减肥vs心脏病:减肥是由热量摄入决定的。心脏病是由饮食中的炎症成分决定的。基于FMTVDMand的人工智能冠状动脉疾病真量化研究

Fleming Rm, Fleming Mr, Harrington Gm, Ayoob Kt, Grotto Dw, Chaudhuri Tk, A. McKusick
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引用次数: 1

摘要

背景:肥胖是由饮食行为引起的。对所有饮食的坚持程度极低,因此,一年或更长时间内不同饮食对健康影响的比较数据有限。目的:通过改变饮食行为来治疗肥胖的根本原因,并比较在等热量条件下使用三种主要饮食类型对长期(一年)心血管健康的影响,包括对替代标志物的影响,最重要的是使用FMTVDM定量定义的实际冠状动脉疾病的定量测量©©方法:在私人诊所进行1年节食和4个月节食后随访的对照实验。参与者:120名肥胖,其他健康,没有其他健康状况的成年人。干预措施:参与者同意遵循和自我管理饮食,医生支持的非指向性饮食咨询每六周提供一次食物选择和份量控制的随访,以达到指定饮食类型1500-1600卡路里的摄入量:低至中等脂肪,低碳水化合物,或素食。结果:依从性、体重减轻、14种心血管脂质和冠状动脉血流健康风险指标的变化。结果:不同饮食对1年体重变化无显著影响(P>0.999)。所有指标对不同饮食差异的效应量(R, R2)均有统计学意义。冠状动脉血流量R (CI95%)=0.48至0.69,低至中等脂肪饮食改善,低碳水化合物饮食降低。炎症因子白细胞介素-6 (R=0.51 ~ 0.71)随低碳水化合物饮食增加,随低至中等脂肪饮食减少。结论:适当的饮食和运动加上时间密集的饮食咨询对大多数人的体重减轻和维持是有效的。非指导性支持性咨询导致高饮食计划参与者保留率。一年的低碳水化合物饮食显著增加心血管风险。长期坚持低脂肪至中等脂肪饮食可显著降低心血管风险因素。纯素饮食是中等脂肪,但效果接近低至中等脂肪。低碳水化合物节食者在研究结束后最不愿意继续节食。冠状动脉血流量的减少可以通过适当的饮食干预逆转。饮食对动脉粥样硬化性冠状动脉疾病的主要影响是炎症,而不是体重减轻。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Weight Loss vs. Heart Disease: Weight Loss is Determined by Caloric Intake. Heart Disease is Determined by Dietary Inflammatory Components. True Quantification of CoronaryArtery Disease Measured by AI Using FMTVDMand#169;and#8471;
Background: Obesity is caused by eating behaviours. Adherence to all diets has been extremely poor, thus, comparative data on health effects of different diets over periods of a year or more are limited. Objective: To treat the root causes of obesity by modifying the eating behaviours and to compare the long-term (one year) cardiovascular health affects using three major types of diets under isocaloric conditions including the impact on surrogate markers and most importantly the quantitative measurement of actual coronary artery disease as quantitatively defined using FMTVDM©℗. Methods: Controlled experiment with one year of dieting and a four-month postdiet follow-up in a private practice setting. Participants: 120 obese, otherwise healthy, adults who are not being seen for other health conditions. Interventions: Participant agreement to follow and self-manage diet, physician supportive nondirective diet counseling providing follow-up at six-week intervals on food selection and portion control to achieve 1500-1600 calorie intake of assigned diet type: low-to moderate-fat, lowered-carbohydrate, or vegan. Outcomes: Adherence, weight loss, changes in 14 cardiovascular lipids and coronary blood flow health risk indices. Results: One-year body mass changes did not differ by diet (P>0.999). Effect sizes (R, R2) for differences between diets were statistically significant for all indices. Coronary blood flow, R (CI95%)=0.48 to 0.69, improved with low-to-moderate-fat and declined with lowered carbohydrate diets. Inflammatory factor Interleukin-6 (R=0.51 to 0.71) increased with lowered carbohydrate and decreased with low-tomoderate- fat diets. Conclusions: Appropriate diet and exercise with time intensive diet counseling can be effective in weight reduction and maintenance for most people. Nondirective supportive counseling leads to high diet program participant retention. One year of a lowered-carbohydrate diet significantly increases cardiovascular risks. Longterm adherence to a low-to-moderate-fat diet significantly reduces cardiovascular risk factors. Vegan diets are intermediate but close to low-to-moderate-fat in effects. Lowered-carbohydrate dieters were least inclined to continue dieting after conclusion of the study. Reductions in coronary blood flow can be reversed with appropriate dietary intervention. The major dietary effect on atherosclerotic coronary artery disease is inflammation and not weight loss.
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