Casagrande S S, Cowie C C
Social & Scientific Systems, Inc., Silver Spring, MD, USA.
Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
J Hum Nutr Diet. 2017 Aug;30(4):479-489. doi: 10.1111/jhn.12443. Epub 2017 Feb 2.
Dietary recommendations for adults with diabetes are to follow a healthy diet in appropriate portion sizes. We determined recent trends in energy and nutrient intakes among a nationally representative sample of US adults with and without type 2 diabetes.
Participants were adults aged ≥20 years from the cross-sectional National Health and Nutrition Examination Surveys, 1988-2012 (N = 49 770). Diabetes was determined by self-report of a physician's diagnosis (n = 4885). Intake of energy and nutrients were determined from a 24-h recall by participants of all food consumed. Linear regression was used to test for trends in mean intake over time for all participants and by demographic characteristics.
Among adults with diabetes, overall total energy intake increased between 1988-1994 and 2011-2012 (1689 kcal versus 1895 kcal; P < 0.001) with evidence of a plateau between 2003-2006 and 2011-2012. In 2007-2012, energy intake was greater for younger than older adults, for men than women, and for non-Hispanic whites versus non-Hispanic blacks. There was no change in the percentage of calories from carbohydrate, total fat or protein. Percentage of calories from saturated fat was similar across study periods but remained above recommendations (11.2% in 2011-2012). Fibre intake significantly decreased and remained below recommendations (P = 0.002). Sodium, cholesterol and calcium intakes increased. There was no change in energy intake among adults without diabetes and dietary trends were similar to those with diabetes.
Future data are needed to confirm a plateau in energy intake among adults with diabetes, although the opportunity exists to increase fibre and reduce saturated fat.
针对成年糖尿病患者的饮食建议是遵循健康饮食并控制适当的份量。我们在美国有和没有2型糖尿病的成年人群体的全国代表性样本中，确定了能量和营养摄入的近期趋势。
参与者为1988 - 2012年横断面全国健康与营养检查调查中年龄≥20岁的成年人（N = 49770）。糖尿病通过医生诊断的自我报告确定（n = 4885）。能量和营养的摄入量通过参与者对所消费的所有食物的24小时回忆来确定。使用线性回归来检验所有参与者以及按人口统计学特征划分的平均摄入量随时间的趋势。
在患有糖尿病的成年人中，1988 - 1994年至2011 - 2012年期间总体总能量摄入量增加（1689千卡对1895千卡；P < 0.001），且有证据表明在2003 - 2006年至2011 - 2012年期间趋于平稳。在2007 - 2012年，年轻人的能量摄入量高于老年人，男性高于女性，非西班牙裔白人高于非西班牙裔黑人。来自碳水化合物、总脂肪或蛋白质的卡路里百分比没有变化。来自饱和脂肪的卡路里百分比在各研究期间相似，但仍高于推荐水平（2011 - 2012年为11.2%）。纤维摄入量显著下降且仍低于推荐水平（P = 0.002）。钠、胆固醇和钙的摄入量增加。没有糖尿病的成年人能量摄入量没有变化，饮食趋势与患有糖尿病的成年人相似。
尽管有机会增加纤维摄入量并减少饱和脂肪，但需要未来的数据来证实成年糖尿病患者的能量摄入量趋于平稳。
