Kim Yoona, Keogh Jennifer B, Clifton Peter M
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Metabolism. 2017 Mar;68:173-183. doi: 10.1016/j.metabol.2016.12.011. Epub 2016 Dec 27.
Red and processed meat and refined grains are associated with an increased risk of type 2 diabetes. Interventions are limited. We hypothesized that a diet high in red and processed meat and refined grains (HMD) would decrease insulin sensitivity compared to a diet high in whole grains, nuts, dairy and legumes with no red meat (HWD).
Forty-nine subjects without diabetes [15 men and 34 women, age, 35.6±15.7 years, body mass index (BMI), 27±5.9kg/m] underwent two 4-week weight-stable dietary interventions in a randomized crossover design. The insulin sensitivity index (ISI) was calculated from the last 30min of a continuous low-dose insulin (25mU/kg·h) and glucose (4mg/kg·min) infusion test (LDIGIT ) at the end of each diet.
The population fell into two very discrete groups: those with a very low insulin response in the LDIGIT on HMD (Group 1<56pmol/L, n=24), and those with relatively normal insulin responses (Group 2>56pmol/L, n=25). Group 2 had significantly higher insulin concentrations [(median and interquartile range) 153, 180 for HMD vs. 123, 149pmol/L for HWD; P=0.019] and glucose concentrations [(mean±standard deviation) 7.4±1.3 for HMD vs.6.7±1.2mmol/L for HWD; P=0.05], resulting in a significantly decreased ISI [(median and interquartile range) 21.1, 34.2 for HMD vs. 31.6, 39.4 for HWD; P=0.014] compared to HWD. Log ISI after HMD was significantly correlated with BMI (r=-0.5; P=0.009), fat mass (r=-0.55; P=0.004) and self-reported activity levels (r=-0.45; P=0.024).
A dietary pattern high in red and processed meat and refined grains decreased insulin sensitivity compared to a dietary pattern high in whole grains, nuts, dairy products and legumes only in relatively insulin-resistant adults.
红肉、加工肉类和精制谷物与2型糖尿病风险增加有关。相关干预措施有限。我们假设，与富含全谷物、坚果、乳制品和豆类且不含红肉的饮食（HWD）相比，富含红肉、加工肉类和精制谷物的饮食（HMD）会降低胰岛素敏感性。
49名无糖尿病受试者[15名男性和34名女性，年龄35.6±15.7岁，体重指数（BMI）27±5.9kg/m²]采用随机交叉设计接受了两次为期4周的体重稳定饮食干预。胰岛素敏感性指数（ISI）是在每种饮食结束时通过连续低剂量胰岛素（25mU/kg·h）和葡萄糖（4mg/kg·min）输注试验（LDIGIT）的最后30分钟计算得出的。
研究人群分为两个非常不同的组：在HMD饮食的LDIGIT试验中胰岛素反应极低的人群（第1组<56pmol/L，n = 24），以及胰岛素反应相对正常的人群（第2组>56pmol/L，n = 25）。第2组的胰岛素浓度显著更高[（中位数和四分位间距）HMD组为153, 180，HWD组为123, 149pmol/L；P = 0.019]和血糖浓度[（平均值±标准差）HMD组为7.4±1.3，HWD组为6.7±1.2mmol/L；P = 0.05]，与HWD相比，导致ISI显著降低[（中位数和四分位间距）HMD组为21.1, 34.2，HWD组为31.6, 39.4；P = 0.014]。HMD饮食后的对数ISI与BMI（r = -0.5；P = 0.009）、脂肪量（r = -0.55；P = 0.004）和自我报告的活动水平（r = -0.45；P = 0.024）显著相关。
与仅富含全谷物、坚果、乳制品和豆类的饮食模式相比，富含红肉、加工肉类和精制谷物的饮食模式仅在相对胰岛素抵抗的成年人中降低了胰岛素敏感性。
