Alternate day fasting for weight loss, weight maintenance, and cardio-protection

隔日禁食有助于减肥、维持体重和保护心脏

• 批准号: 8427370
• 负责人: Krista Amy Varady
• 金额: $ 37.02万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8427370
• 关键词: Address; Adherence; Adipocytes; Attitude; Behavioral; Blood Pressure; Body Weight; Body Weight decreased; Body fat; C-reactive protein; Caloric Restriction; Cell Size; Cell physiology; Cholesterol; Cognitive; Coronary heart disease; Data; Diet; Diet therapy; Eating; Eating Behavior; Energy Intake; Fasting; Food; Future; Hormones; Individual; Intervention; Link; Lipids; Low-Density Lipoproteins; Obesity; Overweight; Particle Size; Phase; Pilot Projects; Plasma; Protocols documentation; Randomized; Regimen; Relative (related person); Research; Risk; Risk Factors; Risk Reduction; Self Efficacy; Testing; Vascular Diseases; Weight; Weight Gain; arm; dietary restriction; disorder risk; experience; feeding; heart disease prevention; heart disease risk; improved; insight; nutrition; prevent; response; restraint; treatment duration; weight maintenance

DESCRIPTION (provided by applicant): Overweight and obese individuals are at increased risk for coronary heart disease (CHD). Losing weight by means of dietary restriction greatly reduces vascular disease risk. The most common dietary restriction protocol implemented is daily calorie restriction (CR). Another dietary restriction regimen employed, although far less commonly, is alternate day modified fasting (ADMF). ADMF involves a "feed day" where food is consumed ad-libitum, alternated with a "fast day", where food intake is partially reduced. Results from our 12- week pilot study show that adherence to ADMF exceeds that of CR after 8 weeks of treatment. This increased adherence to ADMF results in greater weight loss, which produces more pronounced improvements in CHD risk. What has yet to be determined is whether adherence to ADMF remains near maximal for longer treatment durations (24 weeks), and if this improved adherence results in greater reductions in body weight and CHD risk, versus CR. Once weight loss is achieved, weight maintenance is extremely important as CHD risk can increase if weight is regained. Whether ADMF is an effective strategy for weight maintenance remains unknown. Accordingly, the aims of this proposal are: Aim 1: To establish that adherence to ADMF is greater than that of CR during a 24-week intervention period and to determine if increased adherence to ADMF results in greater weight loss; Aim 2: To establish that greater reductions in body weight by ADMF over a 24-week period will result in greater improvements in traditional CHD risk parameters (blood pressure, plasma lipid levels, cholesterol synthesis rate, LDL particle size, and CRP) and emerging CHD risk parameters (fat cell- derived hormones, body fat distribution, and fat cell size) in comparison to CR; and Aim 3: To establish that ADMF is an effective diet therapy to maintain weight loss and sustain improvements in CHD risk indicators, and to compare changes in cognitive and behavioral components of eating between ADMF and CR subjects. A 52-week randomized, controlled, parallel-arm feeding trial will be implemented to test these objectives. The trial will be divided into 3 consecutive intervention periods: (1) 4-week baseline; (2) 24-week weight loss with food provided; and (3) 24-week weight maintenance with no food provided. Overweight and obese subjects (n = 90) will be randomized to 1 of 3 groups: (1) ADMF, 75% energy restriction on the "fast day" and ad libitum fed on the "feed day"; (2) CR, 25% restriction everyday; or 3) control, 100% energy intake every day. During the weight maintenance phase, ADMF subjects will consume 25% of their energy needs on the "fast day" and 175% of their needs on the "feed day", while CR and control subjects will consume 100% of their needs every day. Our findings will show that ADMF can be implemented as an alternative to CR to help overweight and obese individuals lose weight, maintain weight loss, and sustain reductions in CHD risk. This study will also generate insights into the specific behavioral changes that occur with ADMF that explain why ADMF is a successful diet strategy for weight maintenance.

描述（由申请人提供）：超重和肥胖个体患冠心病（CHD）的风险增加。通过限制饮食来减肥可以大大降低血管疾病的风险。最常见的饮食限制方案是每日热量限制（CR）。另一种饮食限制方案是隔日改良禁食（ADMF），尽管不太常见。 ADMF 包括随意食用食物的“喂食日”和部分减少食物摄入量的“禁食日”。我们的 12 周试点研究结果表明，治疗 8 周后，ADMF 的依从性超过了 CR。坚持 ADMF 可以带来更大的体重减轻，从而更显着地降低冠心病风险。尚未确定的是，在较长的治疗持续时间（24 周）内，ADMF 的依从性是否仍保持在接近最大水平，以及与 CR 相比，这种改善的依从性是否会导致体重和 CHD 风险更大程度的降低。一旦体重减轻，维持体重就极其重要，因为如果体重反弹，冠心病的风险就会增加。 ADMF 是否是维持体重的有效策略仍不清楚。因此，该提案的目标是： 目标 1：确定在 24 周干预期内 ADMF 的坚持程度高于 CR，并确定增加 ADMF 的坚持程度是否会导致更大的体重减轻；目标 2：确定与 CR 相比，ADMF 在 24 周内更大程度地降低体重将导致传统 CHD 风险参数（血压、血脂水平、胆固醇合成率、LDL 颗粒大小和 CRP）和新兴 CHD 风险参数（脂肪细胞衍生激素、体脂肪分布和脂肪细胞大小）的更大改善；目标 3：确定 ADMF 是一种有效的饮食疗法，可维持体重减轻并持续改善 CHD 风险指标，并比较 ADMF 和 CR 受试者之间饮食认知和行为成分的变化。将实施为期 52 周的随机、对照、平行臂喂养试验来测试这些目标。试验将分为3个连续的干预期：（1）4周基线； (2) 24周饮食减肥； (3) 24 周不提供食物维持体重。超重和肥胖受试者（n = 90）将被随机分为 3 组中的 1 组：（1）ADMF，“禁食日”限制 75% 能量，并在“进食日”随意进食； （2）CR，每天限制25%；或3）控制，每天100%的能量摄入。在体重维持阶段，ADMF受试者将在“禁食日”消耗其能量需求的25%，在“进食日”消耗其能量需求的175%，而CR和对照受试者将每天消耗其需求的100%。我们的研究结果将表明，ADMF 可以作为 CR 的替代方案来帮助超重和肥胖个体减肥、维持体重减轻并持续降低 CHD 风险。这项研究还将深入了解 ADMF 发生的具体行为变化，解释为什么 ADMF 是维持体重的成功饮食策略。