饮食模式对超重/肥胖者的代谢灵活性、胰岛素敏感性和餐后血糖反应的影响
创作:兵兵 审核:兵兵 01月16日
  • 40名中老年超重/肥胖受试者分为两组,分别进行6周的健康饮食或西方饮食,之后进行高脂高糖饮食测试;
  • 饮食模式对胰岛素刺激诱导的呼吸熵改变、胰岛素敏感性及餐后呼吸熵并无显著影响;
  • 在高脂高糖饮食后30和45分钟时,健康饮食组的餐后血糖升高的更多;
  • 两种饮食模式对空腹血糖和糖化血红蛋白的影响无差异,但健康饮食对空腹胰岛素和胰岛素抵抗有更明显的降低作用。
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兵兵
研究采取平行对照实验,就不同膳食模式对超重或肥胖个体血糖的影响进行测定。研究结果显示,6周健康膳食干预(富含水果和蔬菜、豆类、纤维、坚果、多脂鱼,较少高GI碳水化合物)后,患者进行高脂高糖饮食挑战时的餐后血糖上升更多,可能反映了受试者对低GI食物的适应性。此外,与西式饮食相比,健康饮食对改善代谢灵活性和全身胰岛素敏感性的作用并没有显著优势。
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Effects of a whole diet approach on metabolic flexibility, insulin sensitivity and postprandial glucose responses in overweight and obese adults – A randomized controlled trial

整体饮食法对超重和肥胖患者的代谢灵活性、胰岛素敏感性以及餐后血糖反应的影响:随机对照实验

10.1016/j.clnu.2019.12.010

2019-12-17, Article

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Background & aims: Metabolic flexibility is the ability to adapt fuel oxidation to fuel availability. Metabolic inflexibility has been associated with obesity, the metabolic syndrome and insulin resistance, and can be improved by exercise or weight loss. Dietary changes can modulate metabolic flexibility; however, the effect of a whole diet approach on metabolic flexibility has never been studied. Therefore, our objective was to assess the effect of a healthy diet (HD), as compared to a typical Western diet (WD), on several fasting and postprandial markers of metabolic flexibility and insulin sensitivity.
Methods: In this parallel randomized trial, overweight or obese men and women (50–70 years; BMI 25–35 kg/m2) consumed a healthy diet (HD; high in fruits and vegetables, pulses, fibers, nuts, fatty fish, and low in high-glycemic carbohydrates; n = 19) or a typical Western diet (WD; n = 21) for six weeks, following a two-week run-in period. The change in respiratory quotient upon insulin stimulation (ΔRQ), and insulin sensitivity, expressed as the M-value, were both determined with a hyperinsulinemic euglycemic clamp. Additionally, other fasting and postprandial markers of metabolic flexibility were assessed during a 5-h high-fat high-glycemic mixed meal challenge.
Results: ΔRQ (p = 0.730) and insulin sensitivity (p = 0.802) were not significantly affected by diet. Postprandial RQ did also not show significant differences (p = 0.610), whereas postprandial glucose excursions were significantly higher in the HD group at T30 (p = 0.014) and T45 (p = 0.026) after mixed meal ingestion (p = 0.037). Fasting glucose (p = 0.530) and HbA1c (p = 0.124) remained unchanged, whereas decreases in fasting insulin (p = 0.038) and the HOMA-IR (p = 0.050) were significantly more pronounced with the HD.
Conclusion: A healthy diet for six weeks, without further life-style changes, did not improve metabolic flexibility and whole-body insulin sensitivity, when compared to a Western-style diet. It remains to be determined whether the short time increase in postprandial glucose is physiologically relevant or detrimental to metabolic health.

First Authors:
Eva Fechner

Correspondence Authors:
Patrick Schrauwen

All Authors:
Eva Fechner,Lena Bilet,Harry P F Peters,Harry Hiemstra,Doris M Jacobs,Cara Op‘t Eyndt,Esther Kornips,Ronald P Mensink,Patrick Schrauwen

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