Medeiros Fharlley Lohann, Fernandes Ana Carolina, Kraemer Mariana V S, Padovan Marina, Bernardo Greyce Luci, Uggioni Paula Lazzarin, Rafacho Alex, Proença Rossana P C
Graduate Program in Nutrition and Nutrition in Foodservice Research Centre, Federal University of Santa Catarina (UFSC), Florianópolis 88040-370, SC, Brazil.
Laboratory of Investigation in Chronic Diseases, Center of Biological Sciences, Federal University of Santa Catarina (UFSC), Florianópolis 88037-000, SC, Brazil.
Nutrients. 2025 Mar 18;17(6):1061. doi: 10.3390/nu17061061.
This study aimed to review the structural concepts, definition, classification, and macronutrient and food composition of carbohydrate-restricted diets (CRDs) for individuals with type 2 diabetes mellitus (T2DM). A scoping review was conducted following Joanna Briggs Institute guidelines. Searches were performed in Scopus, PubMed, Web of Science, and Embase, including texts published in Portuguese, English, and Spanish. Official documents from governments, regulatory agencies, and international diabetes organizations were also consulted. In total, 79 articles and 17 official documents were analyzed. The following structural concept was identified: restricted carbohydrate intake decreases the need for endogenous and exogenous insulin, contributing to the maintenance of glycemic control, and justifies its consideration among the nutritional therapy options for individuals with T2DM. CRDs varied in definition, classification, and macronutrient composition. Studies failed to provide detailed information on the food composition of diets, precluding an in-depth understanding of metabolic effects. The existence of several approaches with varying recommendations makes it difficult to generalize the results. International CRD guidelines for T2DM adopt divergent definitions, compromising interpretation, recommendation, and even adherence. Although the concept of CRDs justifies their adoption within the nutritional therapy choices for T2DM, the multiple denominations can hinder understanding and comparison between studies. The lack of information on food composition and carbohydrate types compromises the assessment of the effects and adherence to CRD-based nutritional interventions. We emphasize the need for methodologically consistent studies that evaluate CRDs based on fresh and minimally processed foods with a low glycemic index to support official diabetes guidelines and organizations.
本研究旨在综述2型糖尿病（T2DM）患者碳水化合物限制饮食（CRD）的结构概念、定义、分类以及常量营养素和食物组成。按照乔安娜·布里格斯研究所的指南进行了一项范围综述。在Scopus、PubMed、科学网和Embase中进行了检索，包括葡萄牙语、英语和西班牙语发表的文献。还查阅了政府、监管机构和国际糖尿病组织的官方文件。总共分析了79篇文章和17份官方文件。确定了以下结构概念：限制碳水化合物摄入可减少内源性和外源性胰岛素需求，有助于维持血糖控制，这也证明了其在T2DM患者营养治疗选择中的合理性。CRD在定义、分类和常量营养素组成方面存在差异。研究未能提供饮食食物组成的详细信息，妨碍了对代谢效应的深入理解。存在多种不同建议的方法，使得结果难以推广。国际T2DM的CRD指南采用不同的定义，影响了对其的解释、推荐甚至依从性。尽管CRD的概念证明了其在T2DM营养治疗选择中的应用合理性，但多种命名方式可能会妨碍研究之间的理解和比较。缺乏食物组成和碳水化合物类型方面的信息，影响了对基于CRD的营养干预效果的评估和依从性。我们强调需要进行方法学上一致的研究，基于低血糖指数的新鲜和最少加工的食物来评估CRD，以支持官方糖尿病指南和组织。
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