Water Intake and Weight Control in Older Adults

项目概要/摘要 缺乏实际有效的策略来管理饥饿和坚持体重管理干预 是体重管理领域的一个关键障碍。在概念验证有效性研究中，我们 证明餐前饮水量（500毫升）急剧降低了感知的饥饿感和膳食能量 中老年人摄入量和餐前饮水量（500 ml，每日3次） 增加了体重减轻的量（即，中年和老年人12周后体重增加2 kg） 超重或肥胖。然而，水的消耗可能是重要的体重管理， 当它被消费的时候。为了解决这种可能性，我们提出了一个严格设计的随机对照， 对50岁以上超重或肥胖成年人进行干预试验，比较三组不同饮食的人群 处方：1）餐前饮水量（500 ml，每顿主餐前），低热量饮食; 2）1500 每天消耗的水ml，低热量饮食; 3）低热量饮食，没有关于 按用水量智能水瓶将客观地评估饮水时间和水量。尿渗透压， 尿量和血清渗透压将用作饮水依从性的客观指标 处方.我们将调查饥饿感和饱腹感以及食欲调节激素的变化， 餐前饮水可以改善食欲调节的潜在机制。我们还将调查 水消耗和水合作用对执行功能能力的影响，这可能影响干预 坚持。我们假设在12周时体重减轻，并在12个月时保持体重减轻， 餐前饮水组比每日饮水量和对照组更大。此外，当 结合低热量饮食，餐前饮水将减少饥饿感，增加饱腹感;这些变化将 介导对低热量饮食的坚持和体重减轻的结果。虽然增加水的摄入量可能是 一个有效的体重管理策略，没有证据为基础的建议存在的时间水 这一福利所需要的。我们的研究结果可以确定一种低成本，可操作的饮食策略， 纳入肥胖治疗的临床实践指南，并改善对低热量饮食的坚持 处方通过减少饥饿，增加饱腹感，改善注意力和抑制控制。这 该提案与2020-2030年NIH营养研究战略计划（目标3.5）和膳食计划保持一致。 2020-2025年美国人指南，由于其重点是老年人， 肥胖和水分不足的风险。如果有效，这种水合/体重控制干预方法可以 可应用于临床人群，如患有肥胖症的成年人，他们被规定增加水摄入量， 预防或治疗肾结石疾病或尿路感染，这是常见于老年人。

Project Summary/Abstract The lack of practical and effective strategies to manage hunger and adhere to a weight management intervention represents a critical barrier to the weight management field. In proof-of-concept efficacy studies, we have demonstrated that premeal water consumption (500 ml) acutely reduced perceived hunger and meal energy intake among middle-aged and older adults, and that premeal water consumption (500 ml, 3 times per day) increased the amount of weight lost (i.e., 2 kg greater loss) after 12 weeks among middle-aged and older adults with overweight or obesity. However, water consumption may be important for weight management regardless of when it is consumed. To address this possibility, we propose a rigorously-designed randomized controlled intervention trial in adults aged 50+ years with overweight or obesity comparing three groups with different diet prescriptions: 1) pre-meal water consumption (500 ml, before each main meal) with a hypocaloric diet; 2) 1500 ml water consumed throughout the day with a hypocaloric diet; 3) hypocaloric diet with no instructions regarding water consumption. Smart water bottles will objectively assess water intake timing and volume. Urine osmolality, urine volume, and serum osmolality will be used as objective indicators of compliance with the water intake prescription. We will investigate changes in perceived hunger and fullness and appetite-regulating hormones as potential mechanisms by which premeal water could improve appetite regulation. We will also investigate the impact of water consumption and hydration on executive function capabilities, which may influence intervention adherence. We hypothesize that weight loss at 12 weeks, and weight loss maintenance at 12 months, will be greater in the premeal water group compared to the daily water volume and control groups. Furthermore, when combined with a hypocaloric diet, premeal water will reduce hunger and increase fullness; these changes will mediate adherence to the hypocaloric diet and weight loss outcomes. Although increasing water intake could be an effective weight management strategy, no evidence-based recommendations exist for the timing of water intake needed for this benefit. Our findings could identify a low-cost, actionable dietary strategy that could be incorporated into clinical practice guidelines for obesity treatment, and improve adherence to a hypocaloric diet prescription through reduced hunger, increased fullness, and improved attention and inhibitory control. This proposal is aligned with the 2020-2030 NIH Strategic Plan for Nutrition Research (Objective 3.5) and the Dietary Guidelines for Americans 2020-2025 due to its focus on older adults, an understudied population at increased risk for obesity and inadequate hydration. If effective, this hydration/weight control intervention approach could be applied to clinical populations such as adults with obesity who are prescribed increased water intake to prevent or treat kidney stone disease or urinary tract infections, which are common in older adults.