Hu F B, van Dam R M, Liu S
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Diabetologia. 2001 Jul;44(7):805-17. doi: 10.1007/s001250100547.
Although diet and nutrition are widely believed to play an important part in the development of Type II (non-insulin-dependent) diabetes mellitus, specific dietary factors have not been clearly defined. Much controversy exists about the relations between the amount and types of dietary fat and carbohydrate and the risk of diabetes. In this article, we review in detail the current evidence regarding the associations between different types of fats and carbohydrates and insulin resistance and Type II diabetes. Our findings indicate that a higher intake of polyunsaturated fat and possibly long-chain n-3 fatty acids could be beneficial, whereas a higher intake of saturated fat and trans-fat could adversely affect glucose metabolism and insulin resistance. In dietary practice, exchanging nonhydrogenated polyunsaturated fat for saturated and trans-fatty acids could appreciably reduce risk of Type II diabetes. In addition, a low-glycaemic index diet with a higher amount of fiber and minimally processed whole grain products reduces glycaemic and insulinaemic responses and lowers the risk of Type II diabetes. Dietary recommendations to prevent Type II diabetes should focus more on the quality of fat and carbohydrate in the diet than quantity alone, in addition to balancing total energy intake with expenditure to avoid overweight and obesity.
尽管人们普遍认为饮食和营养在II型（非胰岛素依赖型）糖尿病的发展中起着重要作用，但具体的饮食因素尚未明确界定。关于膳食脂肪和碳水化合物的数量及类型与糖尿病风险之间的关系，存在诸多争议。在本文中，我们详细回顾了有关不同类型的脂肪和碳水化合物与胰岛素抵抗及II型糖尿病之间关联的现有证据。我们的研究结果表明，较高的多不饱和脂肪摄入量，可能还有长链n-3脂肪酸摄入量，可能是有益的，而较高的饱和脂肪和反式脂肪摄入量可能会对葡萄糖代谢和胰岛素抵抗产生不利影响。在饮食实践中，用非氢化多不饱和脂肪替代饱和脂肪酸和反式脂肪酸可显著降低II型糖尿病的风险。此外，高纤维且经过最少加工的全谷物产品组成的低血糖指数饮食，可降低血糖和胰岛素反应，并降低II型糖尿病的风险。预防II型糖尿病的饮食建议应更多地关注饮食中脂肪和碳水化合物的质量而非仅仅数量，同时还要平衡总能量摄入与消耗，以避免超重和肥胖。
