Kendall Cyril W C, Esfahani Amin, Truan Jennifer, Srichaikul Korbua, Jenkins David J A
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, M5S 3E2.
Asia Pac J Clin Nutr. 2010;19(1):110-6.
The effects of tree nuts on risk factors for coronary heart disease (CHD), in particular blood lipids, have been investigated in a number of studies and the beneficial effects are now recognized. The beneficial effects of nuts on CHD in cohort studies have also been clearly demonstrated. However, while there is also reason to believe the unique micro- and macronutrient profiles of nuts may help to control blood glucose levels, relatively few studies have investigated their role in diabetes control and prevention. Nuts are low in available carbohydrate, have a healthy fatty acid profile, and are high in vegetable protein, fiber and magnesium. Acute feeding studies indicate that when eaten alone nuts have minimal effects on raising postprandial blood glucose levels. In addition, when nuts are consumed with carbohydrate rich foods, they blunt the postprandial glycemic response of the carbohydrate meal. Despite the success of these acute studies, only a limited number of trials have been conducted with nuts in type 2 diabetes. These studies have either been of insufficient duration to observe changes in HbA1c, as the standard measure of glycemic control, or have been underpowered. Therefore, more long-term clinical trials are required to examine the role of nuts on glycemic control in patients with prediabetes and diabetes. Overall, there are good reasons to justify further exploration of the use of nuts in the prevention of diabetes and its micro- and macrovascular complications.
多项研究调查了坚果对冠心病（CHD）风险因素的影响，尤其是对血脂的影响，其有益作用现已得到认可。队列研究中坚果对冠心病的有益作用也已得到明确证实。然而，尽管有理由相信坚果独特的微量和宏量营养素组成可能有助于控制血糖水平，但相对较少的研究探讨了它们在糖尿病控制和预防中的作用。坚果的可利用碳水化合物含量低，脂肪酸组成健康，且植物蛋白、纤维和镁含量高。急性喂养研究表明，单独食用坚果时对餐后血糖水平升高的影响最小。此外，当坚果与富含碳水化合物的食物一起食用时，它们会减弱碳水化合物餐的餐后血糖反应。尽管这些急性研究取得了成功，但在2型糖尿病患者中使用坚果进行的试验数量有限。这些研究要么持续时间不足以观察到糖化血红蛋白（HbA1c）这一血糖控制标准指标的变化，要么样本量不足。因此，需要更多长期临床试验来研究坚果在糖尿病前期和糖尿病患者血糖控制中的作用。总体而言，有充分理由进一步探索使用坚果预防糖尿病及其微血管和大血管并发症。
