Long-term effects of a very-low-carbohydrate weight-loss diet and an isocaloric low-fat diet on bone health in obese adults
Long-term effects of a very-low-carbohydrate weight-loss diet and an isocaloric low-fat diet on bone health in obese adults
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DOI：
10.1016/j.nut.2016.03.003
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发表时间：
2016-09-01
期刊：
影响因子：
4.4
通讯作者：
Clifton, Peter M.
中科院分区：
文献类型：
--
作者：
Brinkworth, Grant D.;Wycherley, Thomas P.;Clifton, Peter M.
目的：骨健康受损是极低碳水化合物(LC)饮食中经常被提及的问题，尽管从长期的、良好控制的随机研究中获得的数据有限。这项研究比较了能量限制的LC饮食和传统的高碳水化合物、低脂肪(LF)饮食对12个月后骨骼健康的影响。方法：118名腹型肥胖成年人被随机分为能量限制(类似于6-7MJ/d[类似于1450-1650kcal/d])、计划等热量LC饮食或LF饮食12mo。结果：65名受试者完成研究(LC=32，LF=33；年龄：51.3+/-7.1岁；BMI：33.4+/-4.0 kg/m(2))。两组体重下降相似(LC：-14.5+/-9.8 kg，LF：-11.7+/-7.3 kg；P=0.26)。到1年时，两组的全身骨矿含量均无变化(LC：2.84+/-0.47至2.88+/-0.49 kg，LF：3.00+/-0.52至3.00+/-0.51 kg；P=0.07倍x饮食效应)。两组患者全身骨密度均下降(LC：319.3+/-142.6至396.5+/-172.0 ng/L，LF：276.3+/-100.6至365.9+/-154.2 ng/L)，全身骨密度下降(LC：1.26+/-0.09至1.22+/-0.09g/cm(2)，LF：1.26+/-0.09至1.23+/-0.08g/m(2)，P<；0.001倍)；P<；0.001次)与饮食组成无关(P>；=0.25次x饮食效果)。未来的研究将通过评估临床相关部位(即髋部和脊柱)的局部骨密度和骨转换的多个标志物来加强。结论：在超重和肥胖成年人中，低热量LC饮食和LF饮食后的体重减轻对超过12个月的骨健康指标没有差异。(C)2016 Elsevier Inc.保留所有权利。
Objective: Compromised bone health is a frequently cited concern of very-low-carbohydrate (LC) diets, although limited data are available from long-term, well-controlled, randomized studies. This study compared the effects of an energy-restricted LC diet and traditional, higher-carbohydrate, low-fat (LF) diet on bone health after 12 mo.Methods: One hundred eighteen abdominally obese adults were randomized to consume either an energy-restricted (similar to 6-7 MJ/d [similar to 1450-1650 kcal/d]), planned isocaloric LC, or LF diet for 12 mo. Body weight, total body bone mineral content and bone mineral density (BMD), and serum bone crosslaps were assessed pre- and postintervention.Results: Sixty-five participants completed the study (LC = 32, LF = 33; age: 51.3 +/- 7.1 y; BMI: 33.4 +/- 4.0 kg/m(2)). Weight loss was similar in both groups (LC: -14.5 +/- 9.8 kg, LF: -11.7 +/- 7.3 kg; P = 0.26). By 1 y, total body bone mineral content had not changed in either group (LC: 2.84 +/- 0.47 to 2.88 +/- 0.49 kg, LF: 3.00 +/- 0.52 to 3.00 +/- 0.51 kg; P = 0.07 time x diet effect). In both groups, total body BMD decreased (LC: 1.26 +/- 0.10 to 1.22 +/- 0.09 g/cm(2), LF: 1.26 +/- 0.09 to 1.23 +/- 0.08 g/m(2); P < 0.001 time) and bone serum crosslaps increased (LC: 319.3 +/- 142.6 to 396.5 +/- 172.0 ng/L, LF: 276.3 +/- 100.6 to 365.9 +/- 154.2 ng/L; P < 0.001 time) independent of diet composition (P >= 0.25 time x diet effect). Future studies would be strengthened by the assessment of regional BMD at clinically relevant sites (i.e., hip and spine) and multiple markers of bone turnover.Conclusions: Weight loss following a hypocaloric LC diet compared with an LF diet does not differentially affect markers of bone health over 12 mo in overweight and obese adults. (C) 2016 Elsevier Inc. All rights reserved.