在一项针对超重和肥胖女性的随机对照试验中，通过间歇性或连续性能量限制实现的体重匹配减轻不会导致食欲和进食行为的代偿性增加。

Matched Weight Loss Through Intermittent or Continuous Energy Restriction Does Not Lead To Compensatory Increases in Appetite and Eating Behavior in a Randomized Controlled Trial in Women with Overweight and Obesity.

机构信息

School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.

School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.

出版信息

J Nutr. 2020 Mar 1;150(3):623-633. doi: 10.1093/jn/nxz296.

DOI:10.1093/jn/nxz296

PMID:31825067

Abstract

BACKGROUND

Continuous energy restriction (CER) is purported to be problematic because of reductions in fat-free mass (FFM), compensatory motivation to overeat, and weakened satiety. Intermittent energy restriction (IER) is an alternative behavioral weight loss (WL) strategy that may mitigate some of these limitations.

OBJECTIVE

The objective of the DIVA study was to compare the effects of CER and IER on appetite when the degree of WL (≥5%) is matched.

METHODS

Women with overweight/obesity (BMI 25.0-34.9 kg/m2; age 18-55 y) were recruited for this controlled-feeding RCT via CER (25% daily energy restriction) or IER (alternating ad libitum and 75% energy restriction days). Probe days were conducted at baseline and post-intervention to assess body composition, ad libitum energy intake and subjective appetite in response to a fixed-energy breakfast, and eating behavior traits. After baseline measurements, participants were allocated to CER (n = 22) or IER (n = 24). Per protocol analyses (≥5% WL within 12 wk) were conducted with use of repeated measures ANOVA.

RESULTS

Thirty of 37 completers reached ≥5% WL [CER (n = 18): 6.3 ± 0.8% in 57 ± 16 d, IER (n = 12): 6.6 ± 1.1% in 67 ± 13 d; % WL P = 0.43 and days P = 0.10]. Fat mass [-3.9 (95% CI: -4.3, -3.4) kg] and FFM [-1.3 (95% CI: -1.6, -1.0) kg] were reduced post-WL (P < 0.001), with no group differences. Self-selected meal size decreased post-WL in CER (P = 0.03) but not in IER (P = 0.19). Hunger AUC decreased post-WL (P < 0.05), with no group differences. Satiety quotient remained unchanged and was similar in both groups. Both interventions improved dietary restraint, craving control, susceptibility to hunger, and binge eating (P < 0.001).

CONCLUSIONS

Controlled ≥5% WL via CER or IER did not differentially affect changes in body composition, reductions in hunger, and improvements in eating behavior traits. This suggests that neither CER nor IER lead to compensatory adaptations in appetite in women with overweight/obesity. This trial was registered at clinicaltrials.gov as NCT03447600.

摘要

背景

持续能量限制（CER）据称存在问题，因为它会导致去脂体重（FFM）减少、补偿性过食动机和饱腹感减弱。间歇性能量限制（IER）是一种替代的行为性减肥（WL）策略，可能会减轻其中的一些限制。

目的

DIVA 研究的目的是比较 CER 和 IER 在达到相同 WL 程度（≥5%）时对食欲的影响。

方法

通过 CER（每日能量限制 25%）或 IER（交替自由进食和 75%能量限制日）招募 BMI 为 25.0-34.9kg/m2（年龄 18-55 岁）的超重/肥胖女性（BMI 25.0-34.9kg/m2；年龄 18-55 岁）参加这项对照性喂养 RCT。在基线和干预后进行探针日，以评估身体成分、自由进食能量摄入和对固定能量早餐的主观食欲以及进食行为特征。在基线测量后，参与者被分配到 CER（n=22）或 IER（n=24）组。使用重复测量方差分析进行符合方案分析（12 周内≥5%WL）。

结果

37 名完成者中有 30 名达到≥5%WL[CER（n=18）：57±16d 时 6.3±0.8%，IER（n=12）：67±13d 时 6.6±1.1%；%WL P=0.43，天数 P=0.10]。脂肪量[-3.9（95%CI：-4.3，-3.4）kg]和 FFM[-1.3（95%CI：-1.6，-1.0）kg]在 WL 后减少（P<0.001），组间无差异。自我选择的膳食量在 CER 后减少（P=0.03），但在 IER 中没有减少（P=0.19）。饥饿 AUC 在 WL 后降低（P<0.05），组间无差异。饱腹感指数保持不变，两组相似。两种干预都改善了饮食控制、食欲控制、饥饿易感性和暴饮暴食（P<0.001）。