Water Intake and Weight Control in Older Adults

项目摘要/摘要 缺乏切实有效的战略来管理饥饿和坚持体重控制干预 代表着体重管理领域的一个关键障碍。在概念验证功效研究中，我们有 研究表明，餐前喝水(500毫升)可显著减少饥饿感和进餐能量 中老年人摄入量和餐前水消耗量(500毫升，每天3次) 增加中老年人12周后的减重量(即增加2公斤减重) 超重或肥胖。然而，无论如何，水的消耗对体重管理可能是重要的 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 不同饮食方式对50岁成人超重或肥胖症干预效果的比较 处方：1)餐前喝水(500毫升，每顿主餐前)，低热量饮食；2)1500 在低热量饮食的情况下，全天消耗1毫升的水；3)低热量饮食，没有关于 用水量。智能水瓶将客观地评估进水量和进水量。尿液渗透压， 尿量和血清渗透压将被用作水摄入量依从性的客观指标 处方药。我们将研究饥饿和饱腹感以及食欲调节荷尔蒙的变化 餐前水可以改善食欲调节的潜在机制。我们还将调查 用水量和水合作用对执行功能能力的影响，这可能会影响干预 坚持不懈。我们假设在12周时体重下降，在12个月时保持体重下降将是 与每日饮水量和对照组相比，餐前饮水组的摄入量更大。此外，当 与低卡路里饮食相结合，餐前水将减少饥饿，增加饱腹感；这些变化将 调节对低热量饮食的坚持和减肥效果。尽管增加水摄入量可能会 一种有效的体重管理策略，没有基于证据的建议来确定喝水的时间 这种益处所需的摄入量。我们的发现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 通过减少饥饿、增加饱腹感、改善注意力和抑制控制来开处方。这 建议与2020-2030年美国国立卫生研究院营养研究战略计划(目标3.5)和饮食相一致 2020-2025年美国人指南由于其重点是老年人，研究不足的人口正在增加 肥胖和水分不足的风险。如果有效，这种补水/体重控制干预方法可能 适用于临床人群，如肥胖的成年人，他们被处方增加水的摄入量 预防或治疗肾结石疾病或尿路感染，这在老年人中很常见。

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.