Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala Science Park, 75185 Uppsala, Sweden.
Prog Lipid Res. 2009 Jan;48(1):44-51. doi: 10.1016/j.plipres.2008.10.002. Epub 2008 Nov 7.
Although type 2 diabetes is determined primarily by lifestyle and genes, dietary composition may affect both its development and complications. Dietary fat is of particular interest because fatty acids influence glucose metabolism by altering cell membrane function, enzyme activity, insulin signaling, and gene expression. This paper focuses on the prevention of type 2 diabetes and summarizes the epidemiologic literature on associations between types of dietary fat and diabetes risk. It also summarizes controlled feeding studies on the effects of dietary fats on metabolic mediators, such as insulin resistance. Taken together, the evidence suggests that replacing saturated fats and trans fatty acids with unsaturated (polyunsaturated and/or monounsaturated) fats has beneficial effects on insulin sensitivity and is likely to reduce risk of type 2 diabetes. Among polyunsaturated fats, linoleic acid from the n-6 series improves insulin sensitivity. On the other hand, long-chain n-3 fatty acids do not appear to improve insulin sensitivity or glucose metabolism. In dietary practice, foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products. Consumption of partially hydrogenated fats should be minimized. Additional controlled, long-term studies are needed to improve our knowledge on the optimal proportion of different types of fats to prevent diabetes.
虽然 2 型糖尿病主要由生活方式和基因决定，但饮食成分可能会影响其发展和并发症。膳食脂肪尤其值得关注，因为脂肪酸通过改变细胞膜功能、酶活性、胰岛素信号和基因表达来影响葡萄糖代谢。本文重点讨论 2 型糖尿病的预防，并总结了关于膳食脂肪类型与糖尿病风险之间关联的流行病学文献。它还总结了关于膳食脂肪对代谢介质（如胰岛素抵抗）影响的对照喂养研究。总的来说，有证据表明，用不饱和脂肪（多不饱和脂肪和/或单不饱和脂肪）代替饱和脂肪和反式脂肪酸对胰岛素敏感性有有益影响，并且可能降低 2 型糖尿病的风险。在多不饱和脂肪中，来自 n-6 系列的亚油酸可改善胰岛素敏感性。另一方面，长链 n-3 脂肪酸似乎不会改善胰岛素敏感性或葡萄糖代谢。在饮食实践中，应使用富含植物油的食物（包括未氢化的人造黄油）代替富含饱和脂肪的肉类和高脂肪乳制品。应尽量减少部分氢化脂肪的消耗。需要进行更多的对照、长期研究，以提高我们对预防糖尿病的最佳脂肪类型比例的认识。
