Department of Medicine, New York University Langone Health, New York, NY, USA.
Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
J Nutr. 2021 Aug 7;151(8):2477-2485. doi: 10.1093/jn/nxab128.
The Dietary Approaches to Stop Hypertension (DASH) diet, a high-carbohydrate diet, is highly recommended based on its cardiovascular risk benefits, yet adherence remains persistently low. How subjective impressions of this diet contribute to adherence has not been thoroughly explored. The OmniCarb trial, which compared DASH-style diets varying in glycemic index (GI) and carbohydrate amount, surveyed subjective impressions of such diets.
We examined the effects of GI and carbohydrate amount on qualitative aspects of diet acceptability through secondary outcomes in the OmniCarb trial.
OmniCarb was a randomized, crossover trial of 4 DASH-style diets varying by GI (≥65 compared with ≤45) and carbohydrate amount (40% compared with 58% kcal) in overweight or obese (BMI ≥25 kg/m2) adults (n = 163). Participants consumed each diet in random order over 5-wk periods, separated by 2-wk washouts. At baseline and the end of each feeding period, participants rated hunger, diet satisfaction, and gastrointestinal symptoms (diarrhea/loose stools, constipation, bloating, nausea, and heartburn).
Participant mean age was 52 y, with 52% women, 51% non-Hispanic black, and 56% obese (BMI ≥30). Compared with baseline, all intervention diets decreased heartburn, increased diarrhea/loose stools, and increased bloating, but did not significantly affect constipation or nausea. Compared with lower carbohydrate diets, higher carbohydrate diets increased hunger (RR: 1.16; 95% CI: 1.04, 1.30), increased diet satisfaction (RR: 1.10; 95% CI: 1.01, 1.20), and increased heartburn (RR: 1.49; 95% CI: 1.09, 2.04). Compared with lower GI diets, higher GI diets did not affect hunger (RR: 0.92; 95% CI: 0.83, 1.02), decreased diet satisfaction (RR: 0.83; 95% CI: 0.75, 0.92), and did not affect heartburn (RR: 0.89; 95% CI: 0.70, 1.13). There were no between-diet differences for diarrhea/loose stools, constipation, bloating, and nausea.
Although a higher carbohydrate amount in DASH-style diets can increase diet satisfaction, it can also decrease satiety and increase heartburn in adults with overweight or obesity.This trial is registered at clinicaltrials.gov as NCT00608049.
基于其对心血管风险的益处，高碳水化合物的饮食方法——得舒饮食（DASH）被强烈推荐，但人们的依从性仍然很低。人们对这种饮食的主观印象如何影响其依从性，尚未得到充分探索。OmniCarb 试验比较了不同血糖指数（GI）和碳水化合物含量的 DASH 饮食，调查了人们对这些饮食的主观印象。
我们通过 OmniCarb 试验的次要结果，研究了 GI 和碳水化合物含量对饮食可接受性的定性方面的影响。
OmniCarb 是一项在超重或肥胖（BMI≥25 kg/m2）成年人中进行的随机、交叉试验，比较了 4 种不同 GI（≥65 与≤45）和碳水化合物含量（40%与 58%卡路里）的 DASH 饮食。参与者以随机顺序在 5 周的时间内分别食用每种饮食，中间用 2 周的洗脱期隔开。在基线和每个喂养期结束时，参与者评估饥饿感、饮食满意度和胃肠道症状（腹泻/稀便、便秘、腹胀、恶心和烧心）。
参与者的平均年龄为 52 岁，其中 52%为女性，51%为非西班牙裔黑人，56%为肥胖（BMI≥30）。与基线相比，所有干预饮食都降低了烧心，增加了腹泻/稀便，并增加了腹胀，但对便秘或恶心没有显著影响。与低碳水化合物饮食相比，高碳水化合物饮食增加了饥饿感（RR：1.16；95%CI：1.04，1.30），增加了饮食满意度（RR：1.10；95%CI：1.01，1.20），并增加了烧心（RR：1.49；95%CI：1.09，2.04）。与低 GI 饮食相比，高 GI 饮食对饥饿感没有影响（RR：0.92；95%CI：0.83，1.02），降低了饮食满意度（RR：0.83；95%CI：0.75，0.92），对烧心没有影响（RR：0.89；95%CI：0.70，1.13）。腹泻/稀便、便秘、腹胀和恶心在不同饮食之间没有差异。
尽管 DASH 饮食中较高的碳水化合物含量可以提高饮食满意度，但也会降低成年人的饱腹感，并增加其烧心的风险。这项试验在 clinicaltrials.gov 注册为 NCT00608049。
