O'Dea K, Traianedes K, Ireland P, Niall M, Sadler J, Hopper J, De Luise M
Department of Medicine (University of Melbourne) Repatriation General Hospital, Heidelberg, Victoria, Australia.
J Am Diet Assoc. 1989 Aug;89(8):1076-86.
This study was designed to determine the effects of varying the proportions of carbohydrate, fiber, and fat on metabolic control in Type II diabetes. Ten men, aged 50 to 69 years, with Type II diabetes participated. Four isocaloric diets were consumed for 2 weeks each, with a break of 6 to 14 weeks between diets to ensure no carryover effects. Two of the diets were high in carbohydrate (63% to 65% energy) and low in fat (10% to 12% energy) but differed in their fiber contents (20 vs. 45 gm/day). The other two diets were low in carbohydrate (23% to 27% energy) with either a low or a high fat content (15% vs. 55% energy) and a high or normal protein content (62% vs. 18% energy). The composition of the subjects' usual diets in the week before each of the experimental diets did not vary significantly: carbohydrate 47% to 50% energy, protein 22% to 25% energy, fat 27% to 31% energy, and fiber 24 to 25 gm/day. A 75-gm oral glucose tolerance test and a 12-hour metabolic profile in response to 3 meals typical of the particular diet were conducted before and at the conclusion of each 2-week dietary period. The most significant improvements in metabolic control (as assessed by the effects of the diets on fasting glucose and on lipids, and on the glucose and insulin responses to oral glucose and the mixed meals) were obtained with the high-fiber, high-carbohydrate, low-fat diet and with the low-carbohydrate, high-protein, low-fat diet. Metabolic control was not significantly affected by the low-fiber, high-carbohydrate, low-fat diet, but it deteriorated significantly on the low-carbohydrate, high-fat diet. The results of this study confirmed the importance of high fiber and low fat in improving metabolic control in Type II diabetes. In conclusion, if high-carbohydrate, low-fat diets are to be recommended to patients with diabetes, it is essential that the type of carbohydrate recommended be unrefined and high in fiber.
本研究旨在确定改变碳水化合物、纤维和脂肪比例对II型糖尿病患者代谢控制的影响。10名年龄在50至69岁之间的II型糖尿病男性参与了研究。他们分别食用了四种等热量饮食，每种饮食持续2周，不同饮食之间间隔6至14周以确保没有残留效应。其中两种饮食碳水化合物含量高（占能量的63%至65%）且脂肪含量低（占能量的10%至12%），但纤维含量不同（分别为20克/天和45克/天）。另外两种饮食碳水化合物含量低（占能量的23%至27%），脂肪含量低或高（分别为15%和55%），蛋白质含量高或正常（分别为62%和18%）。在每种实验饮食前一周，受试者日常饮食的组成没有显著差异：碳水化合物占能量的47%至50%，蛋白质占22%至25%，脂肪占27%至31%，纤维为24至25克/天。在每2周饮食期开始前和结束时，分别进行了一次75克口服葡萄糖耐量试验以及针对符合特定饮食的3餐的12小时代谢谱检测。在高纤维、高碳水化合物、低脂肪饮食以及低碳水化合物、高蛋白、低脂肪饮食中，代谢控制得到了最显著的改善（通过饮食对空腹血糖、血脂以及口服葡萄糖和混合餐的葡萄糖和胰岛素反应的影响来评估）。低纤维、高碳水化合物、低脂肪饮食对代谢控制没有显著影响，但低碳水化合物、高脂肪饮食会使其显著恶化。本研究结果证实了高纤维和低脂肪在改善II型糖尿病患者代谢控制方面的重要性。总之，如果要向糖尿病患者推荐高碳水化合物、低脂肪饮食，那么推荐的碳水化合物类型必须是未精制且富含纤维的。
