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脂肪摄入对 1 型糖尿病儿童和青少年血糖控制及心血管危险因素的影响。

Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes.

机构信息

Department of Surgical Sciences, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolic Disorders, University of Verona, 37126 Verona, Italy.

Department of Pediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, S-405 30 Gothenburg, Sweden.

出版信息

Nutrients. 2021 Jul 29;13(8):2625. doi: 10.3390/nu13082625.

Abstract

Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.

摘要

营养治疗是 1 型糖尿病(T1D)管理的基石。血糖控制受饮食成分的影响,这可能导致糖尿病并发症的发展。然而,宏量营养素的具体作用仍存在争议,特别是脂肪摄入。本综述旨在评估儿童和青少年 T1D 患者的脂肪摄入与血糖控制、心血管风险因素、炎症和微生物群之间的关系。高脂肪餐会导致餐后血糖延迟和持续升高,并且经常有报道称,摄入大量脂肪的 T1D 个体的糖化血红蛋白 A1c 水平较高。高脂肪摄入还与心血管风险增加有关,而糖尿病患者的心血管风险高于健康受试者。最后,高脂肪餐通过不同的机制导致餐后促炎反应,包括肠道微生物群的改变。不同的脂肪酸被认为在代谢调节中具有特定的作用,但仍需要进一步的研究。总之,现有证据表明,T1D 儿童和青少年应避免高脂肪摄入,应鼓励他们遵循 ISPAD 和 ADA 建议的健康均衡饮食。这种营养选择可能有助于降低心血管风险和炎症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced4/8401117/4c31dc61556e/nutrients-13-02625-g001.jpg

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