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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2009; 03(04): 190-196
DOI: 10.1055/s-0037-1618686
Ernährungskonzepte
Schattauer GmbH

Senkung der Energiedichte – ein wirksameres Konzept zur langfristigen Gewichtsreduktion?

Lowering energy density – an effective treatment concept for long-term weight reduction?
V. Schusdziarra
1   Klinik für Ernährungsmedizin, Else Kröner Fresenius Zentrum für Ernährungsmedizin, Klinikum rechts der Isar, TU München
,
M. Hausmann
1   Klinik für Ernährungsmedizin, Else Kröner Fresenius Zentrum für Ernährungsmedizin, Klinikum rechts der Isar, TU München
,
J. Erdmann
1   Klinik für Ernährungsmedizin, Else Kröner Fresenius Zentrum für Ernährungsmedizin, Klinikum rechts der Isar, TU München
› Author Affiliations
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Publication History

Publication Date:
22 December 2017 (online)

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Zusammenfassung

Änderungen des Essverhaltens im Rahmen einer Adipositastherapie müssen zu einer hypokalorischen Ernährung führen, die individuelle Vorlieben berücksichtigt und satt macht. Sättigung entsteht beim Menschen akut durch Füllung und Dehnung des Magens, wobei dem Energiegehalt der Nahrung keine Rolle zukommt. Kognitive und sensorische Einflüsse können diese neuroendokrine Regulationsschleife zwischen Magen und Gehirn leicht überspielen und wesentlich zur Steigerung der Energieaufnahme beitragen. Deshalb ist die Energiedichte der verzehrten Lebensmittel von großer Bedeutung für die tägliche Kalorienaufnahme. Dementsprechend ist die Reduktion der Energiedichte eine gute Basis für eine individuell ausgerichtete Änderung der Ernährungsgewohnheiten. Die ambulanten Therapieergebnisse zeigen, dass auch mit diesem Konzept nach Beendigung der aktiv unterstützten Therapiephase die Patienten in der Lage sind, selbstständig weiter Gewicht zu reduzieren.

Summary

A change of eating habits during obesity treatment requires hypocaloric food intake in conjunction with individual food preferences that have a satiating effect. In humans acute satiety is generated by filling and distention of the stomach while food energy content is unimportant. This neuro-endocrine regulation between stomach and hypothalamus can be easily overrolled by cognitive and sensory factors which lead to increased energy intake. Therefore energy density has an important role in daily energy intake and vice versa its reduction is a good basis for an individually tailored change of eating habits.The results of obesity treatment in an outpatient clinic indicate that this concept is also effective for the transition of weight loss from the supported treatment to the ensuing self-treatment phase.

Schlüsselwörter

Energiedichte - Makronährstoffe - Ballaststoffe - Sättigung - Therapiekosten

Keywords

Energy density - macronutrients - dietary fiber - satiety - treatment cost
 

  • Literatur

  • 1 Anderson JW. et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74: 579-584.
    CrossrefPubMedGoogle Scholar
  • 2 Astrup A. et al. The role of low-fat diets in body weight control: a meta-analysis of ad libitum dietary interventions studies. Int J obes Relat Metab Disord 2000; 24: 1545-1552.
    CrossrefPubMedGoogle Scholar
  • 3 Baba NH. et al. High protein vs high carbohydrat hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord 1999; 23: 1202-1206.
    CrossrefPubMedGoogle Scholar
  • 4 Bell EA, Rolls BJ. Energy density of food affects energy intake across multiple levels of fat content in lean and obese woman. Am J Clin Nutr 2001; 73: 1010-1018.
    CrossrefPubMedGoogle Scholar
  • 5 Cotton JR. et al. Fat and satiety: no additional intensification of satiety following a fast supplemented breakfast. Int J Obes 1992; 16 (Suppl. 01) 11.
    PubMedGoogle Scholar
  • 6 Cotton JR. et al. Effect of fat in combination with either protein or carbohydrate. In: Dischuneit HH, Gies FA, Hauner H. et al, eds. Obesity in Europe 93. London: J. Libbey; 1994: 349-355.
    Google Scholar
  • 7 Dansinger ML. et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005; 293: 43-53.
    CrossrefPubMedGoogle Scholar
  • 8 Dansinger ML. et al. Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med 2007; 147: 41-50.
    CrossrefPubMedGoogle Scholar
  • 9 De Castro JM. The time of day of food intake influences overall intake in humans. J Nutr 2004; 134: 104-111.
    CrossrefPubMedGoogle Scholar
  • 10 De Castro JM. The time of day and the proportions of macronutrients eaten are related to total daily food intake. Br J Nutr 2007; 98: 1077-1083.
    PubMedGoogle Scholar
  • 11 Douketis JD. et al. Systematic review of long-term weight loss studies in obese adults: clinical signidicance and applicability to clinical practice. Int J Obes (Lond) 2005; 29: 1153-1167.
    CrossrefPubMedGoogle Scholar
  • 12 Due A. et al. Effect of normal-fat diets, either medium or high in protetin, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord 2004; 28: 1283-1290.
    CrossrefPubMedGoogle Scholar
  • 13 Ello-Martin JA. et al. Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am J Clin Nutr 2007; 85: 1465-1477.
    CrossrefPubMedGoogle Scholar
  • 14 Gardner CD. et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA 2007; 297: 969-977.
    CrossrefPubMedGoogle Scholar
  • 15 Hausmann M. et al. Stellenwert des 24-h-Recalls im Vergleich zum Ernährungsprotokoll in der Adipositasambulanz. Aktuel Ernaehr Med 2007; 32: 185-190.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Kant AK, Graubard BI. Energy density of diets reported by American adults: association with food group intake, nutrient intake, and body weight. Int J Obes (Lond) 2005; 29: 950-956.
    CrossrefPubMedGoogle Scholar
  • 17 Ledikwe JH. et al. Reductions in dietary energy density are associated with weight loss in overweight and obese participants in the PREMIER trial. Am J Clin Nutr 2007; 85: 1212-1221.
    CrossrefPubMedGoogle Scholar
  • 18 Nordmann AJ. et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006; 166: 285-293.
    CrossrefPubMedGoogle Scholar
  • 19 Poppitt SD, Prentice AM. Energy density and its role in the control of food intake: evidence from metabolic and community studies. Appetite 1996; 26: 153-174.
    CrossrefPubMedGoogle Scholar
  • 20 Rolls BJ. et al. Provision of foods differing in energy density affects long-term weight loss. Obes Res 2005; 13: 1052-1060.
    CrossrefPubMedGoogle Scholar
  • 21 Sacks FM. et al. Comparsion of weight-loss diets with different compositions of fat, protein and carbohydrates. N Engl J Med 2009; 360: 859-873.
    CrossrefPubMedGoogle Scholar
  • 22 Schick RR, Schusdziarra V. Regulation of food intake. In: Dischuneit HH, Gies FA, Hauner H. et al. Obesity in Europe. 93 London: J. Libbey; 1994: 335-348.
    Google Scholar
  • 23 Schusdziarra V. et al. Neuroendocrine feeding regulation in the perspective of modern food supply - lessons for obesity treatment. In: Parsons WV, Taylor CM. New Research on Morbid Obesity. Hauppange, NY: Nova Science Pub; 2008: 45-89.
    Google Scholar
  • 24 Schusdziarra V, Hausmann M. Satt essen und abnehmen - individuelle Ernährungsumstellung ohne Diät, 2. Aufl. Neu-Isenburg: MMI; 2008
    PubMedGoogle Scholar
  • 25 Schusdziarra V. et al. Contribution of energy density and food quantity to short-term fluctuations of energy intake in normal weight and obese subjects. Eur J Nutr. 2009 in press.
    PubMedGoogle Scholar
  • 26 Schusdziarra V. et al. Lebensmittelverzehr Übergewichtiger und Adipöser. Aktuel Ernaehr Med 2009; 34: 19-32.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Schusdziarra V. et al. Lebensmittelverzehr sowie Energieaufnahme, Essensmenge und Energiedichte bei Haupt- und Zwischenmahlzeiten Übergewich-tiger und Adipöser. Aktuel Ernaehr Med 2009; 34: 186-194.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Shai I. et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008; 359: 229-241.
    CrossrefPubMedGoogle Scholar
  • 29 Skov AR. et al. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet für the treatment of obesity. Int J Obes Relat Metab Disord 1999; 23: 528-536.
    CrossrefPubMedGoogle Scholar
  • 30 Stubbs RJ. et al. Covert manipulation of energy density of high carbohydrate diets in “preudo free-living”humans. Int J Obes Relat Metab Disord 1998; 22: 885-892.
    CrossrefPubMedGoogle Scholar