Fang Michael, Wang Dan, Rebholz Casey M, Echouffo-Tcheugui Justin B, Tang Olive, Wang Nae-Yuh, Mitchell Christine M, Pilla Scott J, Appel Lawrence J, Selvin Elizabeth
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
Nat Med. 2025 Aug 5. doi: 10.1038/s41591-025-03823-3.
The Dietary Approaches to Stop Hypertension (DASH) diet is rich in foods (fruits, vegetables, whole grains) that may reduce hyperglycemia and glycemic variability. In this randomized crossover feeding trial, 89 participants with type 2 diabetes were fed four isocaloric diets in a random order: the DASH4D diet (a DASH-style diet tailored for diabetes) or a comparison (typical American) diet, each with higher (3,700 mg day at 2,000 kcal) or lower (1,500 mg day at 2,000 kcal) sodium. Each feeding period lasted 5 weeks. The primary outcomes were mean glucose; percentage of time spent with glucose between 70 and 180 mg dl (time in range); and coefficient of variation assessed using 14 days of continuous glucose monitoring during each feeding period. The DASH4D (versus comparison) diet significantly reduced mean glucose (mean difference = -11.1 mg dl; P < 0.001), increased time in range (mean difference = +5.2 percentage points; P < 0.001) and had no effect on the coefficient of variation (P = 0.52). In analyses of secondary outcomes, glucose standard deviation and time spent with hyperglycemia (glucose >180 mg dl and >250 mg dl) were lower in the DASH4D diet, but time spent with hypoglycemia (glucose <70 mg dl and <54 mg dl) was similar across diets. There were no serious adverse events related to continuous glucose monitoring or the study diets. These results suggest that the DASH4D diet is a promising nutritional approach to substantially improve glycemic control in adults with type 2 diabetes. ClinicalTrials.gov registration: NCT04286555 .
终止高血压膳食方法（DASH）饮食富含可能降低高血糖和血糖变异性的食物（水果、蔬菜、全谷物）。在这项随机交叉喂养试验中，89名2型糖尿病参与者被随机安排依次食用四种等热量饮食：DASH4D饮食（一种为糖尿病量身定制的DASH式饮食）或对照（典型美式）饮食，每种饮食又分为高钠（2000千卡时3700毫克/天）或低钠（2000千卡时1500毫克/天）两种。每个喂养期持续5周。主要结局指标为平均血糖；血糖在70至180毫克/分升之间的时间百分比（血糖处于目标范围的时间）；以及在每个喂养期使用14天连续血糖监测评估的变异系数。DASH4D（与对照相比）饮食显著降低了平均血糖（平均差值=-11.1毫克/分升；P<0.001），增加了血糖处于目标范围的时间（平均差值=+5.2个百分点；P<0.001），且对变异系数无影响（P=0.52）。在次要结局分析中，DASH4D饮食的血糖标准差和高血糖（血糖>180毫克/分升和>250毫克/分升）持续时间较低，但各饮食间低血糖（血糖<70毫克/分升和<54毫克/分升）持续时间相似。未出现与连续血糖监测或研究饮食相关的严重不良事件。这些结果表明，DASH4D饮食是一种有望显著改善2型糖尿病成年人血糖控制的营养方法。临床试验.gov注册号：NCT04286555 。
