Adeva-Andany María M, González-Lucán Manuel, Fernández-Fernández Carlos, Carneiro-Freire Natalia, Seco-Filgueira Mónica, Pedre-Piñeiro Ana María
Internal Medicine Department, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain.
Internal Medicine Department, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain.
Clin Nutr ESPEN. 2019 Oct;33:29-38. doi: 10.1016/j.clnesp.2019.05.014. Epub 2019 Jun 6.
Diet composition has a marked impact on the risk of developing type 2 diabetes and cardiovascular disease. Prospective studies show that dietary patterns with elevated amount of animal products and low quantity of vegetable food items raise the risk of these diseases. In healthy subjects, animal protein intake intensifies insulin resistance whereas plant-based foods enhance insulin sensitivity. Similar effects have been documented in patients with diabetes. Accordingly, pre-pregnancy intake of meat (processed and unprocessed) has been strongly associated with a higher risk of gestational diabetes whereas greater pre-pregnancy vegetable protein consumption is associated with a lower risk of gestational diabetes. Population groups that modify their traditional dietary habit increasing the amount of animal products while reducing plant-based foods experience a remarkable rise in the frequency of type 2 diabetes. The association of animal protein intake with insulin resistance is independent of body mass index. In obese individuals that consume high animal protein diets, insulin sensitivity does not improve following weight loss. Diets aimed to lose weight that encourage restriction of carbohydrates and elevated consumption of animal protein intensify insulin resistance increasing the risk of developing type 2 diabetes and cardiovascular disease. The effect of dietary components on insulin sensitivity may contribute to explain the striking impact of eating habits on the risk of type 2 diabetes and cardiovascular disease. Insulin resistance predisposes to type 2 diabetes in healthy subjects and deteriorates metabolic control in patients with diabetes. In nondiabetic and diabetic individuals, insulin resistance is a major cardiovascular risk factor.
饮食构成对2型糖尿病和心血管疾病的发病风险有显著影响。前瞻性研究表明,动物产品含量高而植物性食物含量低的饮食模式会增加这些疾病的风险。在健康受试者中,动物蛋白摄入会增强胰岛素抵抗,而植物性食物则会提高胰岛素敏感性。糖尿病患者也有类似的情况。因此,孕前摄入肉类(加工和未加工)与妊娠期糖尿病的较高风险密切相关,而孕前摄入更多植物蛋白则与妊娠期糖尿病的较低风险相关。改变传统饮食习惯、增加动物产品摄入量同时减少植物性食物的人群,2型糖尿病的发病率显著上升。动物蛋白摄入与胰岛素抵抗的关联独立于体重指数。在食用高动物蛋白饮食的肥胖个体中,体重减轻后胰岛素敏感性并未改善。旨在减肥的饮食若鼓励限制碳水化合物并增加动物蛋白的摄入量,会增强胰岛素抵抗,增加患2型糖尿病和心血管疾病的风险。饮食成分对胰岛素敏感性的影响可能有助于解释饮食习惯对2型糖尿病和心血管疾病风险的显著影响。胰岛素抵抗使健康受试者易患2型糖尿病,并使糖尿病患者的代谢控制恶化。在非糖尿病和糖尿病个体中,胰岛素抵抗是主要的心血管危险因素。