DiNicolantonio James J, O'Keefe James H
James J. DiNicolantonio, PharmD, MSMA member since 2003, are at Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
James H. O'Keefe, MD, MSMA member since 2003, are at Saint Luke's Mid America Heart Institute, Kansas City, Missouri.
Mo Med. 2017 Jul-Aug;114(4):303-307.
Recently, debate has erupted in both the scientific community and throughout the lay public around whether a low-fat or low-carbohydrate diet is better for weight loss. In other words, is it better to cut fat or cut carbohydrate for weight loss. However, going beyond this debate (fat versus carbohydrate), are questions around whether certain fatty acids are worse for promoting insulin resistance, inflammation, and obesity. The overall evidence in the literature suggests that medium-chain saturated fats (such as lauric acid, found in coconut oil) and monounsaturated fat (oleic acid, found in olive oil) are less likely to promote insulin resistance, inflammation, and fat storage compared to long-chain saturated fatty acids (such as stearic acid found in large quantities in butter, but particularly palmitic acid found in palm oil) especially when consumed on top of a diet moderate in refined carbohydrates. Compared to long-chain saturated fats, lauric acid and oleic acid have an increased fatty acid oxidation rate, are more likely to be burned for energy and less likely to be stored in adipose tissue, and thus promote increased energy expenditure. Omega-6 polyunsaturated fatty acids (PUFAs), such as linoleic acid, as found in vegetable oils may contribute to obesity, whereas omega-3 PUFA may be protective. Importantly, both olive oil as part of a Mediterranean diet, and omega-3 from fish and fish oil have been proven to reduce risk of cardiovascular (CV) events.
最近，科学界和普通大众都围绕低脂饮食还是低碳水化合物饮食更有利于减肥展开了争论。换句话说，为了减肥，减少脂肪摄入还是减少碳水化合物摄入更好呢？然而，除了这场争论（脂肪与碳水化合物之争）之外，还有一些问题，即某些脂肪酸是否在促进胰岛素抵抗、炎症和肥胖方面更有害。文献中的总体证据表明，与长链饱和脂肪酸（如黄油中大量存在的硬脂酸，但棕榈油中特别富含的棕榈酸）相比，中链饱和脂肪（如椰子油中的月桂酸）和单不饱和脂肪（橄榄油中的油酸）在与适量精制碳水化合物饮食一起食用时，不太可能促进胰岛素抵抗、炎症和脂肪储存。与长链饱和脂肪相比，月桂酸和油酸的脂肪酸氧化率更高，更有可能被燃烧供能，而不太可能储存在脂肪组织中，因此能促进能量消耗增加。欧米伽-6多不饱和脂肪酸（PUFAs），如植物油中的亚油酸，可能会导致肥胖，而欧米伽-3多不饱和脂肪酸可能具有保护作用。重要的是，橄榄油作为地中海饮食的一部分，以及鱼类和鱼油中的欧米伽-3已被证明可以降低心血管（CV）事件的风险。
