目的:限时进食(TRE)和低碳水化合物饮食(LCD)可改善代谢综合征(MetS)患者的多种心脏代谢参数,但它们对心理健康和饱腹感的影响尚不清楚。在这项研究中,我们的目的是评估TRE的效果,LCD,以及它们的组合(TRE+LCD)对生活质量(QoL)的影响,睡眠,心情,食欲,代谢综合征患者的代谢激素。
方法:这是对单中心的二次分析,3个月,开放标签,研究TRE效果的随机临床试验,LCD,和TRE+LCD对MetS患者体重和心脏代谢参数的影响。这项次要分析检查了QoL,睡眠,心情,使用兰德36项简表(SF-36)和食欲;匹兹堡睡眠质量指数(PSQI);抑郁症,焦虑,和压力量表;和饮食行为评定量表,分别,以及测量的包括瘦素在内的代谢激素水平,胰淀素,葡萄糖依赖性促胰岛素多肽,胰高血糖素样肽-1(GLP-1),胰多肽(PP),和肽YY。通过单向ANOVA和对正态分布变量的事后LSD检验或Kruskal-WallisH检验和对异常分布变量的Nemenyi检验进行组间比较。在Bonferroni调整后的多重比较中,P<0.017被认为是显著的。
结果:共有162名参与者(平均[SD]年龄,41.2[9.9]年;平均[SD]体重指数,29.3[3.4]kg/m2;102[63%]男性)开始干预的人进行了分析。三个月后,只有TRE组降低了GLP-1水平(-0.9[IQR,-1.9至-0.3]pg/mL;P=0.002),PP水平提高(8.9[IQR,-7.6至71.8]pg/mL;P=0.011),SF-36的身体功能(5.2[95%CI,1.9至8.5];P=0.001),SF-36的社会功能(9.1[95%CI,2.5至15.6];P=0.005),SF-36中的角色-物理(24.1[95%CI,11.8至36.4];P<0.001),SF-36中的角色-情绪(22.4[95%CI,12.6至32.2];P<0.001),PSQI中的睡眠效率(0.29[95%CI,0.03至0.55];P=0.021)。与LCD的变化相比,TRE进一步增加了SF-36的总体健康状况(9.7[95%CI,3.3至16.0];P=0.006)。相对于TRE+LCD的变化,TRE显著增加SF-36中的角色-情感(19.9[95%CI4.9至34.8];P=0.006)。睡眠质量的变化,情绪状态,食欲,和代谢激素在三组之间没有差异。更大的体重减轻与瘦素水平降低相关(r=0.538),胰淀素水平降低(r=0.294),总食欲评分降低(r=0.220),改善一般健康状况(r=-0.253)(均P≤0.01)。
结论:TRE,LCD,和TRE+LCD都可以改善心理健康和降低食欲。值得注意的是,在MetS患者中,与LCD或TRELCD相比,TRE在QoL方面产生了更大的益处。
背景:ClinicalTrials.gov标识符:NCT04475822。
OBJECTIVE: Time-restricted eating (TRE) and low-carbohydrate diet (LCD) can improve multiple cardiometabolic parameters in patients with metabolic syndrome (MetS), but their effects on psychosocial health and satiety are unclear. In this study, we aimed to evaluate the effects of TRE, LCD, and their combination (TRE + LCD) on quality of life (QoL), sleep, mood, appetite, and metabolic hormones in patients with MetS.
METHODS: This is a secondary analysis of a single-center, 3-month, open-label, randomized clinical trial investigating the effects of TRE, LCD, and TRE + LCD on weight and cardiometabolic parameters in individuals with MetS. This secondary analysis examined QoL, sleep, mood, and appetite using the Rand 36-Item Short Form (SF-36); Pittsburgh Sleep Quality Index (PSQI); Depression, Anxiety, and Stress Scale; and Eating Behavior Rating Scale, respectively, as well as measured levels of metabolic hormones including leptin, amylin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 (GLP-1), pancreatic polypeptide (PP), and peptide YY. Between-group comparisons were conducted via one-way ANOVAs and post hoc LSD tests for normally distributed variables or Kruskal‒Wallis H tests and the Nemenyi test for abnormally distributed variables. P < 0.017 was considered significant in multiple comparisons following Bonferroni adjustment.
RESULTS: A total of 162 participants (mean [SD] age, 41.2 [9.9] years; mean [SD] body mass index, 29.3 [3.4] kg/m2; 102 [63%] men) who started the intervention were analyzed. After 3 months, only the TRE group decreased GLP-1 levels (-0.9 [IQR, -1.9 to -0.3] pg/mL; P = 0.002), increased PP levels (8.9 [IQR, -7.6 to 71.8] pg/mL; P = 0.011), physical functioning in the SF-36 (5.2 [95% CI, 1.9 to 8.5]; P = 0.001), social functioning in the SF-36 (9.1 [95% CI, 2.5 to 15.6]; P = 0.005), role-physical in the SF-36 (24.1 [95% CI, 11.8 to 36.4]; P < 0.001), role-emotional in the SF-36 (22.4 [95% CI, 12.6 to 32.2]; P < 0.001), and sleep efficiency in the PSQI (0.29 [95% CI, 0.03 to 0.55]; P = 0.021). Compared with changes in LCD, TRE further increased general health in the SF-36 (9.7 [95% CI, 3.3 to 16.0]; P = 0.006). Relative to the changes of TRE + LCD, TRE significantly increased role-emotional in the SF-36 (19.9 [95% CI 4.9 to 34.8]; P = 0.006). Changes in sleep quality, mood status, appetite, and metabolic hormones did not differ among three groups. Greater weight loss was associated with decreased leptin levels (r = 0.538), decreased amylin levels (r = 0.294), reduced total appetite scores (r = 0.220), and improved general health (r = -0.253) (all P ≤ 0.01).
CONCLUSIONS: TRE, LCD, and TRE + LCD all could improve psychosocial health and reduce appetite. Notably, TRE yielded greater benefits in QoL compared with LCD or TRE + LCD in individuals with MetS.
BACKGROUND: ClinicalTrials.gov Identifier: NCT04475822.