Campbell Amy P, Rains Tia M
Joslin Diabetes Center, Boston, MA; and
Egg Nutrition Center, Park Ridge, IL.
J Nutr. 2015 Jan;145(1):164S-169S. doi: 10.3945/jn.114.194878. Epub 2014 Dec 3.
Many misconceptions surround the role of dietary protein in the management of diabetes. Although dietary recommendations for managing diabetes have changed greatly over the centuries, recommended protein intake has remained relatively constant. Currently, recommendations for protein intake are based on individual assessment and the consideration of other health issues and implications, such as the extent of glycemic control, the presence of kidney disease, overweight and obesity, and the age of the patient. Two common misconceptions about dietary protein in diabetes management are that a certain amount of the protein consumed is converted into blood glucose and that consuming too much protein can lead to diabetic kidney disease. These misconceptions have been disproven. For many people with type 2 diabetes, aiming for 20-30% of total energy intake as protein is the goal. Exceptions may be for those individuals with impaired renal function. A protein intake of this amount can be beneficial by improving glycemic control, aiding in satiety and preservation of lean body mass during weight loss in those with both diabetes and prediabetes, and providing for the increased protein requirements of the older adult. Health care providers should discuss the role of dietary protein with their patients, reinforce sources of protein in the diet, and use simple but effective teaching tools, such as the plate method, to convey important nutrition messages. In addition, health care providers should recognize that persons with diabetes are attempting to manage many other aspects of their diabetes, including blood glucose monitoring, physical activity, taking of medication, risk reduction, and problem solving.
围绕膳食蛋白质在糖尿病管理中的作用存在许多误解。尽管几个世纪以来,糖尿病管理的饮食建议发生了很大变化,但推荐的蛋白质摄入量一直相对稳定。目前,蛋白质摄入量的建议是基于个体评估以及对其他健康问题和影响因素的考虑,如血糖控制程度、肾脏疾病的存在、超重和肥胖以及患者的年龄。关于糖尿病管理中膳食蛋白质的两个常见误解是,摄入的一定量蛋白质会转化为血糖,以及摄入过多蛋白质会导致糖尿病肾病。这些误解已被证明是错误的。对于许多2型糖尿病患者来说,目标是使蛋白质摄入量占总能量摄入的20% - 30%。肾功能受损的个体可能是例外情况。这个量的蛋白质摄入可能有益,它可以改善血糖控制,帮助饱腹感,并在糖尿病和糖尿病前期患者减肥期间保持瘦体重,还能满足老年人增加的蛋白质需求。医疗保健提供者应与患者讨论膳食蛋白质的作用,强化饮食中蛋白质的来源,并使用简单但有效的教学工具,如餐盘法,来传达重要的营养信息。此外,医疗保健提供者应认识到糖尿病患者正在尝试管理糖尿病的许多其他方面,包括血糖监测、体育活动、服药、降低风险和解决问题。