Sue D Y, Chung M M, Grosvenor M, Wasserman K
Department of Medicine, Harbor-UCLA Medical Center, Torrance 90509.
Am Rev Respir Dis. 1989 Jun;139(6):1430-4. doi: 10.1164/ajrccm/139.6.1430.
A low proportion of dietary calories as carbohydrate has been suggested for patients with chronic obstructive pulmonary disease, because oxidation of carbohydrate (CHO) compared to fat results in greater CO2 production (VCO2) and, at the same arterial PCO2 (PaCO2), higher alveolar and minute ventilation (VE) and increased dyspnea. We hypothesized that a low CHO-high fat diet, although reducing VCO2 and VE at rest, might result in only a small change in VCO2 and VE during exercise. Eight healthy volunteers were randomized to receive for 24 h either isocaloric diets containing 10% or 70% of total calories from CHO (remainder of nonprotein calories from fat). Measurements of VCO2, VE, and respiratory gas exchange ratio (R) were made at rest and during constant work rate cycle exercise below the anaerobic threshold. Five to seven days later, the alternate diet was given and the studies were repeated. At rest, mean VCO2 and R were significantly lower after the low CHO diet compared to the high CHO diet. Mean resting VE was less but not significantly (high CHO 9.6 [0.7] versus low CHO 8.7 [0.8] L/min, mean [SEM]). During exercise, mean VCO2 and R were significantly less after the low CHO diet, but mean VE was only slightly smaller and not significantly different between diets (high CHO 25.4 [1.1] versus low CHO 24.0 [1.0] L/min). The increase in VCO2 from rest to exercise was relatively independent of the substrate mix recently consumed, suggesting that the exercising muscles use stored muscle glycogen as substrate during short bouts of low-intensity exercise despite changes in substrate utilization by nonmuscle tissues at rest.(ABSTRACT TRUNCATED AT 250 WORDS)
对于慢性阻塞性肺疾病患者,有人建议摄入碳水化合物形式的膳食热量比例要低,因为与脂肪相比,碳水化合物(CHO)氧化会产生更多的二氧化碳(VCO2),并且在相同的动脉血二氧化碳分压(PaCO2)下,会导致更高的肺泡通气量和分钟通气量(VE),并加重呼吸困难。我们推测,低CHO高脂肪饮食虽然在静息状态下会降低VCO2和VE,但在运动期间可能只会使VCO2和VE发生微小变化。八名健康志愿者被随机分为两组,分别接受等热量饮食,其中一组饮食中CHO提供的热量占总热量的10%,另一组为70%(非蛋白质热量的其余部分来自脂肪)。在静息状态和低于无氧阈值的恒定工作率循环运动期间,测量VCO2、VE和呼吸气体交换率(R)。五到七天后,给予另一种饮食并重复研究。静息状态下,与高CHO饮食相比,低CHO饮食后的平均VCO2和R显著降低。静息状态下的平均VE较低,但差异不显著(高CHO组为9.6[0.7],低CHO组为8.7[0.8]升/分钟,均值[标准误])。运动期间,低CHO饮食后的平均VCO2和R显著降低,但平均VE仅略小,两种饮食之间差异不显著(高CHO组为25.4[1.1],低CHO组为24.0[1.0]升/分钟)。从静息到运动时VCO2的增加相对独立于近期摄入的底物组合,这表明在短时间的低强度运动期间,尽管静息时非肌肉组织的底物利用发生了变化,但运动肌肉仍将储存的肌糖原用作底物。(摘要截选至250字)