Lipids and Atherosclerosis Unit, Unidad de Gestión Clinica Medicina Interna, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Av. Menendez Pidal, S/N. 14004, Córdoba, Spain.
CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
Eur J Nutr. 2023 Jun;62(4):1903-1913. doi: 10.1007/s00394-022-03080-x. Epub 2023 Mar 4.
Diabetes remission is a phenomenon described in the context of drastic weight loss due to bariatric surgery or low-calorie diets. Evidence suggests that increasing the intake of plant protein could reduce the risk of type 2 diabetes. We sought for association between changes in plant protein intake in the context of 2 healthy diets without weight loss nor glucose-lowering medication, and diabetes remission in coronary heart disease patients from the CORDIOPREV study.
Newly diagnosed type 2 diabetes participants without glucose-lowering treatment were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was assessed with a median follow-up of 60 months according to the ADA recommendation. Information on patient's dietary intake was collected using food-frequency questionnaires. At first year of intervention, 177 patients were classified according to changes in plant protein consumption into those who increased or decreased its intake, in order to perform an observational analysis on the association between protein intake and diabetes remission.
Cox regression showed that patients increasing plant protein intake were more likely to remit from diabetes than those who decreased its intake (HR = 1.71(1.05-2.77)). The remission occurred mainly at first and second year of follow-up with diminished number of patients achieving remission in the third year onwards. The increase in plant protein was associated with lower intake of animal protein, cholesterol, saturated fatty acids, and fat, and with higher intake of whole grains, fibre, carbohydrates, legumes, and tree nuts.
These results support the need to increase protein intake of vegetal origin as dietary therapy to reverse type 2 diabetes in the context of healthy diets without weight loss.
糖尿病缓解是在减重手术或低热量饮食导致体重急剧下降的背景下描述的一种现象。有证据表明，增加植物蛋白的摄入可以降低 2 型糖尿病的风险。我们在没有体重减轻或降低血糖药物的情况下，寻找 2 种健康饮食中植物蛋白摄入量的变化与冠心病患者糖尿病缓解之间的关联，这是 CORDIOPREV 研究的一部分。
新诊断的 2 型糖尿病患者未经降血糖治疗，随机接受地中海饮食或低脂饮食。根据 ADA 建议，中位数随访 60 个月评估 2 型糖尿病缓解情况。使用食物频率问卷收集患者饮食摄入信息。在干预的第一年，根据植物蛋白摄入量的变化，将 177 名患者分为增加或减少其摄入量的患者，以便对蛋白质摄入与糖尿病缓解之间的关系进行观察性分析。
Cox 回归显示，与减少植物蛋白摄入量的患者相比，增加植物蛋白摄入量的患者更有可能从糖尿病中缓解（HR=1.71（1.05-2.77））。缓解主要发生在随访的第一年和第二年，此后第三年及以后达到缓解的患者数量减少。植物蛋白的增加与动物蛋白、胆固醇、饱和脂肪酸和脂肪的摄入量减少，以及全谷物、纤维、碳水化合物、豆类和坚果的摄入量增加有关。
这些结果支持在没有体重减轻的健康饮食中，增加植物性蛋白质作为饮食疗法逆转 2 型糖尿病的必要性。
