高蛋白早餐对摄入量、食欲及体重的影响研究

发布时间：2018-12-11 08:39

【摘要】：研究背景和目的：全世界大约1／5的儿童肥胖或超重。然而,目前尚缺乏有效的干预措施。因为儿童成长发育之需,节食的方法不合适。儿童缺少对常规锻炼的依从性,难以行之有效。目前也没有有效的减肥药。缩胃手术因并发症还不能常规开展。综合考虑,调整能量摄入似乎成为治疗儿童肥胖的曙光。高蛋白饮食可能会有减肥作用。本研究的目的在于探讨高蛋白早餐对相应的午餐摄入量、食欲激素在肥胖青少年中的影响,旨在为有效治疗儿童肥胖提供可行性策略。方法和材料：本研究共入选一百五十六名肥胖青少年,男性80名,女性76名,平均年龄在14岁左右,体重约58公斤,体重指数(BMI)约32kg/m2,随机地分配到同等热量的早餐组,或为鸡蛋组(n=81),或为馒头组(n=75)。本研究包括两个分课题：第一分课题两次测试间隔为1周；第二分课题两次测试间隔为3个月。测试当天,受试者首先接受一般检查,包括体重,身高,VAS,空腹血采集等。各受试者予以相同热量早餐。之前及之后30、60、120、180分钟时分别以VAS判断其饥饱程度。之前和之后30和180分钟分别采血以放射免疫分析法测定饱食激素多肽YY (PYY)和胰高血糖素样肽-1以及饥饿激素(ghrelin)。四小时后,予以标有热卡的自助餐,并记录摄入量。测试后受试者回家。嘱咐其进食与在参加测试时类似的早餐并记录摄入量。测试分别予一周及3月后重复。统计分析分别在测试间、组问进行比较。Pearson相关系数进行相关性分析。结果：第一分课题部分：两测试问无差异,鸡蛋组和馒头组比较,体重变化无差异,但鸡蛋组受试者在进早餐后3小时时饥饿感不明显,这与其PYY水平的增加相一致。第二分课题部分：两测试问无差异,但两组间比较,鸡蛋组受试者体重减轻明显(3.9%vs.0.2%,p0.001)。这与两组间午餐食物摄入量相关(r=-0.76,p0.001)：鸡蛋组受试者午餐摄入量明显少于馒头组受试者(451vs.567kcal)。早餐后2、3小时,两组受试者饥饿和饱足感差异明显,鸡蛋组受试者饱足感明显,饥饿不著(p0.001)。并且,体重的变化与食欲激素水平的变化相关：早餐后3小时,鸡蛋组受试者PYY水平明显增高(66%vs.18%,p0.001),并且,其增加与体重的减轻成正相关(r=0.89,p0.001)。鸡蛋组受试者GLP-1水平3小时后也明显高于馒头组(6.6%vs.1.1%,p0.001),并且,其增加与体重的减轻成正相关(r=0.78,p0.001)。饥饿激素ghrelin在馒头组受试者中降低更明显(30分钟后-1.1%vs.20.6%,p0.001；180分钟后-5.9%vs.-15.1%,p0.001),并且这与体重的减轻成负相关(r=-0.76,p0.001)。结论：高蛋白早餐有助青少年减肥,可能是通过其对饱食感、食物摄入量以及对食欲激素的调节而达到的。
[Abstract]:Background and objective: about a fifth of the world's children are obese or overweight. However, there is a lack of effective interventions. Because children need to grow up, dieting method is not suitable. Children lack compliance with regular exercise and are difficult to be effective. There is also no effective diet medicine. Gastric contractions can not be performed routinely because of complications. Taken together, adjusting energy intake seems to be the dawn of childhood obesity. A high-protein diet may have a weight loss effect. The purpose of this study was to explore the effects of high protein breakfast on the corresponding intake of lunch and the effect of appetite hormone on obese adolescents in order to provide feasible strategies for the effective treatment of obesity in children. Methods and materials: a total of 156 obese adolescents, 80 males and 76 females, were enrolled in this study. The average age was about 14 years old, the weight was about 58 kg, and the body mass index (BMI) was about 32 kg / m2. They were randomly assigned to the same caloric breakfast group, either egg group (ncai 81) or steamed bread group (n + 75). This study consists of two subtopics: the first one is one week interval and the second is 3 months. On the day of the test, the subjects underwent general examinations, including weight, height, VAS, fasting blood collection and so on. All subjects were given the same calorie breakfast. VAS was used to determine the degree of hunger and satiety before and after 30g 60120180 minutes. Before and after 30 and 180 minutes, blood samples were collected for the determination of satiety hormone peptide YY (PYY), glucagon like peptide-1 and hunger hormone (ghrelin). By radioimmunoassay. Four hours later, a hot-calorie buffet was given and intake was recorded. The subjects went home after the test. Instruct them to eat breakfast that is similar to the one they took at the time of the test and record their intake. The test was repeated one week and three months later. The statistical analysis was compared between the test groups. The correlation coefficient of Pearson was analyzed. Results: in the first part, there was no difference between the two groups. There was no difference in body weight between egg group and steamed bread group, but the hunger feeling of egg group was not obvious at 3 hours after breakfast, which was consistent with the increase of PYY level. The second part: there was no difference between the two groups, but compared with the two groups, the egg group had significant weight loss (3.9vs.0.2g / p0.001). This was correlated with the intake of food for lunch between the two groups (r-0.76, p0.001): the intake of lunch in the egg group was significantly lower than that in the steamed bread group (451vs.567kcal). There were significant differences in hunger and fullness between the two groups at 2h after breakfast, but not between the egg group and the egg group (p0.001). In addition, weight changes were correlated with changes in appetite hormone levels: PYY levels in the egg group were significantly higher than those in the egg group at 3 hours after breakfast (66vs.18g, p0.001), and the increase was positively correlated with weight loss (r = 0.89, r = 0.89). P0.001) The GLP-1 level of egg group was also significantly higher than that of steamed bread group after 3 hours (6.6vs.1.1), and its increase was positively correlated with weight loss (r = 0.78p 0.001). The hunger hormone ghrelin was significantly decreased in the steamed bread group (30 minutes later, -1.1 vs.20.6, p0.001; 180 minutes later, -5.9 vs. -15.1and negatively correlated with weight loss (r-0.76p0.001). Conclusion: high protein breakfast can help adolescents lose weight, possibly through the regulation of satiety, food intake and appetite hormone.
【学位授予单位】：中国人民解放军医学院
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R723.14

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