Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
Joslin Diabetes Center, Boston, MA, USA.
Lancet. 2014 Jun 7;383(9933):1999-2007. doi: 10.1016/S0140-6736(14)60613-9.
In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than is the quantity of these macronutrients. Diets rich in wholegrains, fruits, vegetables, legumes, and nuts; moderate in alcohol consumption; and lower in refined grains, red or processed meats, and sugar-sweetened beverages have been shown to reduce the risk of diabetes and improve glycaemic control and blood lipids in patients with diabetes. With an emphasis on overall diet quality, several dietary patterns such as Mediterranean, low glycaemic index, moderately low carbohydrate, and vegetarian diets can be tailored to personal and cultural food preferences and appropriate calorie needs for weight control and diabetes prevention and management. Although much progress has been made in development and implementation of evidence-based nutrition recommendations in developed countries, concerted worldwide efforts and policies are warranted to alleviate regional disparities.
在过去的几十年中,前瞻性观察研究和临床试验的证据已经趋于一致,支持了个体营养素、食物和饮食模式在 2 型糖尿病的预防和管理中的重要性。所摄入的膳食脂肪和碳水化合物的质量比其数量更为关键。富含全谷物、水果、蔬菜、豆类和坚果的饮食;适量饮酒;以及减少精制谷物、红色或加工肉类和含糖饮料的摄入,已被证明可降低糖尿病风险,并改善糖尿病患者的血糖控制和血脂水平。强调整体饮食质量,几种饮食模式,如地中海饮食、低血糖指数饮食、适度低碳水化合物饮食和素食饮食,可以根据个人和文化的食物偏好以及控制体重和预防和管理糖尿病的适当热量需求进行调整。尽管在发达国家制定和实施基于证据的营养建议方面已经取得了很大进展,但仍需要全球范围内的共同努力和政策来缓解区域差异。