Scully Kevin J, Truex Laura, Brennan Alina, Fowler Robert, Sawicki Gregory S, Uluer Ahmet, Ludwig David S, Ebbeling Cara B, Langlais Leah, Dziok Angela, Freedman Steven D, Putman Melissa S
Division of Endocrinology, Hasbro Children's Hospital, Providence, RI, United States.
Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, United States.
Front Nutr. 2024 Sep 25;11:1441201. doi: 10.3389/fnut.2024.1441201. eCollection 2024.
To achieve and maintain adequate weight, people with cystic fibrosis (CF) May often consume energy-dense, nutrient-poor foods high in added sugars and refined carbohydrates; however, little is known about the glycemic and metabolic effects of dietary composition in this patient population. The objective of this pilot study was to investigate the safety and tolerability of a low glycemic load (LGL) diet in adults with CF and abnormal glucose tolerance (AGT).
Ten adults with CF and AGT completed this prospective, open-label pilot study. Mean age was 27.0 ± 2.1 years, 64% were female, and all had pancreatic insufficiency. Each participant followed his/her typical diet for 2 weeks, then transitioned to a LGL diet via meal delivery service for 8 weeks. The primary outcome was change in weight from baseline to study completion, with safety established if no significant decline was noted. Other key safety outcomes included change in hypoglycemia measured by patient report and continuous glucose monitoring (CGM). Exploratory outcomes included changes in other CGM measures, body composition by dual energy X-ray absorptiometry (DXA), and patient reported outcomes.
There were no significant changes in weight or in subjectively-reported or objectively-measured hypoglycemia. Favorable non-significant changes were noted in CGM measures of hyperglycemia and glycemic variability, DXA measures of fat mass, and gastrointestinal symptom surveys.
A LGL dietary intervention was safe and well tolerated in adults with CF and AGT. These results lay the groundwork for future trials investigating the impact of low-glycemic dietary interventions on metabolic outcomes in the CF population.
为了达到并维持适当体重,囊性纤维化(CF)患者可能经常食用能量密集、营养匮乏且添加糖和精制碳水化合物含量高的食物;然而,对于该患者群体饮食组成的血糖和代谢影响知之甚少。这项初步研究的目的是调查低血糖负荷(LGL)饮食在患有CF且糖耐量异常(AGT)的成年人中的安全性和耐受性。
10名患有CF和AGT的成年人完成了这项前瞻性、开放标签的初步研究。平均年龄为27.0±2.1岁,64%为女性,且均有胰腺功能不全。每位参与者先按照其典型饮食持续2周,然后通过送餐服务过渡到LGL饮食,持续8周。主要结局是从基线到研究结束时体重的变化,若未观察到显著下降则确定为安全。其他关键安全结局包括通过患者报告和持续葡萄糖监测(CGM)测得的低血糖变化。探索性结局包括其他CGM指标的变化、双能X线吸收法(DXA)测量的身体成分以及患者报告的结局。
体重、主观报告或客观测量的低血糖均无显著变化。在高血糖和血糖变异性的CGM指标、脂肪量的DXA测量以及胃肠道症状调查中观察到了有利的非显著变化。
LGL饮食干预在患有CF和AGT的成年人中是安全且耐受性良好的。这些结果为未来研究低血糖饮食干预对CF人群代谢结局影响的试验奠定了基础。