Grilo, Carlos;Small, Dana M.
关键词：
目前的肥胖症治疗方法在短期内可以有效减轻体重，但维持体重减轻仍然是一个重大挑战。在这里，我们调查了干预前膳食脂肪摄入对膳食补充剂支持减肥维持的功效的影响。临床前研究表明，高脂饮食（HFD）使对感知膳食脂质至关重要的迷走神经传入通路变钝，导致对低脂乳剂的偏好降低，并使多巴胺（DA）对胃输注脂质的反应严重减弱。输注肠道脂质信使油酰乙醇胺（OEA），也被HFD耗尽，立即逆转这种DA钝化，并恢复对低脂乳剂的偏好。OEA补充剂用于人类减肥的研究取得了有限的成功。鉴于HFD对这一途径的强烈影响，我们设计了一项研究来测试OEA作为减肥治疗的功效是否与干预前习惯性摄入膳食脂肪有关。我们采用了一项随机、双盲、安慰剂对照试验，其中100名超重/肥胖（OW/OB）成人随机接受OEA或安慰剂每日治疗16个月。在对饮食、代谢健康、肥胖和大脑对可口的能量密集食物的反应进行基线评估后，两组参与者都接受了4个月的行为减肥干预（LEARN®），然后是1年的维持期。该研究的目的是（1）确定干预前膳食脂肪摄入量是否会调节OEA在金标准行为减肥治疗后改善体重减轻和维持体重减轻的能力;（2）确定预测结果和优化分层策略的生物标志物;（3）测试OEA有效性的模型。越来越多的证据表明，肠-脑信号在食物选择中的作用以及饮食对这一回路的调节，都支持关注针对肠-脑轴的干预措施。如果成功，这项工作将为使用易于实施且成本低廉的精准医学方法针对肠道-大脑途径维持减肥提供支持。[www.ClinicalTrials.gov]，标识符[NCT 04614233]。
Current therapies for obesity treatment are effective at producing short-term weight loss, but weight loss maintenance remains a significant challenge. Here we investigate the impact of pre-intervention dietary fat intake on the efficacy of a dietary supplement to support weight loss maintenance. Preclinical work demonstrates that a vagal afferent pathway critical for sensing dietary lipids is blunted by a high-fat diet (HFD), resulting in a reduced preference for a low-fat emulsion and severe blunting of the dopamine (DA) response to the gastric infusion of lipids. Infusion of the gut lipid messenger oleoylethanolamide (OEA), which is also depleted by HFD, immediately reverses this DA blunting and restores preference for the low-fat emulsion. Studies of OEA supplementation for weight loss in humans have had limited success. Given the strong effect of HFD on this pathway, we designed a study to test whether the efficacy of OEA as a weight loss treatment is related to pre-intervention habitual intake of dietary fat. We employed a randomized, double-blind, placebo-controlled trial in which 100 adults with overweight/obesity (OW/OB) were randomized to receive either OEA or placebo daily for 16 months. Following a baseline evaluation of diet, metabolic health, adiposity, and brain response to a palatable an energy dense food, participants in both groups underwent a 4-month behavioral weight loss intervention (LEARN®) followed by a 1-year maintenance period. The study aims are to (1) determine if pre-intervention dietary fat intake moderates the ability of OEA to improve weight loss and weight loss maintenance after a gold standard behavioral weight loss treatment; (2) identify biomarkers that predict outcome and optimize a stratification strategy; and (3) test a model underlying OEA’s effectiveness. Focusing on interventions that target the gut-brain axis is supported by mounting evidence for the role of gut-brain signaling in food choice and the modulation of this circuit by diet. If successful, this work will provide support for targeting the gut-brain pathway for weight loss maintenance using a precision medicine approach that is easy and inexpensive to implement. [www.ClinicalTrials.gov], identifier [NCT04614233].
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DOI：
10.1002/bs.3830090304
发表时间：
1964-01-01
期刊：
BEHAVIORAL SCIENCE
影响因子：
--
作者：
BECKER, GM;DEGROOT, MH;MARSCHAK, J
通讯作者：
MARSCHAK, J
影响因子：
3.4
作者：
Elliott, R;Sahakian, BJ;Robbins, TW
通讯作者：
Robbins, TW
影响因子：
3.4
作者：
Beck, AT;Steer, RA;Ranieri, WF
通讯作者：
Ranieri, WF
影响因子：
3.5
作者：
Green, BG;Dalton, P;Higgins, J
通讯作者：
Higgins, J
影响因子：
25.8
作者：
Grosshans, Martin;Schwarz, Emanuel;Leweke, F. Markus
通讯作者：
Leweke, F. Markus