The causal role of breakfast in energy balance and health: a randomized controlled trial in obese adults.
The causal role of breakfast in energy balance and health: a randomized controlled trial in obese adults.
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DOI：
10.3945/ajcn.115.122044
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Betts JA
中科院分区：
文献类型：
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作者：
Chowdhury EA;Richardson JD;Holman GD;Tsintzas K;Thompson D;Betts JA
背景：肥胖者的早餐与健康之间的因果关系仍不清楚。目的：我们试图进行一项随机对照试验，以检查自由生活的肥胖人群的早餐习惯与能量平衡组成部分之间的因果关系。设计：沐浴早餐项目是一项随机对照试验，在英格兰西南部 21-60 岁的队列中进行基线重复测量和随访，双能 X 射线吸收测定法得出的女性脂肪质量指数≥13 kg/m2（n = 15），男性≥9 kg/m2（n = 8）。在自由生活条件下测量能量平衡的组成部分（静息代谢率、体力活动产热、饮食引起的产热和能量摄入），随机分配每日早餐（1100 之前≥700 kcal）或延长禁食（0 kcal 直到 1200）6 周，并进行基线和后续健康指标测量（例如血液学/脂肪活检）。结果：与禁食期间相比，早餐导致早晨身体活动产热更大（差异：188 kcal/d；95% CI：40, 335），但对 24 小时身体活动产热没有任何一致的影响（差异：272 kcal/d；95% CI：-254, 798）。早餐时的能量摄入量并没有显着高于空腹时的能量摄入量（差异：338 kcal/d；95% CI：-313, 988）。随着时间的推移，两组的体重均有所增加，但治疗对身体成分没有影响，静息代谢率也没有任何变化（稳定在 8 kcal/d 以内）。代谢/心血管健康也对治疗没有反应，除了随着时间的推移，每日早餐对口服葡萄糖耐量测试的胰岛素反应降低，相对于每日禁食的增加而言（P = 0.05）。结论：对于肥胖成年人来说，每日早餐会导致早上进行更多的体力活动，而早上禁食会导致当天晚些时候的部分饮食补偿（即更多的能量摄入）。各组之间的体重变化和大多数健康结果没有差异，但相对于禁食，早餐的胰岛素敏感性增加。该试验在 www.isrctn.org 上注册为 ISRCTN31521726。
Background: The causal nature of associations between breakfast and health remain unclear in obese individuals. Objective: We sought to conduct a randomized controlled trial to examine causal links between breakfast habits and components of energy balance in free-living obese humans. Design: The Bath Breakfast Project is a randomized controlled trial with repeated measures at baseline and follow-up among a cohort in South West England aged 21–60 y with dual-energy X-ray absorptiometry–derived fat mass indexes of ≥13 kg/m2 for women (n = 15) and ≥9 kg/m2 for men (n = 8). Components of energy balance (resting metabolic rate, physical activity thermogenesis, diet-induced thermogenesis, and energy intake) were measured under free-living conditions with random allocation to daily breakfast (≥700 kcal before 1100) or extended fasting (0 kcal until 1200) for 6 wk, with baseline and follow-up measures of health markers (e.g., hematology/adipose biopsies). Results: Breakfast resulted in greater physical activity thermogenesis during the morning than when fasting during that period (difference: 188 kcal/d; 95% CI: 40, 335) but without any consistent effect on 24-h physical activity thermogenesis (difference: 272 kcal/d; 95% CI: −254, 798). Energy intake was not significantly greater with breakfast than fasting (difference: 338 kcal/d; 95% CI: −313, 988). Body mass increased across both groups over time but with no treatment effects on body composition or any change in resting metabolic rate (stable within 8 kcal/d). Metabolic/cardiovascular health also did not respond to treatments, except for a reduced insulinemic response to an oral-glucose-tolerance test over time with daily breakfast relative to an increase with daily fasting (P = 0.05). Conclusions: In obese adults, daily breakfast leads to greater physical activity during the morning, whereas morning fasting results in partial dietary compensation (i.e., greater energy intake) later in the day. There were no differences between groups in weight change and most health outcomes, but insulin sensitivity increased with breakfast relative to fasting. This trial was registered at www.isrctn.org as ISRCTN31521726.