生物与医学2022cell.com
限时进食减少内脏脂肪并改善代谢综合征
Time-restricted eating reduces visceral fat and improves metabolic syndrome
入门 · 约 45 分钟读完前置知识：代谢综合征基础、间歇性禁食概念、基础统计学
导读
这篇论文研究了限时进食（间歇性禁食）对内脏脂肪和代谢综合征的影响。研究对象为超重的中国人群（每日摄入约300克碳水），结果显示限时进食带来了适度的改善，但也伴随一定的肌肉量流失。
HN 关注点：间歇性禁食的健康效果，讨论焦点是研究方法是否严谨（缺乏等热量对照组、多重假设检验未校正）以及结论能否推广到西方人群。
HN 评论精选
这几条评论里：质疑 2 补充 1 亲历 1
质疑研究有方法学缺陷，结论难以推广；运动比饮食干预收益更大更简单
这项研究针对的是超重、每天摄入大量碳水（约300克，估计主要是高GI米饭）的中国人。间歇性禁食带来了一定效果，但也如预期那样流失了一些肌肉。研究测试了很多变量，却似乎没有做多重假设检验校正。这些结果很难推广。如果你本来饮食就不健康，多几个小时不吃当然有好处。一项针对西方人群的类似研究显示等热量间歇性禁食没有效果；另一项研究则显示对肥胖者，禁食加能量限制比单纯能量限制更有效。我不认为数据支持把禁食当作普适策略。对肥胖者来说，少吃、缩短进食时间、晚上少吃的组合可能有益。但作为健康干预，运动的收益远大于饮食干预，而且更简单——多运动对任何人在任何年龄都有益。营养科学的现状则令人困惑，而且稍微改善饮食几乎没什么用。
Gatsky查看英文原文
This study was in Chinese people who were overweight and were eating a lot of carbs (~300g a day). Presumably this was largely high GI rice. IF made a modest difference. They also lost some muscle mass, as expected. The study tested a lot of different variables, apparently without adjusting for multiple hypothesis testing. Hard to generalise these results. If you are eating a toxic diet, I guess more time without it is a good thing. A similar study in a Western population showed no effect of isocaloric IF [1]. In another study, IF with energy restriction in obese subjects was more effective than energy restriction without IF [2]. I don’t see that the data supports IF as a universal strategy. If you are obese, then these studies suggest eating less, for less hours of the day and less at night is probably beneficial. Otherwise, as far as health interventions go, exercise has a much larger magnitude of benefit than dietary interventions. It also has the major advantage of simplicity - more exercise is better for everyone everywhere at every age [3]. Contrast this with the utterly confusing state of nutrition science. And exercise also makes a difference even when you do a little bit, whereas eating a little bit better does almost nothing. [1] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771095 [2] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2794819 [3] This is not 100% true. There are some contraindications to exercise for people with specific conditions. EDIT: When talking about the benefits of exercise versus diet, I mean the effects on health in general (mortality, lifespan, healthspan). Exercise isn't an effective method of weight loss as others have indicated.
质疑缺乏等热量对照，效果可能只是热量限制的体现
我粗略浏览了论文，没看到等热量的对照组，甚至没有测量热量摄入。如果是这样，这不过是又一个'少吃导致减重'的研究，测量的其实是热量限制的好处。他们甚至没有在不同方法之间对等热量限制？
moonchrome查看英文原文
I'm just skimming through the paper and I see no calorie equated control group or even measuring caloric intake. If that's the case than this is another "eating less causes weight loss" study, and measuring the benefits of caloric restriction. They don't even equate caloric restrictions between the methods they compare ?
亲历亲历：IF+生酮逆转了糖尿病前期，认为问题在碳水类型而非总热量
以我的亲身经历：我今年50岁，两年前被诊断为糖尿病前期/代谢综合征，A1C 5.7（临界值），体重189磅。我开始间歇性禁食，先戒掉早餐，后来慢慢戒掉午餐，现在是一天一餐（OMAD）。身体会逐渐适应少吃。我觉得主要问题不是总热量，而是食物类型——简单碳水/糖会刺激胰岛素分泌，而胰岛素才是储存脂肪的元凶。运动只会让你更饿。我现在不再处于糖尿病前期，A1C恢复正常，体重降到165磅，所有血液指标都正常。我有糖尿病家族史（父亲和兄弟都在服药），但医生从不谈饮食，只开二甲双胍。我坚持禁食加生酮饮食两年了，确实有效。主要问题就是简单碳水和进食频率。
adamqureshi查看英文原文
In my own experience I am 50 years old today. I was diagnosed with pre-diabetes / metabolic syndrome with an A1C of 5.7.-(borderline). weight was 189 pounds. 2 years ago. I started IF. Giving up breakfast then slowly giving up lunch and now eating OMAD ( one meal a day). your BODY WILL get used to eating less. IF worked for me. It seems the MAIN problem is NOT total calories, I read a book by Gary Taubes called "the case for keto." I don't know about bio chem but in the book he said it is not the calories you eat but rather the type of food / calorie. MAIN problem is simple carbs / Sugar. ( slow carbs are veggies) . Simple carbohydrates spike insulin and the harmone insulin is the problem it stores fat. Exercise will just make you hungry. I do exercise , i enjoy running in a fasted state 4-5 miles a way and i do bodyweight muscle building training too. I am no longer pre-diabetic and A1C is normal. But i still gotta keep an eye on it. I dropped weight and and getting used to the keto diet + IF. We have a family history of diabetes in my family. ( dad. brothers. ) all have it and they are on meds. Doctor do not tell you about diet they just put them on Metaformin. I am 2 years on IF and keto and it worked for me. I weigh 165 now. All my blood work is back to normal. Main problem are the simple carbs and frequency of eating. Look around you we live in a carb word / sugar ads everywhere. It is VERY VERY hard to stay away from simple / carbs / sugar but you can do it. Eating healthy is NOT CHEAP either. I do tell my family to try IF and or keto but they are addicted to carbs and are all on metaformin or some diabetic meds. - 2 cents
补充称赞论文的图形摘要形式
第一次见到这样的'图形摘要'（PDF第一页），我很喜欢。
Cenk查看英文原文
First time I’ve seen a “Graphical Abstract” like this (page one of the PDF: https://oa.mg/pdf/10.1016-j.xcrm.2022.100777.pdf) but I love it
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