Maki Kevin C, Phillips Alyssa K
Midwest Center for Metabolic and Cardiovascular Research, Glen Ellyn, IL
Midwest Center for Metabolic and Cardiovascular Research, Glen Ellyn, IL.
J Nutr. 2015 Jan;145(1):159S-163S. doi: 10.3945/jn.114.195149. Epub 2014 Dec 3.
Both genetics and lifestyle contribute to type 2 diabetes (T2D), a condition of elevated circulating glucose induced by a collection of metabolic defects including peripheral insulin resistance, elevated hepatic glucose output, and impaired pancreatic insulin secretion. Because the prevalence of T2D and its modifiable risk factors (overweight/obesity, dyslipidemia, hypertension, and physical inactivity) have been increasing in recent decades, there has been growing interest in lifestyle interventions that target T2D management and prevention. Although it is increasingly recognized that lifestyle interventions aimed at encouraging physical activity and reducing body weight can improve insulin sensitivity, nutritional contributions to T2D risk reduction are less clear. Evidence from prospective cohort and randomized controlled trials suggests that diets rich in refined dietary carbohydrate [particularly those with a high glycemic index (GI)] may elevate T2D risk; however, the appropriate combination of macronutrients to optimize metabolic health has not been fully described. To date, the collective evidence suggests that diets rich in low-GI carbohydrates, cereal fiber, resistant starch, fat from vegetable sources (unsaturated fat), and lean sources of protein should be emphasized, whereas refined sugars and grains (high-GI carbohydrates) are to be avoided in order to lower risk of T2D and its related risk factors and comorbidities.
遗传因素和生活方式都会导致2型糖尿病（T2D），这是一种由多种代谢缺陷引起的循环葡萄糖水平升高的病症，这些代谢缺陷包括外周胰岛素抵抗、肝脏葡萄糖输出增加和胰腺胰岛素分泌受损。由于近几十年来T2D的患病率及其可改变的风险因素（超重/肥胖、血脂异常、高血压和身体活动不足）一直在增加，因此人们对针对T2D管理和预防的生活方式干预越来越感兴趣。尽管越来越多的人认识到旨在鼓励身体活动和减轻体重的生活方式干预可以改善胰岛素敏感性，但营养对降低T2D风险的作用尚不清楚。前瞻性队列研究和随机对照试验的证据表明，富含精制膳食碳水化合物[特别是那些血糖指数（GI）高的食物]的饮食可能会增加T2D风险；然而，尚未充分描述优化代谢健康的宏量营养素的适当组合。迄今为止，综合证据表明，应强调富含低GI碳水化合物、谷物纤维、抗性淀粉、植物来源的脂肪（不饱和脂肪）和优质蛋白质的饮食，而应避免食用精制糖和谷物（高GI碳水化合物），以降低T2D及其相关风险因素和合并症的风险。
