Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.
Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.
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DOI：
10.1186/1743-7075-1-13
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发表时间：
2004-11-08
影响因子：
4.5
通讯作者：
Kraemer W
中科院分区：
文献类型：
--
作者：
Volek J;Sharman M;Gómez A;Judelson D;Rubin M;Watson G;Sokmen B;Silvestre R;French D;Kraemer W
比较等热量、能量限制的极低碳水化合物生酮（VLCK）和低脂（LF）饮食对超重/肥胖男性和女性体重减轻、身体组成、躯干脂肪量和静息能量消耗（REE）的影响。随机、平衡、两个饮食阶段的临床干预研究。给受试者开了两种能量限制（~ 500 kcal/天）饮食：VLCK饮食，目标是将碳水化合物水平降低到能量的10%以下并诱导酮症; LF饮食，目标与国家建议相似（%碳水化合物：脂肪：蛋白质= ~60：25：15%）。15名健康、超重/肥胖男性（平均值± s.e.m.：年龄33.2 ± 2.9岁，体质量109.1 ± 4.6 kg，体质量指数34.1 ± 1.1 kg/m2）和13名绝经前妇女（年龄34.0 ± 2.4岁，体质量76.3 ± 3.6 kg，体质量指数29.6 ± 1.1 kg/m2）。在基线和每次饮食干预后测定体重减轻、身体成分、躯干脂肪（通过双能X线吸收测定法）和静息能量消耗（REE）。数据分析组间差异，仅考虑第一饮食阶段，组内差异考虑每个人对两种饮食的反应。VLCK（%碳水化合物：脂肪：蛋白质= ~9：63：28%）和LF（~58：22：20%）期间食物记录的实际营养素摄入量存在显著差异。饮食能量受到限制，但在VLCK（1855千卡/天）期间略高于男性LF（1562千卡/天）饮食。组间和组内比较都显示VLCK在减肥、总脂肪减少和男性躯干脂肪减少方面优于LF饮食（尽管能量摄入量显著增加）。大多数女性也对VLCK饮食反应更好，特别是在躯干脂肪损失方面。躯干脂肪的更大减少不仅仅是由于更大的总脂肪损失，因为在VLCK饮食期间，男性和女性的躯干脂肪/总脂肪的比例也显着降低。正如预期的那样，两种饮食的绝对REE（千卡/天）均有所下降，但相对于体重（千卡/公斤）表示的REE仅在男性的VLCK饮食中得到了更好的维持。个体反应清楚地表明，大多数男性和女性在VLCK上经历的体重和脂肪损失比LF饮食更大。这项研究表明，VLCK对LF饮食的短期体重和脂肪损失有明显的好处，特别是在男性中。VLCK饮食在躯干区域的脂肪优先损失是新颖的，具有潜在的临床意义，但需要进一步验证。这些数据为代谢优势的概念提供了额外的支持，饮食代表了大量营养素分布的极端情况。
To compare the effects of isocaloric, energy-restricted very low-carbohydrate ketogenic (VLCK) and low-fat (LF) diets on weight loss, body composition, trunk fat mass, and resting energy expenditure (REE) in overweight/obese men and women. Randomized, balanced, two diet period clinical intervention study. Subjects were prescribed two energy-restricted (-500 kcal/day) diets: a VLCK diet with a goal to decrease carbohydrate levels below 10% of energy and induce ketosis and a LF diet with a goal similar to national recommendations (%carbohydrate:fat:protein = ~60:25:15%). 15 healthy, overweight/obese men (mean ± s.e.m.: age 33.2 ± 2.9 y, body mass 109.1 ± 4.6 kg, body mass index 34.1 ± 1.1 kg/m2) and 13 premenopausal women (age 34.0 ± 2.4 y, body mass 76.3 ± 3.6 kg, body mass index 29.6 ± 1.1 kg/m2). Weight loss, body composition, trunk fat (by dual-energy X-ray absorptiometry), and resting energy expenditure (REE) were determined at baseline and after each diet intervention. Data were analyzed for between group differences considering the first diet phase only and within group differences considering the response to both diets within each person. Actual nutrient intakes from food records during the VLCK (%carbohydrate:fat:protein = ~9:63:28%) and the LF (~58:22:20%) were significantly different. Dietary energy was restricted, but was slightly higher during the VLCK (1855 kcal/day) compared to the LF (1562 kcal/day) diet for men. Both between and within group comparisons revealed a distinct advantage of a VLCK over a LF diet for weight loss, total fat loss, and trunk fat loss for men (despite significantly greater energy intake). The majority of women also responded more favorably to the VLCK diet, especially in terms of trunk fat loss. The greater reduction in trunk fat was not merely due to the greater total fat loss, because the ratio of trunk fat/total fat was also significantly reduced during the VLCK diet in men and women. Absolute REE (kcal/day) was decreased with both diets as expected, but REE expressed relative to body mass (kcal/kg), was better maintained on the VLCK diet for men only. Individual responses clearly show the majority of men and women experience greater weight and fat loss on a VLCK than a LF diet. This study shows a clear benefit of a VLCK over LF diet for short-term body weight and fat loss, especially in men. A preferential loss of fat in the trunk region with a VLCK diet is novel and potentially clinically significant but requires further validation. These data provide additional support for the concept of metabolic advantage with diets representing extremes in macronutrient distribution.