Diabetes Unit, Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel; Department of Internal Medicine, Diabetes Unit, Hospital de Clinicas Caracas, Central University, Caracas, Venezuela.
Diabetes Unit, Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
J Nutr Biochem. 2017 Nov;49:1-7. doi: 10.1016/j.jnutbio.2017.07.005. Epub 2017 Jul 21.
Acute studies show that addition of whey protein at breakfast has a glucose-lowering effect through increased incretin and insulin secretion. However, whether this is a long-term effect in Type 2 diabetes is unknown. Fifty-six Type 2 diabetes participants aged 58.9±4.5 years, BMI 32.1±0.9 kg/m and HbA 7.8±0.1% (61.6±0.79 mmol/mol) were randomized to one of 3 isocaloric diets with similar lunch and dinner, but different breakfast: 1) 42 g total protein, 28 g whey (WBdiet, n=19); 2) 42 g various protein sources (PBdiet, n=19); or 3) high-carbohydrate breakfast, 17 g protein from various sources (CBdiet, n=18). Body weight and HbA were examined after 12 weeks. All participants underwent three all-day meal challenges for postprandial glycemia, insulin, C-peptide, intact glucagon-like peptide 1 (iGLP-1), ghrelin and hunger and satiety scores. Overall postprandial AUC was reduced by 12% in PBdiet and by 19% in WBdiet, compared with CBdiet (P<.0001). Compared with PBdiet and CBdiet, WBdiet led to a greater postprandial overall AUC for insulin, C-peptide, iGLP-1 and satiety scores, while postprandial overall AUC for ghrelin and hunger scores were reduced (P<.0001). After 12 weeks, HbA was reduced after WBdiet by 0.89±0.05% (11.5±0.6 mmol/mol), after PBdiet by 0.6±0.04% (7.1±0.31 mmol/mol) and after CBdiet by 0.36±0.04% (2.9±0.31 mmol/mol) (P<.0001). Furthermore, the participants on WBdiet lost 7.6±0.3 kg, PBdiet 6.1±0.3 kg and CBdiet 3.5±0.3 kg (P<.0001). Whey protein-based breakfast is an important adjuvant in the management of Type 2 diabetes.
急性研究表明，早餐时添加乳清蛋白通过增加肠促胰岛素和胰岛素分泌来降低血糖。然而，在 2 型糖尿病中这是否是长期效果尚不清楚。56 名年龄 58.9±4.5 岁、BMI 32.1±0.9kg/m 和 HbA 7.8±0.1%（61.6±0.79mmol/mol）的 2 型糖尿病患者被随机分配到 3 种等热量饮食中的 1 种，午餐和晚餐相似，但早餐不同：1）42g 总蛋白，28g 乳清（WBdiet，n=19）；2）42g 各种蛋白质来源（PBdiet，n=19）；或 3）高碳水化合物早餐，17g 来自各种来源的蛋白质（CBdiet，n=18）。12 周后检查体重和 HbA。所有参与者进行了 3 次全天餐挑战以检测餐后血糖、胰岛素、C 肽、完整胰高血糖素样肽 1（iGLP-1）、胃饥饿素和饥饿感和饱腹感评分。与 CBdiet 相比，PBdiet 和 WBdiet 使餐后总 AUC 降低 12%和 19%（P<.0001）。与 PBdiet 和 CBdiet 相比，WBdiet 导致胰岛素、C 肽、iGLP-1 和饱腹感评分的餐后总 AUC 更大，而胃饥饿素和饥饿评分的餐后总 AUC 降低（P<.0001）。12 周后，WBdiet 使 HbA 降低 0.89±0.05%（11.5±0.6mmol/mol），PBdiet 降低 0.6±0.04%（7.1±0.31mmol/mol），CBdiet 降低 0.36±0.04%（2.9±0.31mmol/mol）（P<.0001）。此外，接受 WBdiet 的参与者体重减轻了 7.6±0.3kg，PBdiet 组体重减轻了 6.1±0.3kg，CBdiet 组体重减轻了 3.5±0.3kg（P<.0001）。乳清蛋白早餐是 2 型糖尿病管理的重要辅助手段。
