Franz Marion J
Nutrition Concepts by Franz Inc, Minneapolis, Minnesota.
Am J Med Sci. 2016 Apr;351(4):374-9. doi: 10.1016/j.amjms.2016.02.001.
Diabetes nutrition therapy provided for individuals with diabetes must be based on research documenting effectiveness. The roles of differing macronutrient percentages, eating patterns and weight loss interventions are controversial.
A review of research related to these topics is summarized.
Clinical trials as well as systematic reviews and Cochrane reviews report an approximately 1-2% lowering of hemoglobin A1c as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. There are no ideal percentages of macronutrients or eating patterns or both that apply to all persons with diabetes. Clinical trials demonstrate the effectiveness of modest weight loss and physical activity for the prevention or delay of type 2 diabetes. However, as the disease progresses, weight loss interventions may or may not result in beneficial glycemic and other metabolic outcomes.
To be effective, diabetes nutrition therapy must be individualized. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs and economics) and the individual׳s ability and willingness to make lifestyle changes all must be considered when educating or counseling individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity and support are important. A reduced energy intake for persons with prediabetes or type 2 diabetes and matching insulin to planned carbohydrate intake for insulin users is nutrition therapy interventions shown to be effective in achieving glycemic and other metabolic outcomes.
为糖尿病患者提供的糖尿病营养治疗必须基于证明其有效性的研究。不同宏量营养素百分比、饮食模式和体重减轻干预措施的作用存在争议。
总结了与这些主题相关的研究综述。
临床试验以及系统评价和Cochrane评价报告称，根据糖尿病的类型和病程以及血糖控制水平，营养治疗干预措施可使糖化血红蛋白水平降低约1%至2%，并产生其他有益结果。不存在适用于所有糖尿病患者的理想宏量营养素百分比或饮食模式或两者兼而有之的情况。临床试验证明适度体重减轻和体育活动对预防或延缓2型糖尿病有效。然而，随着疾病进展，体重减轻干预措施可能会或可能不会产生有益的血糖和其他代谢结果。
为有效起见，糖尿病营养治疗必须个体化。在对糖尿病患者进行教育或咨询时，必须考虑治疗目标、个人偏好（如传统、文化、宗教、健康观念和经济状况）以及个人做出生活方式改变的能力和意愿。强调适量摄入营养丰富食物的健康饮食模式、规律的体育活动和支持很重要。对糖尿病前期或2型糖尿病患者减少能量摄入，以及为使用胰岛素的患者将胰岛素与计划的碳水化合物摄入量相匹配，是已证明对实现血糖和其他代谢结果有效的营养治疗干预措施。
