Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaClinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, CanadaDivision of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, CanadaLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaClinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, CanadaCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
Diabetes Care. 2014 Jul;37(7):1806-14. doi: 10.2337/dc13-2990. Epub 2014 Jun 14.
Despite their independent cardiovascular disease (CVD) advantages, effects of α-linolenic acid (ALA), monounsaturated fatty acid (MUFA), and low-glycemic-load (GL) diets have not been assessed in combination. We therefore determined the combined effect of ALA, MUFA, and low GL on glycemic control and CVD risk factors in type 2 diabetes.
The study was a parallel design, randomized trial wherein each 3-month treatment was conducted in a Canadian academic center between March 2011 and September 2012 and involved 141 participants with type 2 diabetes (HbA1c 6.5%-8.5% [48-69 mmol/mol]) treated with oral antihyperglycemic agents. Participants were provided with dietary advice on either a low-GL diet with ALA and MUFA given as a canola oil-enriched bread supplement (31 g canola oil per 2,000 kcal) (test) or a whole-grain diet with a whole-wheat bread supplement (control). The primary outcome was HbA1c change. Secondary outcomes included calculated Framingham CVD risk score and reactive hyperemia index (RHI) ratio.
Seventy-nine percent of the test group and 90% of the control group completed the trial. The test diet reduction in HbA1c units of -0.47% (-5.15 mmol/mol) (95% CI -0.54% to -0.40% [-5.92 to -4.38 mmol/mol]) was greater than that for the control diet (-0.31% [-3.44 mmol/mol] [95% CI -0.38% to -0.25% (-4.17 to -2.71 mmol/mol)], P = 0.002), with the greatest benefit observed in those with higher systolic blood pressure (SBP). Greater reductions were seen in CVD risk score for the test diet, whereas the RHI ratio increased for the control diet.
A canola oil-enriched low-GL diet improved glycemic control in type 2 diabetes, particularly in participants with raised SBP, whereas whole grains improved vascular reactivity.
尽管 α-亚麻酸（ALA）、单不饱和脂肪酸（MUFA）和低血糖负荷（GL）饮食具有独立的心血管疾病（CVD）优势，但尚未评估它们联合应用的效果。因此，我们旨在确定 ALA、MUFA 和低 GL 联合应用对 2 型糖尿病患者血糖控制和 CVD 危险因素的综合影响。
这是一项平行设计、随机试验，于 2011 年 3 月至 2012 年 9 月在加拿大学术中心进行，每个 3 个月的治疗期涉及 141 名接受口服降糖药治疗的 2 型糖尿病患者（HbA1c 6.5%-8.5%[48-69mmol/mol]）。参与者接受了低 GL 饮食的饮食建议，ALA 和 MUFA 作为富含菜籽油的面包补充剂（每 2000 千卡热量提供 31 克菜籽油）（试验组），或全谷物饮食，全麦面包补充剂（对照组）。主要结局为 HbA1c 的变化。次要结局包括计算的弗雷明汉 CVD 风险评分和反应性充血指数（RHI）比值。
试验组有 79%和对照组有 90%的参与者完成了试验。试验组 HbA1c 降低 0.47%（-5.15mmol/mol）（95%CI-0.54%至-0.40%[-5.92 至-4.38mmol/mol]），优于对照组的 0.31%（-3.44mmol/mol）[95%CI-0.38%至-0.25%[-4.17 至-2.71mmol/mol]，P=0.002），在收缩压较高的患者中获益最大。试验组 CVD 风险评分降低更为明显，而对照组 RHI 比值升高。
富含菜籽油的低 GL 饮食改善了 2 型糖尿病患者的血糖控制，尤其是收缩压升高的患者，而全谷物饮食改善了血管反应性。
