Is severe carbohydrate restriction necessary for appetite suppression? The ASKED randomized controlled trial

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2024-10-15 DOI:10.1002/oby.24133

Jessica A. Roekenes, Marthe I. Aukan, Ola Jakob Bomo, Ingeborg Brechan, Katarina A. Knudsen, Jonas G. Hansen, Sílvia R. Coutinho, Jens F. Rehfeld, Helen Truby, Amanda Sainsbury, Mette Svendsen, Catia Martins

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Abstract

Objective

This trial aimed to compare three low-energy diets (LEDs) with different amounts of carbohydrates (CHO) on ketosis and changes in hunger feelings in adults with obesity.

Methods

A total of 101 adults (51 female) with obesity (BMI, mean [SEM], 34.7 [0.4] kg/m²) were randomized to follow three isocaloric LEDs (1000 kcal/day) for 8 weeks, containing either low, medium, or high CHO (70, 100, and 130 g/day, respectively), and 4 weeks of refeeding and weight stabilization. Body weight (BW) and composition, hunger and other appetite ratings, concentrations of β-hydroxybutyrate (βHB), and appetite-related hormones were measured at baseline and at the end of weeks 8 and 12.

Results

At week 8, weight loss and βHB concentrations were significantly different among groups: Low CHO group versus Medium CHO group (BW: 2.32 [0.95] kg, 95% CI: 0.44 to 4.21, p = 0.016; βHB: −0.40 [0.09] mM, 95% CI: −0.67 to −0.09, p < 0.001); Low CHO group versus High CHO group (BW: 2.29 [0.96] kg, 95% CI: 0.39 to 4.19, p = 0.016; βHB: −0.644 [0.10] mM, 95% CI: −0.84 to −0.44, p < 0.001); and Medium CHO group versus High CHO group (BW: −0.03 [0.94] kg, 95% CI: −1.89 to 1.84, p = 0.977; βHB: −0.15 [0.08] mM, 95% CI: −0.30 to 0.002, p = 0.054). No significant differences in hunger were found among groups: Low CHO group versus Medium CHO group (−10.87 [5.92] mm, 95% CI: −0.82 to 22.57, p = 0.068); Low CHO group versus Medium CHO group (7.74 [7.36] mm, 95% CI: −6.77 to 22.26, p = 0.294); and Medium CHO group versus High CHO group (−3.13 [7.48] mm, 95% CI: −17.89 to 11.63, p = 0.676).

Conclusions

Although the findings of this trial are not definitive, changes in hunger ratings with weight loss did not differ among groups. Additional studies with CHO intake of up to 130 g in 1000-kcal/day LEDs are warranted to replicate these findings.

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抑制食欲是否需要严格限制碳水化合物？ASKED 随机对照试验。

试验目的本试验旨在比较三种不同碳水化合物（CHO）含量的低能量饮食（LEDs）对肥胖症成人酮病和饥饿感变化的影响：共有 101 名肥胖成人（51 名女性）（体重指数（BMI），平均值[SEM]，34.7 [0.4] kg/m2）被随机分配到三种等热量低能量饮食（1000 千卡/天）中，分别采用低、中或高 CHO（分别为 70、100 和 130 克/天），为期 8 周，然后进行为期 4 周的复食并稳定体重。在基线以及第8周和第12周结束时测量体重（BW）和成分、饥饿感和其他食欲评分、β-羟丁酸（βHB）浓度以及食欲相关激素：结果：第 8 周时，各组的体重减轻率和β-羟丁酸浓度有显著差异：低CHO组与中CHO组相比（体重：2.32 [0.95] kg，95% CI：0.44 至 4.21，p = 0.016；βHB：-0.40 [0.09] mM，95% CI：-0.67 至 -0.09，p 结论：尽管这项试验的结果并不令人信服，但我们可以肯定的是，低CHO组与中CHO组之间存在明显差异：尽管这项试验的结果并不确定，但各组在减轻体重后饥饿感的变化并无差异。有必要对1000千卡/天的LED摄入高达130克的CHO进行更多研究，以复制这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.