- 期刊
低脂飲食與低碳水化合物飲食對過重或肥胖女性體重及體脂改變之比較探討
Effects of Low-Carbohydrate Diet and Low- Fat Diet on Body Weight Loss and Body Fat Changes on Overweight and Obese Women
摘要
研究顯示低碳水化合物飲食短期減輕體重及下降體脂效果較傳統低脂飲食顯著，但一般維持1年後減重效果並無顯著不同。本研究目的為比較低脂飲食與低碳水化合物飲食對過重或肥胖女性體重及體組成改變之差異。本研究收集57位過重或肥胖女性，年齡為20 ~ 65歲，排除懷孕、惡性腫瘤、精神疾病、糖尿病、肝臟疾病、腸胃道及心血管疾病患者，且無使用任何降低血糖、血壓、血脂的藥物。受試者接受隨機分派為低脂（carbohydrate 50%, protein20%, and fat 30%, n = 28） 或低碳水化合物飲食（carbohydrate 4 -40%, n =29），介入為期1年，兩者均接受1200 kcal/day 的低熱量飲食。受試者需接受每週飲食諮詢及體適能課程並填寫飲食紀錄為期8週。經過1年介入，低碳水化合物飲食組與低脂飲食組體重、體脂、腰圍、胰島素濃度、胰島素阻抗性均較減重前明顯下降，其中低碳水化合物飲食組的體重減輕（3.8 ± 3.3 kg vs.1.7 ± 3.4 kg, p = 0.009）、體脂下降（2.0 ± 1.6% vs. 0.6 ± 1.8%, p = 0.001）程度較低脂飲食組更為明顯。低脂飲食組的腰圍（4.9 ± 7.0 cm vs. 4.6 ± 5.6cm）、胰島素濃度（3.6 ± 5.5 μU/mL vs. 2.8 ± 3.7 μU/mL）、胰島素阻抗性（1.1 ± 2.0 vs. 0.6 ± 1.0）下降較多，但2 組間無達到統計上顯著差異。追蹤1 年後C-reactive protein（CRP），僅有低碳水化合物飲食組組內有明顯下降（p = 0.03），低碳水化合物飲食組與低脂組介入1 年後之改變量則為邊緣性統計差異（LC: 1.4 ± 3.7 mg/L vs. LF: 0.3 ± 1.9 mg/L, p = 0.09）。針對過重或肥胖女性，在營養師指導下進行為期1 年的低碳水化合物飲食或低脂飲食介入，可降低體重及體脂，未來仍需更長時間介入的大型研究證實其效益。
並列摘要
The main features of low-carbohydrate diet (LC diet) are low-carbohydrate, highprotein, and high-fat. Studies have shown that LC diet could produce a greater weight loss effect than low-fat diet (LF diet) in short term. However, effects of both diets on extent of weight reduction appear to be similar after one year intervention. Therefore, we conducted a study to compare the differences between LC diet and LF diet in the loss of body weight, body composition on overweight and obese people. In this study, we recruited 57 overweight and obese women, age between 20－65 years, and excluded those with pregnancy, malignant tumor, mental illness, diabetes, liver disease, gastrointestinal diseases, and cardiovascular diseases. Recruited subjects also were not on medicine to lower blood sugar, blood pressure, or blood lipids. Initially, subjects were randomized into two groups as LF diet (n = 28) or LC diet (n = 29), and then followed for one year by registered dietitians. Participants received LF diet with three macronutrients in a fixed ratio (carbohydrate 50%, protein 20%, and fat 30%) or LC diet (carbohydrate 4－40%). Both diets were low calorie diet and provided approximately 1200 kcal/day. Subjects needed to participate activities including physical fitness training and dietary counseling weekly, and to record dietary contents for eight weeks. Body weight, waist circumference, fasting glucose, blood lipid, estimated glomerular filtration rate (eGFR), fasting serum insulin, insulin resistance, C-reactive protein (CRP) concentrations, and body composition at baseline, 2, 6, and 12 months were recorded and monitored. Body Composition Analyzer was employed to analyze body composition in order to investigate the differences in weight loss and body composition changes between two diets. After one year intervention, subjects in LC diet group had significantly greater reduction in weight loss (3.8 ± 3.3 kg vs. 1.7 ± 3.4 kg, p = 0.009) and body fat (2.0 ± 1.6% vs. 0.6 ± 1.8%, p = 0.001) compared to those in LF diet group. However, no statistically significant differences in waist circumference (4.9 ± 7.0 cm vs. 4.6 ± 5.6 cm), fasting serum insulin (3.6 ± 5.5 μU/mL vs. 2.8 ± 3.7 μU/mL), and insulin resistance (1.1 ± 2.0 vs. 0.6 ± 1.0) between the two dietary groups. CRP in LC group has significantly greater reduction than in the LF group, but the difference was marginal (LC: 1.4 ± 3.7 mg/L vs. LF: 0.3 ± 1.9 mg/ L, p = 0.09). This study revealed that overweight and obese women in the LC diet group had significant weight loss and decreased body fat (%) than those in the LF diet group after participating the weight control program for one year. Larger scale and long term well-controlled studies are needed to confirm additional benefits of LC diet on , although no significant differences were noted for fasting glucose, blood lipid, cardiovascular and renal function parameters.