Diabetes Center, Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8642, Japan.
Department of Home Care Medicine, Saiyu Clinic, 3-217-1 Sagamicho, Koshigaya-shi, Saitama 343-0823, Japan.
Nutrients. 2018 Aug 13;10(8):1080. doi: 10.3390/nu10081080.
This study aimed to elucidate the effect of an energy restricted and carbohydrate restricted diet on the management of Japanese diabetes patients. Several databases including MEDLINE, EMBASE, and the Japan Medical Abstracts Society were searched for relevant articles published prior to June 2017. The articles identified were systematically reviewed. We identified 286 articles on an energy restricted diet, assessed seven and included two studies in our review. On a carbohydrate restricted diet, 75 articles were extracted, seven articles assessed and three included in the review, of which two were the studies that were selected for the energy restricted diet group, since they compared energy restricted diets with carbohydrate restricted diets. All selected studies were on Japanese patients with type 2 diabetes. No studies for type 1 diabetes were found in our search. Two randomized controlled trials on an energy restricted diet were also included in the three studies for a carbohydrate restricted diet. All the three randomized controlled trials showed better glucose management with the carbohydrate restricted diet. Our study revealed that there is very little evidence on diets, particularly in Japanese patients with diabetes, and that the energy restricted diet, which has been recommended by the Japan Diabetes Society in the sole dietary management approach, is not supported by any scientific evidence. Our findings suggest that the carbohydrate restricted diet, but not the energy restricted diet, might have short term benefits for the management of diabetes in Japanese patients. However, since our analysis was based on a limited number of small randomized controlled trials, large scale and/or long term trials examining the dietary approaches in these patients are needed to confirm our findings.
本研究旨在阐明限制能量和碳水化合物的饮食对日本糖尿病患者管理的影响。检索了 MEDLINE、EMBASE 和日本医学文摘学会等数据库，以获取截至 2017 年 6 月前发表的相关文章。对确定的文章进行了系统评价。我们在限制能量饮食方面发现了 286 篇文章，评估了 7 篇并纳入了 2 篇研究进行综述。在限制碳水化合物饮食方面，提取了 75 篇文章，评估了 7 篇并纳入了 3 篇综述，其中 2 篇是为能量限制饮食组选择的研究，因为它们比较了能量限制饮食与碳水化合物限制饮食。所有入选的研究均为日本 2 型糖尿病患者。我们的搜索没有发现 1 型糖尿病的研究。在纳入的 3 项碳水化合物限制饮食研究中，还包括了 2 项关于能量限制饮食的随机对照试验。所有 3 项随机对照试验均显示碳水化合物限制饮食对血糖控制更有优势。我们的研究表明，关于饮食，特别是在日本糖尿病患者中，证据非常有限，而日本糖尿病学会推荐的单一饮食管理方法中的能量限制饮食，并没有任何科学证据支持。我们的研究结果表明，碳水化合物限制饮食而非能量限制饮食可能对日本患者的糖尿病管理有短期益处。然而，由于我们的分析基于少数小型随机对照试验，因此需要大规模和/或长期试验来检验这些患者的饮食方法，以确认我们的研究结果。
