Objective To investigate the efficiency and safety of protein-enriched meal replacements in overweight and obese Chinese with hyp erlipidemia.Methods Totally 100 overweight/obese participants with hyperlipidemia (age≥30,BMI25-40) without diabetes or chronic kidney disease were randomly enrolled into either calorie restriction high-protein meal replacement (HPMR) group or calorie restriction with high-carbohydrate meal replacement (HCMR) group.HPMR group were given high protein diet (energy composition was 30％ protein,20％ fat and 50％ carbohydrate) and meal replacement (one shake contains 24.1 g protein,3.5 g fat and 25.0 g carbohydrate);HCMR group were given high carbohydrate diet (energy composition was 15％ protein,20％ fat and 65％ carbohydrate) and meal replacement (one shake contains 4.0 g protein,2.4 g fat and 49.0 g carbohydrate).In a course of 12 weeks,subjects were advised to consume one meal replacement as breakfast and another one as lunch or afternoon snack.Dinner was a regular meal with healthy foods.Subjects were given general advice for increasing their activity level with a goal of 30 minutes of aerobic exercise per day,but no heavy resistance exercise was recommended during the study.The results of the grip strength,body composition,laboratory examination,and assessment of satiety and hunger were reviewed respectively at the beginning,2,4,8 and 12 weeks.Results Totally 49 subjects of HPMR group and 44 subjects of HCMP group completed the study.There were no significant differences on metabolic indicators between two groups at base line except fasting blood glucose.Third party illuminate blind.It showed that there was better improving trend in HPMR group on fat mass,hand grip,serum urine acid and albumin level.While,the differences of metabolism between two groups were not significant because of energy restriction.Also,there was no statistical difference on score of hunger and meal satisfaction assessment.Conclusion Energy restriction with high protein meal replacement method may be a safe and effective way to lose weight in Chinese population.%目的 探讨高蛋白质营养代餐对于超重或肥胖合并高脂血症人群的有效性和安全性.方法 招募100例年龄≥30岁,体重指数(BMI) 25～40的超重或肥胖合并高三酰甘油血症者,排除糖尿病、肾脏病、肝功能异常者.按照数字随机对照表分为2组:(1)试验组给予限能量高蛋白膳食(蛋白质供能30％,脂肪供能20％,碳水化合物供能50％)及代餐品(每份含24.1 g蛋白质,3.5 g脂肪,25.0 g碳水化合物);(2)对照组,给予限能量高碳水化合物膳食(蛋白质供能15％,脂肪供能20％,碳水化合物供能65％)及代餐品(每份含4.0g蛋白质,2.4 g脂肪,49.0 g碳水化合物).每天早餐和下午加餐食用代餐品各1份.观察12周,在起始、第2、4、8、12周测握力、人体成分、实验室检查及满意度和饥饿感评估.对所有人推荐增加日常活动量,每天30 min有氧运动,但并不强制体育训练.结果 共93例受试者完成试验,其中试验组49例、对照组44例.入组前两组受试者除血糖外,所有代谢性指标差异均无统计学意义.试验结束后两组均降低了体重,平均下降(6.5±3.4) kg,均改善了胰岛素、肝功能、尿酸水平等代谢性指标.由第三方揭盲,发现在体脂水平、握力、血尿酸、白蛋白指标中,试验组有更佳的改善趋势,但由于两组均采用限制总能量摄入,代谢性指标差异无统计学意义二试验前后饥饿感、满意感差异均无统计学意义.结论 对超重或肥胖且合并高脂血症者采用严格限能量代餐,能够改善除体重外的体成分及尿酸等代谢性指标,是安全有效的减重方法.
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