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未加工的不溶性纤维可降低2型糖尿病患者的餐后高血糖:一项随机试验。

Postprandial hyperglycemia in patients with type 2 diabetes is reduced by raw insoluble fiber: A randomized trial.

作者信息

Moreira Fernanda Duarte, Mendes Guilherme F, Nascimento Gabriel D M, Reis Caio E G, Gallassi Andrea D, Welker Alexis F

机构信息

Universidade de Brasilia, Brazil.

Nutrition Department, Catholic University of Brasília, Brasilia, Brazil.

出版信息

Nutr Metab Cardiovasc Dis. 2024 Dec;34(12):2673-2679. doi: 10.1016/j.numecd.2023.09.013. Epub 2023 Dec 10.

Abstract

BACKGROUND AND AIMS

A lower risk of type 2 diabetes mellitus (T2DM) is associated with the intake of insoluble fiber. This contradicts the postulate that insoluble fibers do not decrease postprandial glycemic response and that only viscous gel-forming soluble fibers would do this. This study aimed to investigate the effect of a dose of insoluble fibers that meets dietary recommendations on postprandial hyperglycemia in T2DM patients.

METHODS AND RESULTS

This is a randomized crossover clinical trial. Nineteen T2DM men randomly ate a balanced breakfast either without (Control) or with prior consumption of insoluble fibers (5.8 g) in the form of 15 g of raw wheat bran (RWB). Glycemia was measured at fasting and 15, 30, 45, 60, 90, and 120 min postprandially. Markers of taste intensity and palatability were assessed after breakfast intake. The glucose peak rise of 87 mg/dL and the incremental area under the curve (AUC) elicited by the breakfast were decreased by RWB (15.80 % and 23.14 %, respectively). Time-to-glucose-peak did not differ between groups. The addition of the RWB to the meal decreased its level of creaminess and tasty and increased the sourness and bitterness.

CONCLUSIONS

The postprandial hyperglycemia in T2DM patients in response to complex carbohydrates was decreased by prior intake of a recommended dose of raw insoluble fibers. This antihyperglycemic effect is in accordance with the acarbose-like property of raw insoluble fibres, but not of heated ones (e.g., bread and pasta), to inhibit the activities of the carbohydrate-digesting enzymes alpha-glucosidase/alpha-amylase.

REGISTRATION NUMBER FOR CLINICAL TRIALS

RBR-98tx28b (https://ensaiosclinicos.gov.br/rg/RBR-98tx28b).

摘要

背景与目的

2型糖尿病(T2DM)风险较低与不溶性纤维的摄入有关。这与一种假设相矛盾,即不溶性纤维不会降低餐后血糖反应,只有形成粘性凝胶的可溶性纤维才会有此作用。本研究旨在调查符合饮食建议剂量的不溶性纤维对T2DM患者餐后高血糖的影响。

方法与结果

这是一项随机交叉临床试验。19名T2DM男性随机食用一份均衡早餐,一份不添加任何物质(对照组),另一份在食用前摄入15克生麦麸(RWB)形式的不溶性纤维(5.8克)。在空腹以及餐后15、30、45、60、90和120分钟测量血糖。早餐摄入后评估味觉强度和适口性指标。RWB使早餐引起的血糖峰值升高87mg/dL以及曲线下增量面积(AUC)分别降低(分别降低15.80%和23.14%)。两组之间血糖达到峰值的时间没有差异。在餐食中添加RWB会降低其奶油感和美味程度,并增加酸味和苦味。

结论

T2DM患者在摄入复合碳水化合物后,预先摄入推荐剂量的生不溶性纤维可降低餐后高血糖。这种降血糖作用与生不溶性纤维(而非加热后的纤维,如面包和意大利面)类似阿卡波糖的特性相符,即抑制碳水化合物消化酶α-葡萄糖苷酶/α-淀粉酶的活性。

临床试验注册号

RBR-98tx28b(https://ensaiosclinicos.gov.br/rg/RBR-98tx28b)

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