Research Center for Nutrition and Food Safety, Institute of Military Preventive Medicine, Third Military Medical University, Chongqing Key Laboratory of Nutrition and Food Safety, Chongqing Medical Nutrition Research Center, Chongqing, China.
Department of Health Supervision, Center for Disease Control and Prevention of Shenyang Joint Logistic Support Center, Shenyang, China.
Am J Clin Nutr. 2018 Aug 1;108(2):256-265. doi: 10.1093/ajcn/nqy120.
The combined effect of a low-carbohydrate, high-protein (LCHP) diet and omega-3 (n-3) polyunsaturated fatty acid (PUFA) supplementation on patients with type 2 diabetes (T2D) is not known.
The aim of this study was to evaluate the effect of an LCHP diet combined with ω-3 (LCHP+ω-3) on glycemic control in patients with T2D.
In this randomized, double-blind, parallel-controlled trial, 122 newly diagnosed participants with T2D were randomly assigned to receive a high-carbohydrate, low-protein diet with low ω-3 PUFAs [control (CON)], an LCHP, ω-3, or LCHP+ω-3 diet for 12 wk. The ratio of carbohydrate to protein was 42:28 in the LCHP and LCHP+ω-3 diet and 54:17 in the CON and ω-3 diet. The participants were given 6 g fish oil/d (containing 3.65 g docosahexaenoic acid, eicosapentaenoic acid, and docosapentaenoic acid/d) in the ω-3 and LCHP+ω-3 diet groups or 6 g corn oil/d (placebo) in the CON and LCHP diet groups.
Compared with the CON diet group, greater decreases in glycated hemoglobin (HbA1c) and fasting glucose were observed in all of the other 3 diet groups at 12 wk. Of note, HbA1c reduction in the LCHP+ω-3 diet group (-0.51%; 95% CI: -0.64%, -0.37%) was greater than that in the LCHP (P = 0.03) and ω-3 (P = 0.01) diet groups at 12 wk. In terms of fasting glucose, only the LCHP+ω-3 diet group showed a significant decrease at 4 wk (P = 0.03 compared with CON). Moreover, the reduction in fasting glucose in the LCHP+ω-3 diet group (-1.32 mmol/L; 95% CI: -1.72, -0.93 mmol/L) was greater than that in the LCHP (P = 0.04) and ω-3 (P = 0.03) diet groups at 12 wk.
The LCHP+ω-3 diet provided greater effects on HbA1c and fasting glucose and faster effects on fasting glucose than both the LCHP and ω-3 diets, indicating the potential necessity of combining an LCHP diet with ω-3 PUFAs in T2D control. This trial was registered at chictr.org.cn/ as ChiCTR-TRC-14004704.
低碳水化合物、高蛋白（LCHP）饮食与ω-3（n-3）多不饱和脂肪酸（PUFA）联合补充对 2 型糖尿病（T2D）患者的影响尚不清楚。
本研究旨在评估 LCHP 饮食联合 ω-3（LCHP+ω-3）对 T2D 患者血糖控制的影响。
这是一项随机、双盲、平行对照试验，122 例新诊断的 T2D 患者被随机分配接受高碳水化合物、低蛋白质饮食，同时补充低 ω-3 PUFAs[对照组（CON）]、LCHP、ω-3 或 LCHP+ω-3 饮食 12 周。LCHP 和 LCHP+ω-3 饮食中碳水化合物与蛋白质的比例为 42:28，CON 和 ω-3 饮食中为 54:17。ω-3 和 LCHP+ω-3 饮食组给予 6 g 鱼油/d（含二十二碳六烯酸、二十碳五烯酸和二十二碳五烯酸/d 3.65 g），CON 和 LCHP 饮食组给予 6 g 玉米油/d（安慰剂）。
与 CON 饮食组相比，在其他 3 种饮食组中，12 周时糖化血红蛋白（HbA1c）和空腹血糖均有更大程度的降低。值得注意的是，LCHP+ω-3 饮食组的 HbA1c 降低幅度（-0.51%；95%CI：-0.64%，-0.37%）大于 LCHP（P=0.03）和 ω-3（P=0.01）饮食组。就空腹血糖而言，只有 LCHP+ω-3 饮食组在 4 周时出现显著下降（与 CON 相比，P=0.03）。此外，LCHP+ω-3 饮食组空腹血糖降低幅度（-1.32 mmol/L；95%CI：-1.72，-0.93 mmol/L）大于 LCHP（P=0.04）和 ω-3（P=0.03）饮食组。
LCHP+ω-3 饮食在控制 HbA1c 和空腹血糖方面的效果优于 LCHP 和 ω-3 饮食，且对空腹血糖的影响更快，提示在 T2D 控制中可能需要将低碳水化合物高蛋白饮食与 ω-3 PUFAs 联合应用。本试验在中国临床试验注册中心注册，注册号为 ChiCTR-TRC-14004704。
