全小麦粉对肥胖者的减肥效果评价

Evaluation of weight loss effect of whole wheat flour on obese people

目的探索性研究全小麦粉(以下简称全麦粉)替代部分主食对肥胖者体重的影响,并从胰岛素抵抗与炎症反应角度初步探讨全麦粉对肥胖人群的减肥机制。方法在和田市某社区,根据纳入排除标准招募48名肥胖者和20名正常体重者,48名肥胖者随机分2组为干预组(27名)和对照组(21名),正常体重者作为正常对照组(20名)。全麦粉为石磨粉,根据当地居民饮食特点用150 g石磨全麦粉制作馕饼,每日替代部分主食,进行为期3个月(2019年9月16日—12月16日)的膳食干预。干预前后进行人体测量(体重、身高、腰围、臀围)和生化指标检测(血脂、空腹血糖、胰岛素、C-反应蛋白)。计算体质指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)。比较BMI、腰围、血脂、血糖及C-反应蛋白(CRP)干预前后的变化,初步评价全麦粉减肥效果。结果与干预前比较,全麦粉干预组体重、腰围、BMI及WHR分别由(86.44±12.67)kg、(106.19±9.44)cm、32.43±3.04、0.94±0.06,降低至(84.76±12.41)kg、(103.84±9.14)cm、31.80±3.07和0.91±0.06,差异均有统计学意义(均P<0.01),提示全麦粉膳食干预对肥胖者具有减肥作用。与干预前比较,3组干预后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)均显著升高,高密度脂蛋白胆固醇(HDL-C)降低;干预组与肥胖对照组空腹血糖(FBG)升高;3组空腹胰岛素(FINS)及HOMA-IR干预后无显著变化,提示全麦粉并没有显著改善机体胰岛素抵抗状态;干预后干预组CRP由(2.99±2.22)mg/L下降至(2.21±1.86)mg/L,差异有统计学意义(P<0.05),提示全麦粉干预对肥胖者具有改善全身炎症状态的作用。结论由全麦粉替代部分主食可降低肥胖人群体重和腰围,提示对腹型肥胖作用明显,其机制可能通过降低机体低度炎症反应而发挥作用。

Objective To explore the impact of whole wheat flour instead of some staple foods on the weight of obese people,and from the perspective of insulin resistance and inflammatory response to preliminarily explore the weight loss mechanism of whole wheat flour on obese people.Methods In a community in Hotan City,48 obese persons and 20 normal-weight persons were recruited according to the inclusion and exclusion criteria.The 48 obese persons were randomly divided into intervention group(27 cases)and control group(21 cases),and the normal weight people served as the normal control group(20 cases).The wholewheat flour was stone-ground flour,and 150 g stone-ground whole-wheat flour was used to make naan according to the dietary characteristics of local residents.It replaced part of the staple food every day and underwent a 3-month dietary intervention(September 16 to December 16,2019).Before and after the intervention,anthropometric measurements(weight,height,waist circumference,hip circumference)and biochemical indicators tests(blood lipids,fasting blood glucose,insulin,C-reactive protein)were performed.The body mass index(BMI),waist-to-hip ratio(WHR)and insulin resistance index(HOMA-IR)were calculated.The BMI,waist circumference,blood lipids,blood glucose and C-reactive protein were compared before and after intervention to preliminarily evaluate the weight loss effect of whole wheat flour.Results Compared with those before the intervention,the weight,waist circumference,BMI and WHR of the whole wheat flour intervention group decreased from(86.44±12.67)kg,(106.19±9.44)cm,32.43±3.04,0.94±0.06 to(84.76±12.41)kg,(103.84±9.14)cm,31.80±3.07 and 0.91±0.06,and the differences were statistically significant(all P<0.01),suggesting that whole-wheat meal intervention had a weight loss effect on obese people.Compared with before the intervention,the total cholesterol(TC),triglycerides(TG),and low-density lipoprotein(LDL-C)of the three groups after the intervention were significantly increased,and the high-density lipoprotein(HDL-C)was reduced,the fasting blood glucose(FBG)of the intervention group and the obesity control group increased,the fasting insulin(FINS)and HOMA-IR of the three groups had no significant changes after intervention,indicating that whole wheat flour did not significantly improve the body’s insulin resistance.After the intervention,the CRP of the intervention group decreased from(2.99±2.22)mg/L to(2.21±1.86)mg/L,the difference was statistically significant(P<0.05),suggesting that whole wheat flour intervention could improve the systemic inflammation in obese people.Conclusion Replacing part of the staple food with whole wheat flour can reduce the weight and waist circumference of obese people,suggesting that it has an obvious effect on abdominal obesity,and its mechanism may play a role by reducing the body’s low-grade inflammatory response.