China's weight loss research tops NEJM: a concise method that provides important evidence

Obesity is one of the most serious chronic diseases that threaten human health
.

The survey shows that more than 1/2 of adults in China are overweight or obese, and the overweight and obesity rates are 34.
3% and 16.
4% respectively
.

The clinical intervention of obesity mainly includes three methods: life>
.

Life>
.

 On April 21, 2022, the New England Journal of Medicine (NEJM) published the results of a single-center clinical trial on calorie restriction combined with time-restricted eating and simple calorie restriction for weight loss led by Professor Zhang Huijie of Southern Medical University Nanfang Hospital.
In obese patients, the time-restricted diet program was not superior to the calorie restriction program in terms of weight loss and other benefits, and the two programs resulted in a mean change in body weight of -8.
0 kg (95% CI, -9.
6 to -6.
4) over one year.
and -6.
3 kg (95% CI, -7.
8~-4.
7)
.

The results of this blockbuster study will provide high-level evidence for dietary intervention in obese patients in China
.

"NEJM Frontiers of Medicine" specially invited researcher Zong Geng, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, to interpret this study
.

To read the full text translation, please visit the official website of NEJM Medical Frontiers, APP or click on the WeChat applet picture
.

Weight loss is a long-sought-after topic
.

Not only because obesity is a key risk factor for major chronic diseases such as diabetes, cardiovascular, cancer, etc.
, but also because public aesthetics have produced more and more stringent demands for a reasonable weight
.

Looking back at the top medical journals over the years, we can see a large number of weight loss intervention studies on drugs, exercise, and diet
.

Among them, bariatric surgery is very effective and less rebound, but the burden on patients and clinics is also the largest, so it is only suitable for some severely obese patients; oral and injectable drugs have large side effects and obvious rebound after drug withdrawal, and are still used in China.
Some way to go; relatively speaking, dietary and life>
.

Finding interventions with low burden and good effect for obese people will remain a scientific problem of great practical significance
.

Restricting eating time is a simple and feasible way to lose weight, which has a long history in Chinese traditional culture
.

On the one hand, shortening the eating window period can effectively reduce food intake and reduce energy intake; on the other hand, there is also evidence that restricting eating time can improve blood sugar, inhibit inflammation, and reduce the production of free radicals
.

However, the number of existing clinical studies is small and the sample size is small, and it is not clear whether restricting eating time has additional effects and long-term safety than restricting energy intake
.

On April 21, 2022, the New England Journal of Medicine (NEJM) published a single-center intervention study on energy restriction and weight loss by Prof.
Zhang Huijie, Southern Hospital of Southern Medical University, in a 1-year study of 139 study participants.
In the intervention, total energy intake was restricted through dietary guidance (1500-1800 kcal for men and 1200-1500 kcal for women), the results showed that whether restricting energy intake only or additionally restricting eating time, the body weight of the study participants All decreased significantly within one year, and there was no significant difference between groups
.

This article provides important data for clinical practice of time-restricted eating as a weight loss tool, confirms time-restricted dietary intervention as a safe, effective and alternative obesity management option, and emphasizes calorie restriction while adhering to time-restricted eating importance
.

In terms of the effect of the intervention, this paper found that restricting eating time does not seem to have an additional weight loss effect, which is inconsistent with existing intermittent fasting research results
.

An intuitive guess is that restricting the eating time may not be strict enough (8 hours), but some scholars have found that the weight loss effect of restricting the eating time to 4, 6, and 8 hours is equivalent; and the 8-hour eating and time period adopted in this article are Choice is obviously more generalized
.

Another possible reason is that the pre-enrollment eating window was not large enough for study participants (previous studies included those who ate longer than 14 hours), so the effect of restricting eating time was not significant
.

A closer look at the study data shows that the difference between the two groups was -1.
8 kg (95% CI, -4 to 0.
4)
.

Further screening of study participants, increased sample size, and duration of interventions are expected to yield results that differ significantly between groups
.

The long-term safety and compliance of low-energy and restricted eating time are two other aspects worthy of attention in this paper, and are also the key to popularization and application
.

In terms of safety, 27.
5%-32.
9% of the study participants experienced side effects, of which 15.
9%-20.
0% were digestive tract problems; therefore, it is particularly important to fully informed consent and communicate with study participants
.

At the same time, life>
.

This study set up high-frequency online and offline follow-up, which ensured that 84% of the study participants had good compliance, which is very rare
.

However, as the intervention progressed, this ratio decreased as expected, and total energy intake also appeared to be trending upward
.

Such concise and practical research is exactly what our age needs
.

After receiving the review request, I contacted Professor Zhang's doctoral advisor and Professor Li Xiaoying, director of the Endocrinology Department of Zhongshan Hospital of Fudan University, to hear his views on this article
.

We have talked many times before about another study completed by Professor Zhang during his Ph.
D.
training: by allowing study participants to exercise on a treadmill every day, the liver fat content of patients with non-alcoholic fatty liver decreased by 4% to 5%.
%
.

The intervention methods and detection indicators used in the two studies are not new, but they provide important basis for clinical practice, and can be regarded as typical cases of scientific research oriented to people's life and health
.

With the increase of national investment in science and technology and the maturity of various high and new technologies, more and more teams have applied various expensive and complex detection technologies and equipment to their research, and the results have become "indiscriminate and charming"
.

In the process, the question of whether technology is an end or a means seems to blur
.

Whether there is a situation of blindly stacking technologies in pursuit of new ideas is worth vigilant
.

Since there is no distinction between black and white cats that catch mice, perhaps it is even less necessary to distinguish between Persian cats and local cats
.

Finally, I wish us an early victory over the epidemic and the prosperity of our great motherland
.


Calorie Restriction with or without Time-Restricted Eating in Weight LossLiu D, Huang Y, Huang C, et al.
DOI: 10.
1056/NEJMoa2114833Abstract BackgroundTime-restricted eating for weight loss The long-term efficacy and safety of the drug are unknown
.

Methods We randomly assigned 139 obese patients to receive time-restricted eating (eating only between 8:00 am and 4:00 pm) plus caloric restriction or daily calorie restriction alone
.

During a 12-month period, all participants were placed on a calorie-restricted diet containing 1500-1800 kcal/day for men and 1200-1500 kcal/day for women
.

The primary outcome was the difference in change from baseline in body weight between the two groups; secondary outcomes included changes in waist circumference, body mass index (BMI), body fat mass, and metabolic risk factor indicators
.

RESULTS: Of a total of 139 participants who underwent randomization, 118 (84.
9%) completed the 12-month follow-up
.

The mean change from baseline in body weight at 12 months was -8.
0 kg (95% confidence interval [CI], -9.
6 to -6.
4) and -6.
3 kg (95% confidence interval [CI], -9.
6 to -6.
4) in the time-restricted diet group and the daily calorie-restricted group, respectively CI, -7.
8~-4.
7)
.

There was no significant difference in weight change between the two groups at the 12-month assessment (net difference, -1.
8 kg; 95% CI, -4.
0 to 0.
4; P=0.
11)
.

Results for waist circumference, BMI, body fat, lean body mass, blood pressure, and metabolic risk factors were consistent with the primary outcome
.

In addition, there was no significant difference between the two groups in the number of adverse events
.

CONCLUSIONS: In obese patients, time-restricted dietary regimens were not superior to daily calorie restriction regimens in terms of weight loss, body fat, or metabolic risk factors
.

(Funded by the National Key Research and Development Project of China [No.
2018YFA0800404]; the registration number in ClinicalTrials.
gov is NCT03745612
.

) The author introduces Geng Zong, researcher and doctoral supervisor, from the Chinese Academy of Sciences in 2013 The Institute of Nutritional Sciences received a Ph.
D.
, and was supported by the European Union Marie Curie Scholarship to carry out postdoctoral research in Europe
.

From 2014 to 2018, he was a postdoctoral fellow in the Department of Nutrition, Harvard School of Public Health
.

In 2018, he was employed as a researcher at the Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences
.

Up to now, 21 papers have been published as the first author or corresponding author in the internationally renowned medical and nutritional journals New England Journal of Medicine, British Medical Journal, Circulation, Circulation Research, Diabetes Care, PLoS Medicine,
etc.

Related research has received continuous attention from the world's mainstream media (The New York Times, Time Magazine, CBS, CNN, FOX, etc.
)
.

He has been funded by the Talent Introduction Program of the Chinese Academy of Sciences and the Outstanding Youth Science Fund Project of the Fund Committee, and participated in the academic-level scientific research projects of the Chinese Academy of Sciences and the "13th Five-Year" National Key R&D Program
.

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.

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