Weight control in the physician's office
Weight control in the physician's office
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DOI：
10.1001/archinte.161.13.1599
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发表时间：
2001-07-09
影响因子：
--
通讯作者：
Bovee, V
中科院分区：
文献类型：
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作者：
Ashley, JM;St Jeor, ST;Bovee, V
背景：生活方式的改变包括饮食、行为和身体活动是成功控制体重的基石。替代餐（每天1-2次）纳入传统的生活方式干预措施可能为超重患者在初级保健环境中提供额外的策略。（平均年龄40.4 ± 5.5岁，体重82 ± 10 kg，体重指数30 ± 3 kg/m2）参加了一项为期1年的减肥研究，包括26个疗程。这些妇女被随机分配到3个不同的传统生活方式为基础的组：（1）营养师主导的团体干预（每节1小时），（2）营养师主导的小组干预，包括代餐（每节1小时），或（3）初级保健办公室干预，包括个别医生和护士访问的膳食替代品（每次10-15分钟）。结果：对于完成1年的74名受试者（65%），使用代餐的初级保健办公室干预与不使用代餐的传统营养师领导的小组干预一样有效（平均+/- SD体重减轻，分别为4.3% +/- 6.5%和4.1% +/-6.4%）。营养师主导组的比较显示，使用代餐的女性保持了显着更大的体重减轻（9.1% +/- 8.9% vs 4.1% +/- 6.4%）（P = .03）。各组间的分析显示，体重减轻5%至10%与体脂百分比、体重指数、腰围、静息能量消耗、胰岛素水平、总胆固醇水平和低密度脂蛋白胆固醇水平的显著降低（P = 0.01）相关。体重减轻10%或以上与额外的显着（P = 0.05）改善血压和甘油三酯level.Conclusions：传统的生活方式干预，使用代餐可以有效地控制体重和减少慢性疾病的风险，在医生的办公室设置以及在营养师领导的小组设置。
Background: Lifestyle changes involving diet, behavior, and physical activity are the cornerstone of successful weight control. Incorporating meal replacements (1-2 per day) into traditional lifestyle interventions may offer an additional strategy for overweight patients in the primary care setting.Methods: One hundred thirteen overweight premenopausal women (mean +/- SD age, 40.4 +/- 5.5 years; weight, 82 +/- 10 kg; and body mass index, 30 +/- 3 kg/m(2)) participated in a 1-year weight-reduction study consisting of 26 sessions. The women were randomly assigned to 3 different traditional lifestyle-based groups: (1) dietitian-led group intervention (1 hour per session), (2) dietitian-led group intervention incorporating meal replacements (1 hour per session), or (3) primary care office intervention incorporating meal replacements with individual physician and nurse visits (10-15 minutes per visit).Results: For the 74 subjects (65%) completing 1 year, the primary care office intervention using meal replacements was as effective as the traditional dietitian-led group intervention not using meal replacements (mean +/- SD weight loss, 4.3% +/- 6.5% vs 4.1% +/- 6.4%, respectively). Comparison of the dietitian-led groups showed that women using meal replacements maintained a significantly greater weight loss (9.1% +/- 8.9% vs 4.1% +/- 6.4%) (P = .03). Analysis across groups showed that weight loss of 5% to 10% was associated with significant (P = .01) reduction in percentage of body fat, body mass index, waist circumference, resting energy expenditure, insulin level, total cholesterol level, and low-density lipoprotein cholesterol level. Weight loss of 10% or greater was associated with additional significant (P = .05) improvements in blood pressure and triglyceride level.Conclusions: A traditional lifestyle intervention using meal replacements can be effective for weight control and reduction in risk of chronic disease in the physician's office setting as well as in the dietitian-led group setting.