Rušavý Zdeněk, Žourek Michal
Vnitr Lek. 2016 Fall;62(11 Suppl 4):S94-99.
The diabetic diet is one of the pillars of diabetes treatment. The rapid development of knowledge relating to the treatment of diabetes also includes diet. The paper focuses on the importance of a diet in the treatment of type 2 diabetes and prevention of atherosclerosis. Its main goal is to assess the impact of a composition of macronutrients on individuals with type 2 diabetes. The paper is divided into several parts, each of which ends with a conclusion. The first part examines weight reduction. The diet aimed at a weight loss is effective, it can effectively prevent diabetes, it leads to improvements in glucose control and reduction of the risk factors for atherosclerosis, however it will not impact on cardiovascular morbidity and mortality until after more than 20 years. The second part deals with "healthy" foods. The studies exploring this area are not convincing. The only really rational component of food in relation to atherosclerosis is dietary fibres. Important is a balanced diet combined with regular physical activities. The third part focuses on the composition of macronutrients. It turns out that, considering a low-calorie diet, the effects of high- and low-carbohydrate diets on people with diabetes are similar with regard to weight loss and lowering of HbA1c, however the low-carbohydrate diet is associated with lower glycemic variability and a reduced need for anti-diabetic drugs. We do not know how the comparison of the two extreme diets would come out regarding individuals with a high energy diet. Currently it is useful to focus on the quality of individual macronutrients. Choose foods containing carbohydrates with a low glycemic index and high fibre foods, prefer fats that contain a low proportion of saturated fatty acids. The fourth part discusses the recent recommendation of the Czech Diabetes Society regarding the composition of macronutrients in the diabetic diet. As compared with the diet proposed earlier, lower intake of fibre-rich carbohydrates and higher intake of proteins and fats with a low content of saturated fatty acids is now recommended. Experts recommendations on this subject are included.Key words: atherosclerosis - diabetic diet - HbA1c - macronutrients - low-carbohydrate diet - obesity - dietary fibres - high-carbohydrate diet - health food.
糖尿病饮食是糖尿病治疗的支柱之一。与糖尿病治疗相关的知识的快速发展也包括饮食方面。本文重点关注饮食在2型糖尿病治疗和动脉粥样硬化预防中的重要性。其主要目标是评估宏量营养素组成对2型糖尿病患者的影响。本文分为几个部分,每个部分都以结论结尾。第一部分探讨体重减轻。旨在减肥的饮食是有效的,它可以有效预防糖尿病,改善血糖控制并降低动脉粥样硬化的危险因素,然而,直到20多年后它才会对心血管发病率和死亡率产生影响。第二部分涉及“健康”食品。探索这一领域的研究并不具有说服力。与动脉粥样硬化相关的食物中唯一真正合理的成分是膳食纤维。重要的是均衡饮食并结合定期体育活动。第三部分关注宏量营养素的组成。结果表明,考虑到低热量饮食,高碳水化合物饮食和低碳水化合物饮食对糖尿病患者在减肥和降低糖化血红蛋白方面的效果相似,然而低碳水化合物饮食与较低的血糖变异性和减少抗糖尿病药物的需求有关。我们不知道对于高能量饮食的个体,这两种极端饮食的比较结果会如何。目前关注个体宏量营养素的质量是有用的。选择血糖指数低的含碳水化合物食物和高纤维食物,优先选择饱和脂肪酸含量低的脂肪。第四部分讨论了捷克糖尿病协会最近关于糖尿病饮食中宏量营养素组成的建议。与早期提出的饮食相比,现在建议减少富含纤维的碳水化合物的摄入量,增加饱和脂肪酸含量低的蛋白质和脂肪的摄入量。包括了专家关于这个主题的建议。关键词:动脉粥样硬化 - 糖尿病饮食 - 糖化血红蛋白 - 宏量营养素 - 低碳水化合物饮食 - 肥胖 - 膳食纤维 - 高碳水化合物饮食 - 健康食品