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2型糖尿病控制不佳的成年患者中低碳水化合物和高脂肪饮食摄入情况

Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus.

作者信息

Ma Yunsheng, Olendzki Barbara C, Hafner Andrea R, Chiriboga David E, Culver Annie L, Andersen Victoria A, Merriam Philip A, Pagoto Sherry L

机构信息

Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

出版信息

Nutrition. 2006 Nov-Dec;22(11-12):1129-36. doi: 10.1016/j.nut.2006.08.006. Epub 2006 Oct 4.

Abstract

OBJECTIVE

This study examined baseline dietary intake, body weight, and physiologic status in patients enrolled in a dietary intervention for type 2 diabetes mellitus (T2DM).

METHODS

Dietary, physiologic, and demographic information were collected at baseline from 40 adult patients with poorly controlled T2DM (glycosylated hemoglobin >7%) who participated in a clinical trial at an academic medical center in Worcester, Massachusetts, USA.

RESULTS

The average age at enrollment was 53.5 y (SD 8.4), average body mass index was 35.48 kg/m(2) (SD 7.0), and glycosylated hemoglobin was 8.3% (SD 1.2). Participants were predominantly white, married, and employed full time. Forty-eight percent were men. Seventy-eight percent had hyperlipidemia, and 68% had hypertension. Reported baseline daily average energy intake was 1778 kcal (SD 814), daily carbohydrate was 159 g (SD 71.5), and dietary fiber was 11.4 g (SD 5.2). The dietary composition was 35% carbohydrate, 45% fat (15% saturated fat), and 20% protein. The American Diabetes Association (ADA) guidelines recommends 45-65% of energy from carbohydrate, 20-35% from fat (<7% saturated), and 20% from protein.

CONCLUSION

These patients reported a low-carbohydrate, low-fiber, high-fat (especially saturated) diet, although they stated they are not following any of the popular low-carbohydrate diets. Patients with T2DM may find the current trend toward reducing weight through low-carbohydrate diets attractive for control of blood glucose, despite ADA recommendations. This dietary pattern may represent a popular trend that extends beyond our particular study and, if so, has serious cardiovascular implications in this vulnerable population of T2DM patients.

摘要

目的

本研究调查了参与2型糖尿病(T2DM)饮食干预的患者的基线饮食摄入量、体重和生理状态。

方法

从40名成年T2DM控制不佳(糖化血红蛋白>7%)的患者中收集基线时的饮食、生理和人口统计学信息,这些患者在美国马萨诸塞州伍斯特市的一家学术医疗中心参加了一项临床试验。

结果

入组时的平均年龄为53.5岁(标准差8.4),平均体重指数为35.48kg/m²(标准差7.0),糖化血红蛋白为8.3%(标准差1.2)。参与者主要为白人、已婚且全职工作。48%为男性。78%患有高脂血症,68%患有高血压。报告的基线每日平均能量摄入量为1778千卡(标准差814),每日碳水化合物摄入量为159克(标准差71.5),膳食纤维为11.4克(标准差5.2)。饮食组成中碳水化合物占35%,脂肪占45%(饱和脂肪占15%),蛋白质占20%。美国糖尿病协会(ADA)指南建议碳水化合物提供45 - 65%的能量,脂肪提供20 - 35%(饱和脂肪<7%),蛋白质提供20%的能量。

结论

这些患者报告的是低碳水化合物、低纤维、高脂肪(尤其是饱和脂肪)饮食,尽管他们表示未遵循任何流行的低碳水化合物饮食。尽管有ADA的建议,但T2DM患者可能会发现当前通过低碳水化合物饮食减轻体重的趋势对控制血糖具有吸引力。这种饮食模式可能代表了一种超出我们特定研究范围的流行趋势,如果是这样,对这一脆弱的T2DM患者群体具有严重的心血管影响。

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