Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC 3065, Australia.
Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
Nutrients. 2018 Jun 6;10(6):733. doi: 10.3390/nu10060733.
We compared the impact of a high versus low energy intake first meal on glucose and insulin responses during prolonged sitting in individuals with prediabetes. Thirteen adults with overweight/obesity and prediabetes (mean ± SD age: 60 ± 6 years, BMI: 33 ± 4 kg/m²; 2 h OGTT: 8.9 ± 1.1 mmol/L) completed two randomised trials: 10 h uninterrupted sitting, incorporating three meals with matching macronutrient compositions but different energy distributions: High-Energy Breakfast (HE-BF; breakfast: 50%, lunch: 30%, dinner: 20% energy intake), Low-Energy Breakfast (LE-BF: 20%/30%/50% energy intake). Venous blood was sampled from 08:00⁻18:00 h for determination of plasma glucose and insulin concentrations, with 24 h continuous glucose monitoring (CGM). Total glucose area under the curve (AUC; +5.7 mmol/L/h, = 0.019) and mean plasma glucose concentrations (+0.5 mmol/L, = 0.014) were greater after HE-BF compared to LE-BF. In the HE-BF condition, compared to LE-BF, there was a greater incremental area under the curve (iAUC) for plasma glucose post-breakfast (+44 ± 59%, = 0.007), but lower iAUC post-lunch (−55 ± 36%, < 0.001). Total insulin AUC was greater (+480 mIU/mL/h, < 0.01) after HE-BF compared to LE-BF. Twenty-four-hour (24 h) CGM revealed no differences in mean glucose and total AUC between conditions. Compared to a low-energy first meal, a high-energy first meal elicited exaggerated plasma insulin and glucose responses until lunch but had little effect on 24 h glycaemia. During periods of prolonged sitting, adults with prediabetes may have more beneficial postprandial insulin responses to a low-energy first meal.
我们比较了高能量摄入和低能量摄入的第一餐对超重/肥胖和糖尿病前期个体长时间久坐期间血糖和胰岛素反应的影响。13 名超重/肥胖和糖尿病前期患者（平均年龄 ± 标准差为 60 ± 6 岁，BMI 为 33 ± 4 kg/m²；2 h OGTT 为 8.9 ± 1.1 mmol/L）完成了两项随机试验：10 h 不间断坐姿，摄入三种宏量营养素组成相同但能量分布不同的膳食：高能量早餐（HE-BF；早餐 50%，午餐 30%，晚餐 20%能量摄入）、低能量早餐（LE-BF：20%/30%/50%能量摄入）。从 08:00 到 18:00 抽取静脉血样，以测定血浆葡萄糖和胰岛素浓度，同时进行 24 h 连续血糖监测（CGM）。与 LE-BF 相比，HE-BF 后总血糖曲线下面积（AUC；+5.7 mmol/L/h， = 0.019）和平均血浆葡萄糖浓度（+0.5 mmol/L， = 0.014）更高。在 HE-BF 条件下，与 LE-BF 相比，早餐后血糖增量 AUC（iAUC）更大（+44 ± 59%， = 0.007），但午餐后 iAUC 更低（−55 ± 36%， < 0.001）。与 LE-BF 相比，HE-BF 后总胰岛素 AUC 更大（+480 mIU/mL/h， < 0.01）。24 h CGM 显示两种条件下平均血糖和总 AUC 无差异。与低能量的第一餐相比，高能量的第一餐会导致餐后胰岛素和血糖反应更加明显，但对 24 h 血糖几乎没有影响。在长时间久坐期间，糖尿病前期患者可能对低能量的第一餐有更有益的餐后胰岛素反应。
