Calle-Pascual A L, Saavedra A, Benedi A, Martin-Alvarez P J, Garcia-Honduvilla J, Calle J R, Marañes J P
Servicio de Endocrinologia y Nutricion, Hospital Universitario San Carlos, Madrid, España.
Horm Metab Res. 1995 Nov;27(11):499-502. doi: 10.1055/s-2007-980011.
In order to study the nutritional pattern in obese subjects living in an area with a Mediterranean diet, as well as the modifications in nutritional behaviour, cardiovascular risk factors and insulin sensitivity induced by changes in nutritional pattern, 54 obese patients completed a 20-week behaviour programme. They prospectively fulfilled a food records diary in order to ascertain their nutritional pattern. Weight, body mass index (BMI). waist-to-hip ratio (WHR), blood pressure (BP), cholesterol, HDL-c, LDL-c, triglycerides, fasting and 2 h-post glucose load plasma glucose were determined at the onset and at the end of the study. Insulin sensitivity index (SI), and glucose effectiveness (Sg) were assessed by using the modified FSIVGTT. The usual diet in obese patients living in a Mediterranean country is low in carbohydrates (35%) and high in fats (43%), 55% of the latter being monounsaturated fatty acids (MUFAs), especially olive oil. After the educational programme they decreased the caloric intake to slightly over 700 Kcal/day, with a reduction of 36% in carbohydrates consumption, 18% in proteins and 43% in fats (46% in MUFAs). These modifications resulted in a decrease in weight, BMI, WHR, BP, and fasting and 2 h-post glucose load plasma glucose (all p < 0.05), whereas the lipoprotein profile did not change. In a similar way SI and Kg (glucose disappearance rate) increased, while fasting plasma insulin (FPI) decreased (p < 0.05) and Sg and I1+3 remained unaffected. Our results indicate that weight loss induced by caloric restriction improves insulin sensitivity rather insulin secretory capacity or glucose effectiveness, and all the cardiovascular risk factors but lipoproteic profile, that remains unchanged, probably because of the lower MUFAs consumption. These facts should be taken into account when recommending changes in the diet of obese patients with a Mediterranean-style diet.
为了研究生活在地中海饮食地区的肥胖受试者的营养模式，以及营养模式变化所引起的营养行为、心血管危险因素和胰岛素敏感性的改变，54名肥胖患者完成了一项为期20周的行为计划。他们前瞻性地填写了食物记录日记，以确定自己的营养模式。在研究开始和结束时测定体重、体重指数（BMI）、腰臀比（WHR）、血压（BP）、胆固醇、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、甘油三酯、空腹及葡萄糖负荷后2小时的血浆葡萄糖。使用改良的FSIVGTT评估胰岛素敏感性指数（SI）和葡萄糖效能（Sg）。生活在地中海国家的肥胖患者的日常饮食碳水化合物含量低（35%），脂肪含量高（43%），其中55%为单不饱和脂肪酸（MUFA），尤其是橄榄油。经过教育计划后，他们将热量摄入降低到略高于700千卡/天，碳水化合物摄入量减少36%，蛋白质减少18%，脂肪减少43%（MUFA减少46%）。这些改变导致体重、BMI、WHR、BP以及空腹及葡萄糖负荷后2小时的血浆葡萄糖下降（均p<0.05），而脂蛋白谱没有变化。同样，SI和Kg（葡萄糖消失率）增加，而空腹血浆胰岛素（FPI）下降（p<0.05），Sg和I1+3未受影响。我们的结果表明，热量限制引起的体重减轻改善了胰岛素敏感性，而非胰岛素分泌能力或葡萄糖效能，并且改善了除脂蛋白谱外的所有心血管危险因素，脂蛋白谱可能因MUFA摄入量降低而保持不变。在建议改变具有地中海式饮食的肥胖患者的饮食时，应考虑这些事实。
