Determining optimal approaches for weight maintenance

Penelitian ini menilai efektivitas 2 program pendukung dan dua jenis diet dalam mempertahankan penurunan berat badan.

 

Diikuti oleh 200 wanita yang telah berhasil turun >5% BB, desain randomized controlled, 2x2 faktorial. Dibandingkan antara program pendukung intensif terhadap program pendukung sederhana. Dan dibandingkan antara diet tinggi karbohidrat terhadap diet tinggi mono-unsaturated fatty acid (MUFA)

 

Setelah 2 tahun didapatkan tidak ada beda signifikan antara kedua program pendukung.

Sedangkan diet tinggi MUFA menyebabkan kadar kolesterol total dan LDL lebih tinggi signifikan dibanding konsumsi diet tinggi karbohidrat.

 

Kesimpulan setelah berhasil mencapai penurunan BB sebaiknya diikuti dengan program pendukung, meskipun sederhana (dan murah) namun terbukti dapat mempertahankan penurunan BB.

 

Research

CMAJ. May 12, 2009; 180 (10). doi:10.1503/cmaj.080974. © 2009 Canadian Medical Association or its licensors

Determining optimal approaches for weight maintenance: a randomized controlled trial

Kelly S. Dale, PhD MSc, Kirsten A. McAuley, MBChB PhD, Rachael W. Taylor, PhD BSc, Sheila M. Williams, DSc BSc, Victoria L. Farmer, MSc, Paul Hansen, PhD MEc, Sue M. Vorgers, RN, Alexandra W. Chisholm, MCApSc PhD and Jim I. Mann, DM PhD

From the Departments of Human Nutrition (Dale, McAuley, Taylor, Vorgers, Chisholm, Mann), Preventive and Social Medicine (Williams), and Economics (Hansen), University of Otago; and the Edgar National Centre for Diabetes Research (McAuley, Taylor, Farmer, Mann), Dunedin, New Zealand

Background: Weight regain often occurs after weight loss in overweight individuals. We aimed to compare the effectiveness of 2 support programs and 2 diets of different macronutrient compositions intended to facilitate long-term weight maintenance.

Methods: Using a 2 x 2 factorial design, we randomly assigned 200 women who had lost 5% or more of their initial body weight to an intensive support program (implemented by nutrition and activity specialists) or to an inexpensive nurse-led program (involving "weigh-ins" and encouragement) that included advice about high-carbohydrate diets or relatively high-monounsaturated-fat diets.

Results: In total, 174 (87%) participants were followed-up for 2 years. The average weight loss (about 2 kg) did not differ between those in the support programs (0.1 kg, 95% confidence interval [CI] –1.8 to 1.9, p = 0.95) or diets (0.7 kg, 95% CI –1.1 to 2.4, p = 0.46). Total and low-density lipoprotein (LDL) cholesterol levels were significantly higher among those on the high-monounsaturated-fat diet (total cholesterol: 0.17 mmol/L, 95% CI 0.01 to 0.33; p = 0.040; LDL cholesterol: 0.16 mmol/L, 95% CI 0.01 to 0.31; p = 0.039) than among those on the high-carbohydrate diet. Those on the high-monounsaturated-fat diet also had significantly higher intakes of total fat (5% total energy, 95% CI 3% to 6%, p < 0.001) and saturated fat (2% total energy, 95% CI 1% to 2%, p < 0.001). All of the other clinical and laboratory measures were similar among those in the support programs and diets.

Interpretation: A relatively inexpensive program involving nurse support is as effective as a more resource-intensive program for weight maintenance over a 2-year period. Diets of different macronutrient composition produced comparable beneficial effects in terms of weight loss maintenance.