Yuan Yahui, Chen Chun, Liu Qiaoyun, Luo Yehao, Yang Zhaojun, Lin YuPing, Sun Lu, Fan Guanjie
School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Food Funct. 2024 Dec 9;15(24):11961-11974. doi: 10.1039/d4fo00337c.
: Despite considerable literature supporting the benefit of dietary interventions in individuals with type 2 diabetes mellitus (T2DM) and overweight/obesity, which diet works best is currently unknown. We conducted a systematic review and network meta-analysis (NMA) to evaluate the comparative effectiveness of different dietary approaches in overweight or obese adults with T2DM. : We searched EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed up till July 2023 for controlled studies using different dietary approaches. Next, we updated the literature search to September 2024 but found no new relevant studies. Glycated hemoglobin A1c (HbA1c) levels and body weight were used as primary outcomes. For each outcome, a pooled effect was determined for each intervention compared with other interventions. Mean differences (MDs) and 95% confidence intervals (95% CIs) were computed. The surface under the cumulative ranking curve (SUCRA) was used for ranking the dietary approaches. Moreover, confidence was assessed using the CINeMA (confidence in network meta-analysis) framework. : Overall, 31 trials that compared eight diet interventions (Mediterranean, moderate-carbohydrate, low-carbohydrate, vegetarian, low-glycaemic index/load, low-fat, high-protein and control diets) and involved 3096 people were included. In terms of glycemic control, the Mediterranean diet yielded the best ranking (SUCRA: 88.15%), followed by the moderate-carbohydrate diet (SUCRA: 83.3%) and low-carbohydrate (LC) diet (SUCRA: 55.7%). In terms of anthropometric measurements, the LC diet (SUCRA: 74.6%) ranked first, followed by the moderate-carbohydrate diet (SUCRA: 68.7%) and vegetarian diet (SUCRA: 57%). These results also showed that the differences in almost all dietary patterns regarding anthropometric measurements were mostly small and often trivial. : In summary, the Mediterranean diet was the most efficient dietary intervention for the improvement of glycaemic control, and the LC diet obtained the highest score for anthropometric measurements in individuals with T2DM and concurrent overweight/obesity.
尽管有大量文献支持饮食干预对2型糖尿病（T2DM）和超重/肥胖个体有益，但目前尚不清楚哪种饮食效果最佳。我们进行了一项系统评价和网状meta分析（NMA），以评估不同饮食方法对超重或肥胖的T2DM成年人的相对有效性。
我们检索了截至2023年7月的EMBASE、Cochrane对照试验中央登记册（CENTRAL）和PubMed，以查找使用不同饮食方法的对照研究。接下来，我们将文献检索更新至2024年9月，但未发现新的相关研究。糖化血红蛋白A1c（HbA1c）水平和体重被用作主要结局指标。对于每个结局指标，确定每种干预措施与其他干预措施相比的合并效应。计算平均差异（MDs）和95%置信区间（95% CIs）。累积排序曲线下面积（SUCRA）用于对饮食方法进行排序。此外，使用CINeMA（网状meta分析的置信度）框架评估置信度。
总体而言，纳入了31项试验，这些试验比较了八种饮食干预措施（地中海饮食、适度碳水化合物饮食、低碳水化合物饮食、素食饮食、低血糖指数/负荷饮食、低脂饮食、高蛋白饮食和对照饮食），涉及3096人。在血糖控制方面，地中海饮食排名最佳（SUCRA：88.15%），其次是适度碳水化合物饮食（SUCRA：83.3%）和低碳水化合物（LC）饮食（SUCRA：55.7%）。在人体测量方面，LC饮食（SUCRA：74.6%）排名第一，其次是适度碳水化合物饮食（SUCRA：68.7%）和素食饮食（SUCRA：57%）。这些结果还表明，几乎所有饮食模式在人体测量方面的差异大多较小，且往往微不足道。
总之，地中海饮食是改善血糖控制最有效的饮食干预措施，而LC饮食在T2DM合并超重/肥胖个体的人体测量方面得分最高。
