低脂纯素饮食最适合减肥，比地中海饮食效果更好

诸平

Fig 1 New rsesearch shows that a low-fat vegan diet significantly reduces harmful advanced glycation end-products (AGEs) by 73%, compared to no reduction with a Mediterranean diet, and is associated with notable weight loss. The study highlights the vegan diet’s effectiveness in cutting down AGEs primarily by eliminating meat and reducing the intake of added fats and dairy products, challenging the efficacy of the Mediterranean diet in weight management and reduction of dietary AGEs.

据美国负责任医学医师委员会（Physicians Committee for Responsible Medicine）2024年8月11日提供的消息，比地中海饮食更好:一项新的研究表明，这种饮食方式最适合减肥（Better Than the Mediterranean: A New Study Reveals That This Type of Diet Is Best for Weight Loss）。

一项研究发现，低脂纯素饮食(Low Fat Vegan Diet)可以减少73%的炎症性晚期糖基化终产物（advanced glycation end-products简称AGEs），并显著减轻体重，挑战了地中海饮食（Mediterranean diet）通常声称的减肥优势。

负责任医学医师委员会等机构的研究人员在《营养前沿》（Frontiers in Nutrition）上发表的一项新研究表明，低脂纯素饮食可以减少73%的有害炎症化合物，即晚期糖基化终产物(AGEs)。相比之下，地中海饮食没有观察到AGEs的减少。此外，纯素饮食的参与者平均体重减轻了13磅（1 lb ≈ 0.4536 kg, 13 lb ≈ 5.90 kg），而地中海饮食的参与者体重没有变化。原文详见：Hana Kahleova, Tatiana Znayenko-Miller, Giulianna Motoa, Emma Eng, Alex Prevost, Jaime Uribarri, Richard Holubkov, Neal D. Barnard. Dietary advanced glycation end-products and their associations with body weight on a Mediterranean diet and low-fat vegan diet: a randomized, cross-over trial. Frontiers in Nutrition (Sec. Nutrition and Metabolism), 2024, 11: 1426642. DOI: 10.3389/fnut.2024.1426642. ePub: 15 July 2024.

参与此项研究的有来自美国华盛顿的负责任医学医师委员会（Physicians Committee for Responsible Medicine, Washington, DC, United States）、美国博卡拉顿的佛罗里达大西洋大学（Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States）、美国纽约的西奈山伊坎医学院（Icahn School of Medicine at Mount Sinai, New York, NY, United States）、美国盐湖城的犹他大学（School of Medicine, University of Utah, Salt Lake City, UT, United States）、美国华盛顿特区乔治华盛顿大学医学和健康科学学院（George Washington University School of Medicine and Health Sciences, Washington, DC, United States）的研究人员。

此项研究的低脂纯素饮食中AGEs的减少主要来自不食用肉类(41%)，尽量减少添加脂肪的摄入(27%)和避免乳制品(14%)。该研究的第一作者、医学博士、负责任医学医师委员会临床研究主任汉娜·科勒奥娃（Hana Kahleova）说：“这项研究有助于打破地中海饮食最适合减肥的神话。选择低脂纯素饮食，避免地中海饮食中常见的乳制品和油，有助于减少有害的晚期糖基化终产物（AGEs）的摄入，从而显著减轻体重。”

了解AGEs及其影响（Understanding AGEs and Their Effects）

AGEs可通过饮食摄入，动物产品中AGEs的含量通常高于植物性食品。在干燥条件下用高温烹饪，如烧烤，会导致AGEs的大量形成，特别是在动物性食品中，这些食品也富含脂肪。

体内大量的AGEs循环会导致胰岛素抵抗，从而导致体重增加。AGEs还与炎症和氧化应激有关，后者会导致心脏病和2型糖尿病等慢性疾病。

这项新研究是对先前医师委员会的一项比较低脂纯素饮食和地中海饮食的研究（ a previous Physicians Committee study comparing a low-fat vegan diet to a Mediterranean diet）的二次分析。该研究将参与者随机分配到低脂纯素饮食(包括水果、蔬菜、谷物和豆类)或地中海饮食(主要包括水果、蔬菜、豆类、鱼类、低脂乳制品和特级初榨橄榄油)，为期16周。两组都没有卡路里限制。然后，参与者回到他们的基线饮食，为期四周的洗脱期（four-week washout period），然后再换成相反的一组，再持续16周。膳食AGEs是根据自我报告的饮食摄入记录计算的。使用已发布的AGE内容数据库，将AGE分数分配给每种食品。

汉娜·科勒奥娃博士补充说:“我们的研究表明，你可以利用你盘子里的能量来减肥，低脂肪的素食饮食富含水果、蔬菜、谷物和豆类，AGEs含量低。这是一种既简单又美味的方法来保持健康的体重和对抗慢性疾病。”

据国际糖尿病联合会(International Diabetes Federation简称IDF)网站提供的数据，2015年，全球估计有4.15亿人患有糖尿病，约有500万人死于糖尿病，估计每65秒就有一人死亡。2021年全球约有5.37亿成年人（20-79岁）患有糖尿病，预计到2030年，糖尿病患者总数将增加到6.43亿，到2045年将增加到7.83亿。未来20年全球患有糖尿病的人数变化趋势如图2所示。肥胖与糖尿病有关，因此减肥与控制体重也是预防糖尿病的重要措施之一。

表1 全球糖尿病患者人数

图2全球糖尿病患者人数变化趋势

上述介绍，仅供参考。欲了解更多信息，敬请注意浏览原文或者相关报道。

Abstract:

Objective: Evidence suggests that changes in dietary advanced glycation end-products (AGEs) may influence body weight, but the effects of different dietary patterns remain to be explored.

The aim of this study was to compare the effects of a Mediterranean and a low-fat vegan diet on dietary AGEs and test their association with body weight.

Materials and methods: In this randomized cross-over trial, 62 overweight adults were assigned to a Mediterranean or a low-fat vegan diet for 16-week periods in random order, separated by a 4-week washout. Body weight was the primary outcome. Three-day diet records were analyzed using the Nutrition Data System for Research software and dietary AGEs were estimated, using an established database. Statistical approaches appropriate for crossover trials were implemented.

Results: Dietary AGEs decreased by 73%, that is, by 9,413 kilounits AGE/day (95% −10,869 to −7,957); p < 0.001, compared with no change on the Mediterranean diet (treatment effect −10,303 kilounits AGE/day [95% CI −13,090 to −7,516]; p < 0.001). The participants lost 6.0 kg on average on the vegan diet, compared with no change on the Mediterranean diet (treatment effect −6.0 kg [95% CI −7.5 to −4.5]; p < 0.001). Changes in dietary AGEs correlated with changes in body weight (r = +0.47; p < 0.001) and remained significant after adjustment for total energy intake (r = +0.39; p = 0.003).

Conclusion: Dietary AGEs did not change on the Mediterranean diet but decreased on a low-fat vegan diet, and this decrease was associated with changes in body weight, independent of energy intake.

Clinical trial registration https://clinicaltrials.gov/, identifier NCT03698955