间歇性禁食、适度碳水化合物组合饮食和抗炎饮食对糖尿病前期患者心血管代谢状况的影响；一项开放标签随机临床试验。

Effect of intermittent fasting, portfolio-moderate-carbohydrate, and anti-inflammatory diets on cardio-metabolic status in pre-diabetic patients; an open-label randomized clinical trial.

作者信息

Pasdar Yahya, Saber Amir, Rezvani Nayebali, Bozorgi Samaneh, Moradi Shima, Cheshmeh Sahar, Niazi Hossein, Najafi Farid

机构信息

Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Department of Nutrition Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Diabetol Metab Syndr. 2025 Aug 7;17(1):319. doi: 10.1186/s13098-025-01901-7.

DOI:10.1186/s13098-025-01901-7

PMID:40770722

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12330102/

Abstract

BACKGROUND

Pre-diabetes is a condition characterized by hyperglycemia that does not meet the cutoff for the diagnosis of diabetes and increases the risk of non-communicable diseases. Choosing an appropriate diet is necessary to prevent the progression of pre-diabetes to diabetes. Therefore, the present study aimed to compare the effects of 3 diets, including intermittent fasting (IF) 5:2, portfolio-moderate-carbohydrate (PMC), and anti-inflammatory (AI) diets, compared to a healthy diet with carbohydrate distribution.

METHODS

This open label randomized clinical trial was performed on 98 patients with pre-diabetes that were randomly divided into four intervention groups, including IF 5:2 (n = 24), PMC (n = 24), AI (n = 25), and control group (n = 25). Adherence to these dietary intervention was assessed by dietary recall. Glycemic indices (fasting blood sugar (FBS) and hemoglobin A1c (HbA1c)), lipid profile, body composition, anthropometric indices (weight, waist circumference (WC), and body mass index (BMI)), and hs-C reactive protein (CRP) were assessed before and after dietary intervention. Mixed model regression was used for statistical analysis.

RESULTS

Compared to the control group, the AI diet significantly reduced weight (β: -1.02; 95% CI: -1.96, -0.07; P = 0.017), FBS (β: -6.42; 95% CI: -12.9, -0.06; P = 0.026), and HbA1c (β: -0.27; 95% CI: -0.55, -0.007; P = 0.028). IF 5:2 showed significant reductions in waist circumference, BMI, FBS, and HbA1c, while PMC intervention resulted in significant improvements in FBS and HbA1c compared to the control group.

CONCLUSIONS

The study demonstrated that AI, IF 5:2, and PMC diets improved glycemic control and anthropometric indices in pre-diabetic patients, with the AI diet showing the greatest beneficial effects. These findings suggest that anti-inflammatory dietary approaches may be an effective strategy for pre-diabetes management.

LEVEL OF EVIDENCE

Level I, randomized clinical trial.

TRIAL REGISTRATION

Registration number IRCT20200608047697N2, data 2024-05-16, https://irct.behdasht.gov.ir/trial/76653 .

摘要

背景

糖尿病前期是一种以高血糖为特征的病症，其血糖水平未达到糖尿病的诊断标准，但会增加患非传染性疾病的风险。选择合适的饮食对于预防糖尿病前期发展为糖尿病至关重要。因此，本研究旨在比较三种饮食（包括间歇性禁食5:2、组合适度碳水化合物饮食（PMC）和抗炎饮食（AI））与碳水化合物分布均衡的健康饮食的效果。

方法

本开放标签随机临床试验对98例糖尿病前期患者进行，将其随机分为四个干预组，包括间歇性禁食5:2组（n = 24）、PMC组（n = 24）、AI组（n = 25）和对照组（n = 25）。通过饮食回顾评估对这些饮食干预的依从性。在饮食干预前后评估血糖指标（空腹血糖（FBS）和糖化血红蛋白（HbA1c））、血脂谱、身体成分、人体测量指标（体重、腰围（WC）和体重指数（BMI））以及高敏C反应蛋白（CRP）。采用混合模型回归进行统计分析。

结果

与对照组相比，AI饮食显著降低了体重（β：-1.02；95%置信区间：-1.96, -0.07；P = 0.017）、FBS（β：-6.42；95%置信区间：-12.9, -0.06；P = 0.026）和HbA1c（β：-0.27；95%置信区间：-0.55, -0.007；P = 0.028）。间歇性禁食5:2组的腰围、BMI、FBS和HbA1c显著降低，而与对照组相比，PMC干预使FBS和HbA1c有显著改善。