Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Clin Endocrinol (Oxf). 2012 Oct;77(4):508-12. doi: 10.1111/j.1365-2265.2012.04450.x.
Insulin resistance (IR) has been proposed as the strongest single predictor for incident type 2 diabetes and is mainly caused by adiposity as a result of chronic excessive energy intake. Loss of body weight and fat mass improve insulin sensitivity. However, independent of energy intake and changes in body weight/composition, dietary content and specific metabolic effects of certain nutrients may play significant additional roles in influencing IR. These effects are mainly relatively modest, with modulation of IR and diabetes risk within the range of 10-30%, but could be of major relevance on a population level. Examples include dietary concepts and patterns such as the traditional Mediterranean diet; the isoenergetic modulation of the composition of types of fatty acids in the diet; low-carbohydrate-high-protein diets; the quality of carbohydrate-rich foods, which includes the concepts of glycaemic index (GI) and glycaemic load; and, not necessarily related to the GI concept, specific metabolic effects of high-fibre diets, with relevant differences between the type of fibre consumed. Effects of further selected foods (e.g. coffee, tea and nuts) and micronutrients (e.g. magnesium, selenium and zinc) on the modulation of IR have been reviewed elsewhere. This study focuses on changes in IR by isoenergetic modulation of the main macronutrients (fat, carbohydrates including dietary fibre, and dietary protein), with discussion of novel concepts and the potential interplay of food components in the current dietary concepts.
胰岛素抵抗（IR）被认为是 2 型糖尿病发生的最强单一预测因素，主要是由于慢性过量能量摄入导致肥胖引起的。减轻体重和脂肪量可以提高胰岛素敏感性。然而，独立于能量摄入和体重/成分的变化，某些营养素的饮食含量和特定代谢作用可能在影响 IR 方面发挥重要的附加作用。这些作用主要是相对适度的，对 IR 和糖尿病风险的调节在 10-30%的范围内，但在人群水平上可能具有重要意义。例如，传统地中海饮食等饮食理念和模式；饮食中脂肪酸类型组成的等能量调节；低碳水化合物高蛋白饮食；富含碳水化合物的食物质量，包括血糖生成指数（GI）和血糖负荷的概念；以及不一定与 GI 概念相关的高纤维饮食的特定代谢作用，与所消耗的纤维类型存在相关差异。其他一些食物（如咖啡、茶和坚果）和微量营养素（如镁、硒和锌）对 IR 调节的影响已在其他地方进行了综述。本研究重点关注通过主要宏量营养素（脂肪、碳水化合物（包括膳食纤维）和蛋白质）的等能量调节对 IR 的变化，并讨论了当前饮食理念中食物成分的新观念和潜在相互作用。
