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2型糖尿病预防的综合策略:饮食与运动的作用。

Integrated strategies for type 2 diabetes prevention: The role of diet and exercise.

作者信息

Tecce Nicola, Proganò Mattia, Menafra Davide, Docimo Annamaria, Zarrilli Stefano, Scairati Roberta, Lisa Pelosi Anna, Pivonello Rosario, Colao Annamaria

机构信息

Department of Clinical Medicine and Surgery, Department of Endocrinology, University Federico II of Naples, Naples, Italy.

Unesco Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy.

出版信息

AIMS Public Health. 2025 Apr 8;12(2):418-450. doi: 10.3934/publichealth.2025024. eCollection 2025.

Abstract

BACKGROUND

Type 2 diabetes (T2D) is a prevalent global health problem largely caused by lifestyle factors, including poor diet and physical inactivity. With the increasing incidence of T2D, effective prevention strategies are urgently needed. This review examines the role of different dietary patterns and exercise regimens in the prevention and management of T2D, focusing on their effects on glycemic control, insulin sensitivity, and cardiovascular health.

METHODS

A narrative review was conducted synthesizing evidence from clinical trials, cohort studies, and meta-analyses. The review focused on the effects of low-carbohydrate diets (LCDs), Mediterranean diets (MDs), plant-based diets, high-protein diets (HPDs), and various exercise regimens, including aerobic, resistance, and high-intensity interval training (HIIT).

RESULTS

Dietary interventions, particularly MD and plant-based diets, are associated with improved glycemic control and reduced risk of developing T2D. LCDs show short-term benefits for weight management and HbA1c reduction, although adherence remains a challenge. HPDs show mixed results, with some benefits for lipid profiles but inconsistent effects on glycemic control. Exercise programs, especially combined aerobic and resistance training, significantly improve glycemic control, insulin sensitivity, and cardiovascular risk factors. HIIT emerges as an effective option for improving metabolic health in individuals at risk for or living with T2D.

CONCLUSIONS

A combination of dietary modification and physical activity, particularly Mediterranean and plant-based diets coupled with combined aerobic and resistance exercise, appears to be the most effective strategy for the prevention and management of T2D. Future research should focus on personalized approaches that integrate both diet and exercise to tailor interventions to individual patient needs.

摘要

背景

2型糖尿病(T2D)是一个普遍存在的全球健康问题,主要由包括不良饮食和缺乏身体活动在内的生活方式因素引起。随着T2D发病率的不断上升,迫切需要有效的预防策略。本综述探讨了不同饮食模式和运动方案在T2D预防和管理中的作用,重点关注它们对血糖控制、胰岛素敏感性和心血管健康的影响。

方法

进行了一项叙述性综述,综合了来自临床试验、队列研究和荟萃分析的证据。该综述重点关注低碳水化合物饮食(LCDs)、地中海饮食(MDs)、植物性饮食、高蛋白饮食(HPDs)以及各种运动方案的影响,包括有氧运动、抗阻运动和高强度间歇训练(HIIT)。

结果

饮食干预,特别是地中海饮食和植物性饮食,与改善血糖控制和降低患T2D的风险相关。低碳水化合物饮食在体重管理和降低糖化血红蛋白(HbA1c)方面显示出短期益处,尽管坚持执行仍然是一项挑战。高蛋白饮食的结果不一,对血脂有一些益处,但对血糖控制的影响并不一致。运动计划,特别是有氧运动和抗阻运动相结合,能显著改善血糖控制、胰岛素敏感性和心血管危险因素。高强度间歇训练成为改善有T2D风险或患有T2D的个体代谢健康的有效选择。

结论

饮食调整和体育活动相结合,特别是地中海饮食和植物性饮食,再加上有氧运动和抗阻运动相结合,似乎是预防和管理T2D最有效的策略。未来的研究应侧重于个性化方法,将饮食和运动结合起来,根据个体患者的需求定制干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba9b/12277773/e594f62d6ec1/publichealth-12-02-024-g001.jpg

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