A randomized trial of a low-carbohydrate diet for obesity
A randomized trial of a low-carbohydrate diet for obesity
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DOI：
10.1056/nejmoa022207
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发表时间：
2003-05-22
影响因子：
158.5
通讯作者：
Klein, S
中科院分区：
文献类型：
--
作者：
Foster, GD;Wyatt, HR;Klein, S
背景：尽管低碳水化合物、高蛋白、高脂肪（阿特金斯）饮食法很受欢迎，但尚无随机对照试验评估其疗效。方法：我们进行了一项为期一年的多中心对照试验，涉及63名肥胖男性和女性，他们被随机分配到低碳水化合物，高蛋白，高脂肪饮食或低热量，高碳水化合物，低脂肪（传统）饮食。为了复制大多数节食者使用的方法，专业的接触是最少的。结果：低碳水化合物饮食的受试者在3个月时比常规饮食的受试者体重减轻更多（平均[+/-SD]， -6.8+/-5.0对-2.7+/- 3.7%体重，P=0.001）和6个月时（-7.0+/-6.5对-3.2+/- 5.6%体重，P=0.02），但12个月时差异不显著（-4.4+/-6.7对-2.5+/- 6.3%体重，P=0.26）。三个月后，两组之间的总脂蛋白或低密度脂蛋白胆固醇浓度没有显著差异。在研究的大部分时间里，低碳水化合物饮食的受试者高密度脂蛋白胆固醇浓度的增加和甘油三酯浓度的下降要大于传统饮食的受试者。两种饮食都能显著降低舒张压和口服葡萄糖负荷下的胰岛素反应。结论：低碳水化合物饮食在前六个月比传统饮食产生更大的体重减轻（绝对差异，约为4%），但一年后差异不显著。低碳水化合物饮食与冠心病的一些危险因素有较大的改善有关。两组的依从性都很差，减员率也很高。要确定低碳水化合物、高蛋白、高脂肪饮食的长期安全性和有效性，还需要更长期、更大规模的研究。
BACKGROUND:Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy.METHODS:We conducted a one-year, multicenter, controlled trial involving 63 obese men and women who were randomly assigned to either a low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. Professional contact was minimal to replicate the approach used by most dieters.RESULTS:Subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet at 3 months (mean [+/-SD], -6.8+/-5.0 vs. -2.7+/-3.7 percent of body weight; P=0.001) and 6 months (-7.0+/-6.5 vs. -3.2+/-5.6 percent of body weight, P=0.02), but the difference at 12 months was not significant (-4.4+/-6.7 vs. -2.5+/-6.3 percent of body weight, P=0.26). After three months, no significant differences were found between the groups in total or low-density lipoprotein cholesterol concentrations. The increase in high-density lipoprotein cholesterol concentrations and the decrease in triglyceride concentrations were greater among subjects on the low-carbohydrate diet than among those on the conventional diet throughout most of the study. Both diets significantly decreased diastolic blood pressure and the insulin response to an oral glucose load.CONCLUSIONS:The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets.