Mann J
Department of Human Nutrition, Edgar National Centre for Diabetes Research, University of Otago, Dunedin, New Zealand.
Eur J Clin Nutr. 2007 Dec;61 Suppl 1:S100-11. doi: 10.1038/sj.ejcn.1602940.
The nature of carbohydrate is of considerable importance when recommending diets intended to reduce the risk of type II diabetes and cardiovascular disease and in the treatment of patients who already have established diseases. Intact fruits, vegetables, legumes and wholegrains are the most appropriate sources of carbohydrate. Most are rich in nonstarch polysaccharides (NSPs) (dietary fibre) and other potentially cardioprotective components. Many of these foods, especially those that are high in dietary fibre, will reduce total and low-density lipoprotein cholesterol and help to improve glycaemic control in those with diabetes. There is no good long-term evidence of benefit when NSPs or other components of wholegrains, fruits, vegetables and legumes are added to functional and manufactured foods. Frequent consumption of low glycaemic index foods has been reported to confer similar benefits, but it is not clear whether such benefits are independent of the dietary fibre content of these foods or the fact that low glycaemic index foods tend to have intact plant cell walls. Furthermore, it is uncertain whether functional and manufactured foods with a low glycaemic index confer the same long-term benefits as low glycaemic index plant-based foods. A wide range of carbohydrate intake is acceptable, provided the nature of carbohydrate is appropriate. Failure to emphasize the need for carbohydrate to be derived principally from wholegrain cereals, fruits, vegetables and legumes may result in increased lipoprotein-mediated risk of cardiovascular disease, especially in overweight and obese individuals who are insulin resistant.
在推荐旨在降低II型糖尿病和心血管疾病风险的饮食时，以及在治疗已确诊疾病的患者时，碳水化合物的性质相当重要。完整的水果、蔬菜、豆类和全谷物是最合适的碳水化合物来源。大多数富含非淀粉多糖（NSPs）（膳食纤维）和其他潜在的心脏保护成分。这些食物中的许多，尤其是膳食纤维含量高的食物，会降低总胆固醇和低密度脂蛋白胆固醇，并有助于改善糖尿病患者的血糖控制。将全谷物、水果、蔬菜和豆类中的NSPs或其他成分添加到功能性食品和加工食品中，长期来看并没有明显的益处。据报道，经常食用低血糖指数食物也有类似的好处，但尚不清楚这些好处是否独立于这些食物的膳食纤维含量，或者是否因为低血糖指数食物往往具有完整的植物细胞壁。此外，尚不确定低血糖指数的功能性食品和加工食品是否能带来与基于植物的低血糖指数食物相同的长期益处。只要碳水化合物的性质合适，广泛的碳水化合物摄入量都是可以接受的。如果不强调碳水化合物主要应来自全谷物、水果、蔬菜和豆类，可能会增加脂蛋白介导的心血管疾病风险，尤其是在超重和肥胖的胰岛素抵抗个体中。
