Brand-Miller Jennie, McMillan-Price Joanna, Steinbeck Katherine, Caterson Ian
Human Nutrition Unit, University of Sydney, NSW 2006, Australia.
Asia Pac J Clin Nutr. 2008;17 Suppl 1:16-9.
Weight loss can be achieved by any means of energy restriction, but the challenge is to achieve sustainable weight loss and prevent weight 'creep' without increasing the risk of chronic disease. The modest success of low fat diets has prompted research on alternative dietary strategies including high protein diets and low glycemic index (GI) diets. Conventional high carbohydrate diets, even when based on whole grain foods, increase postprandial glycaemia and insulinemia and may compromise weight control via mechanisms relating to appetite stimulation, fuel partitioning and metabolic rate. This paper makes the case for the benefits of low glycemic index diets over higher protein diets. Both strategies are associated with lower postprandial glycemia and both are commonly labelled as 'low glycemic load' but the long-term health effects are likely to be different. There is now a large body of evidence comprising observational prospective cohort studies, randomised controlled trials and mechanistic experiments in animal models, that provides robust support for low GI carbohydrate diets in the prevention of obesity, diabetes and cardiovascular disease. While lower carbohydrate, higher protein diets also increase the rate of weight loss, cohort studies and meta-analyses of clinical trials suggest the potential for increased mortality.
通过任何能量限制手段都可以实现体重减轻，但挑战在于实现可持续的体重减轻并防止体重“反弹”，同时不增加慢性病风险。低脂饮食取得的有限成功促使人们对其他饮食策略进行研究，包括高蛋白饮食和低血糖指数（GI）饮食。传统的高碳水化合物饮食，即使是以全谷物食品为基础，也会增加餐后血糖和胰岛素水平，并且可能通过与食欲刺激、能量分配和代谢率相关的机制影响体重控制。本文阐述了低血糖指数饮食相较于高蛋白饮食的益处。这两种策略都与较低的餐后血糖水平相关，并且通常都被标记为“低血糖负荷”，但长期健康影响可能有所不同。现在有大量证据，包括观察性前瞻性队列研究、随机对照试验以及动物模型的机制实验，这些都为低GI碳水化合物饮食在预防肥胖、糖尿病和心血管疾病方面提供了有力支持。虽然低碳水化合物、高蛋白饮食也能提高体重减轻的速度，但队列研究和临床试验的荟萃分析表明存在死亡率增加的可能性。
