Preventative Health Flagship, Commonwealth Scientific and Industrial Research Organisation, Food and Nutritional Sciences, Adelaide, Australia.
Diabetes Care. 2010 May;33(5):969-76. doi: 10.2337/dc09-1974. Epub 2010 Feb 11.
OBJECTIVE To evaluate the effects of two low-fat hypocaloric diets differing in the carbohydrate-to-protein ratio, with and without resistance exercise training (RT), on weight loss, body composition, and cardiovascular disease (CVD) risk outcomes in overweight/obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 83 men and women with type 2 diabetes (aged 56.1 +/- 7.5 years, BMI 35.4 +/- 4.6 kg/m(2)) were randomly assigned to an isocaloric, energy-restricted diet (female subjects 6 MJ/day, male subjects 7 MJ/day) of either standard carbohydrate (CON; carbohydrate:protein:fat 53:19:26) or high protein (HP; 43:33:22), with or without supervised RT (3 days/week) for 16 weeks. Body weight and composition, waist circumference (WC), and cardiometabolic risk markers were assessed. RESULTS Fifty-nine participants completed the study. There was a significant group effect (P <or= 0.04) for body weight, fat mass, and WC with the greatest reductions occurring in HP+RT (weight [CON: -8.6 +/- 4.6 kg, HP: -9.0 +/- 4.8 kg, CON+RT: -10.5 +/- 5.1 kg, HP+RT: -13.8 +/- 6.0 kg], fat mass [CON: -6.4 +/- 3.4 kg, HP: -6.7 +/- 4.0 kg, CON+RT: -7.9 +/- 3.7 kg, HP+RT: -11.1 +/- 3.7 kg], and WC [CON: -8.2 +/- 4.6 cm, HP: -8.9 +/- 3.9 cm, CON+RT: -11.3 +/- 4.6 cm, HP+RT: -13.7 +/- 4.6 cm]). There was an overall reduction (P < 0.001) in fat-free mass (-2.0 +/- 2.3 kg), blood pressure (-15/8 +/- 10/6 mmHg), glucose (-2.1 +/- 2.2 mmol/l), insulin (-4.7 +/- 5.4 mU/l), A1C (-1.25 +/- 0.94%), triglycerides (-0.47 +/- 0.81 mmol/l), total cholesterol (-0.67 +/- 0.69 mmol/l), and LDL cholesterol (-0.37 +/- 0.53 mmol/l), with no difference between groups (P >or= 0.17). CONCLUSIONS An energy-restricted HP diet combined with RT achieved greater weight loss and more favorable changes in body composition. All treatments had similar improvements in glycemic control and CVD risk markers.
评估两种低碳水化合物低热量饮食的效果，这两种饮食的碳水化合物与蛋白质比例不同，同时还结合了抗阻运动训练（RT），以观察其对超重/肥胖 2 型糖尿病患者的体重减轻、身体成分和心血管疾病（CVD）风险结果的影响。
共有 83 名 2 型糖尿病患者（年龄 56.1 ± 7.5 岁，BMI 35.4 ± 4.6 kg/m²）被随机分配到能量限制的等热量饮食（女性受试者 6 MJ/天，男性受试者 7 MJ/天），分别为标准碳水化合物（CON；碳水化合物：蛋白质：脂肪为 53:19:26）或高蛋白（HP；43:33:22），并结合或不结合监督下的 RT（每周 3 天），持续 16 周。评估体重和身体成分、腰围（WC）以及心脏代谢风险标志物。
59 名参与者完成了研究。体重、脂肪量和 WC 存在显著的组间效应（P ≤ 0.04），其中 HP+RT 组的降幅最大（体重[CON：-8.6 ± 4.6 kg，HP：-9.0 ± 4.8 kg，CON+RT：-10.5 ± 5.1 kg，HP+RT：-13.8 ± 6.0 kg]，脂肪量[CON：-6.4 ± 3.4 kg，HP：-6.7 ± 4.0 kg，CON+RT：-7.9 ± 3.7 kg，HP+RT：-11.1 ± 3.7 kg]，WC[CON：-8.2 ± 4.6 cm，HP：-8.9 ± 3.9 cm，CON+RT：-11.3 ± 4.6 cm，HP+RT：-13.7 ± 4.6 cm]）。脂肪量（-2.0 ± 2.3 kg）、血压（-15/8 ± 10/6 mmHg）、血糖（-2.1 ± 2.2 mmol/l）、胰岛素（-4.7 ± 5.4 mU/l）、A1C（-1.25 ± 0.94%）、甘油三酯（-0.47 ± 0.81 mmol/l）、总胆固醇（-0.67 ± 0.69 mmol/l）和 LDL 胆固醇（-0.37 ± 0.53 mmol/l）均有显著降低（P < 0.001），但各组间无差异（P ≥ 0.17）。
能量限制的高蛋白饮食与 RT 相结合可实现更大的体重减轻，并对身体成分产生更有利的变化。所有治疗方法在血糖控制和 CVD 风险标志物方面均有相似的改善。
