The effects of carbohydrate, unsaturated fat, and protein intake on measures of insulin sensitivity: results from the OmniHeart trial.
The effects of carbohydrate, unsaturated fat, and protein intake on measures of insulin sensitivity: results from the OmniHeart trial.
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DOI：
10.2337/dc12-0869
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发表时间：
2013-05
期刊：
影响因子：
16.2
通讯作者：
Miller ER 3rd
中科院分区：
文献类型：
--
作者：
Gadgil MD;Appel LJ;Yeung E;Anderson CA;Sacks FM;Miller ER 3rd
胰岛素敏感性受损会增加患心血管疾病的风险。虽然热量限制和体重减轻会增加胰岛素敏感性，但改变常量营养素成分对胰岛素敏感性的影响尚不确定。本研究的目的是确定富含碳水化合物的饮食（CARB；类似于停止高血压的饮食方法[DASH]饮食）、富含蛋白质的饮食（PROT；主要来自植物的蛋白质）和富含不饱和脂肪的饮食（UNSAT；主要是单不饱和饮食）对胰岛素敏感性的影响。本研究为随机、对照、三期交叉喂养研究。该研究的参与者是164名高血压前期或1期高血压无糖尿病患者。每组饮食6周，饮食之间有2-4周的洗脱期。在整个研究过程中，体重保持不变。对于我们的主要结局，我们使用期末空腹血糖和胰岛素计算定量胰岛素敏感性检查指数（QUICKI）。QUICKI是一种有效的胰岛素敏感性测量方法。初步分析采用广义估计方程。基线时，平均（SD） BMI为30.2 (6.1)kg/m2，平均（SD） QUICKI为0.35（0.04）。UNSAT饲粮提高了QUICKI 0.005，高于CARB饲粮（P = 0.04）。与CARB相比，PROT无显著影响。用不饱和脂肪部分替代碳水化合物的饮食可能改善心血管疾病高危人群的胰岛素敏感性。鉴于公认的持续减肥的挑战，我们的研究结果提出了一种改善胰岛素敏感性的替代方法。
Impaired insulin sensitivity increases the risk of cardiovascular disease. Although calorie restriction and weight loss increase insulin sensitivity, the effects of modifying macronutrient composition on insulin sensitivity are uncertain. The purpose of this study is to determine the effects on insulin sensitivity of a carbohydrate-rich diet (CARB; similar to the Dietary Approaches to Stop Hypertension [DASH] diet), a protein-rich diet (PROT; protein predominantly from plant sources), and an unsaturated fat–rich diet (UNSAT; predominantly monounsaturated). This study was a randomized, controlled, three-period, crossover feeding study. The study participants were 164 individuals with prehypertension or stage 1 hypertension without diabetes. Diets were administered for 6 weeks each, with a washout period between diets of 2–4 weeks. Weight was held constant throughout the study. For our primary outcome, we calculated the quantitative insulin sensitivity check index (QUICKI) using the end-of-period fasting serum glucose and insulin. QUICKI is a validated measure of insulin sensitivity. The primary analyses used generalized estimating equations. At baseline, mean (SD) BMI was 30.2 (6.1) kg/m2, and mean (SD) QUICKI was 0.35 (0.04). The UNSAT diet increased QUICKI by 0.005, more than the CARB diet (P = 0.04). PROT had no significant effect compared with CARB. A diet that partially replaces carbohydrate with unsaturated fat may improve insulin sensitivity in a population at risk for cardiovascular disease. Given the well-recognized challenges of sustaining weight loss, our results suggest an alternative approach for improving insulin sensitivity.