Piatti P M, Pontiroli A E, Saibene A, Santambrogio G, Paroni R, Magni F, Galli-Kienle M, Mistrali S, Monti L D, Pozza G
Istituto Scientifico San Raffaele, Università di Milano, Italy.
Int J Obes Relat Metab Disord. 1993 Jul;17(7):375-81.
The ideal hypocaloric diet should reduce body weight, decrease fat more than muscle tissue, and ameliorate insulin sensitivity and lipid levels. The aim of this study was to investigate the effect of three hypocaloric diets with different carbohydrate (CHO) and fat contents on body weight reduction, insulin release and sensitivity, and lipid levels in patients with simple obesity. Twenty-five obese subjects with normal glucose tolerance were randomly allocated to three hypocaloric (800 kcal) diets containing: 60% high complex/high starch and fibre (HC/HSF-CHO) and 20% fat (group 1;11 subjects); 60% high simple/high natural fibre (HS/HNF-CHO) and 20% fat (group 2; 7 subjects); or 20% CHO (L-CHO) and 60% fat (group 3; 7 subjects). The remaining 20% of the diet was protein. In all cases the duration of the diet was 21 days. Before and after the diet, seven subjects from each group underwent a hyperglycemic clamp, and the other four subjects of group 1 underwent a euglycemic-hyperinsulinemic clamp, combined with a glucose turnover study. A similar decrease in body weight, fat-free mass, fat mass, total cholesterol, LDL cholesterol and apo B levels was observed in the three groups. The M/I ratio during hyperglycemic and euglycemic-hyperinsulinemic clamp and the glucose turnover rate during euglycemic-hyperinsulinemic clamp significantly decreased, and FFA levels significantly increased only after the HC/HSF-CHO diet. HDL cholesterol and apo A1 significantly increased only during the HS/HNF-CHO diet.(ABSTRACT TRUNCATED AT 250 WORDS)
理想的低热量饮食应能减轻体重,减少脂肪多于肌肉组织,并改善胰岛素敏感性和血脂水平。本研究的目的是调查三种不同碳水化合物(CHO)和脂肪含量的低热量饮食对单纯性肥胖患者体重减轻、胰岛素释放与敏感性以及血脂水平的影响。25名糖耐量正常的肥胖受试者被随机分配到三种低热量(800千卡)饮食组:60%高复合/高淀粉和纤维(HC/HSF-CHO)且20%脂肪(第1组;11名受试者);60%高单糖/高天然纤维(HS/HNF-CHO)且20%脂肪(第2组;7名受试者);或20% CHO(低碳水化合物组,L-CHO)且60%脂肪(第3组;7名受试者)。饮食的其余20%为蛋白质。在所有情况下,饮食持续时间均为21天。饮食前后,每组7名受试者进行了高血糖钳夹试验,第1组的另外4名受试者进行了正常血糖-高胰岛素钳夹试验,并结合葡萄糖代谢研究。三组受试者的体重、去脂体重、脂肪量、总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B水平均出现类似程度的下降。高血糖和正常血糖-高胰岛素钳夹试验期间的M/I比值以及正常血糖-高胰岛素钳夹试验期间的葡萄糖代谢率显著降低,仅在HC/HSF-CHO饮食后游离脂肪酸(FFA)水平显著升高。高密度脂蛋白胆固醇和载脂蛋白A1仅在HS/HNF-CHO饮食期间显著升高。(摘要截断于250字)