The 'carnivore connection' - evolutionary aspects of insulin resistance
The 'carnivore connection' - evolutionary aspects of insulin resistance
复制标题
DOI：
10.1038/sj.ejcn.1601351
复制
发表时间：
2002-03-01
影响因子：
4.7
通讯作者：
Miller, JB
中科院分区：
文献类型：
--
作者：
Colagiuri, S;Miller, JB
胰岛素抵抗很常见，由生理（衰老、体能）、病理（肥胖）和遗传因素决定。对胰岛素抵抗的代谢代偿反应是高胰岛素血症，其主要目的是维持正常的糖耐量。 “食肉动物联系”假设膳食蛋白质和碳水化合物的数量以及膳食碳水化合物的血糖指数的变化在胰岛素抵抗和高胰岛素血症的演变中发挥关键作用。在冰河时代，胰岛素抵抗提供了生存和繁殖的优势，冰河时代主导了人类的进化，在此期间人们食用高蛋白低碳水化合物饮食。随着上一个冰河时代的结束和农业的出现，膳食碳水化合物增加了。尽管这导致碳水化合物消耗量急剧增加，但这些传统碳水化合物食品的血糖指数较低，并且仅产生血浆胰岛素的适度增加。工业革命改变了膳食碳水化合物的质量。与粗磨面粉或全谷物相比，碾磨谷物使淀粉更容易消化，餐后血糖和胰岛素反应增加 2 - 3 倍。胰岛素抵抗和高胰岛素血症的结合是许多现代疾病的共同特征。过去 50 年来，便利食品和外卖“快餐”的爆炸式增长使大多数人摄入的热量远远超过了日常能量需求，由此产生的肥胖已成为增加胰岛素抵抗患病率的一个主要因素。
Insulin resistance is common and is determined by physiological (aging, physical fitness), pathological (obesity) and genetic factors. The metabolic compensatory response to insulin resistance is hyperinsulinaemia, the primary purpose of which is to maintain normal glucose tolerance. The 'carnivore connection' postulates a critical role for the quantity of dietary protein and carbohydrate and the change in the glycaemic index of dietary carbohydrate in the evolution of insulin resistance and hyperinsulinaemia. Insulin resistance offered survival and reproductive advantages during the Ice Ages which dominated human evolution, during which a high-protein low-carbohyd rate diet was consumed. Following the end of the last Ice Age and the advent of agriculture, dietary carbohydrate increased. Although this resulted in a sharp increase in the quantity of carbohydrate consumed, these traditional carbohydrate foods had a low glycaemic index and produced only modest increases in plasma insulin. The industrial revolution changed the quality of dietary carbohydrate. The milling of cereals made starch more digestible and postprandial glycaemic and insulin responses increased 2 - 3 fold compared with coarsely ground flour or whole grains. This combination of insulin resistance and hyperinsulinaemia is a common feature of many modern day diseases. Over the last 50y the explosion of convenience and takeaway 'fast foods' has exposed most populations to caloric intakes far in excess of daily energy requirements and the resulting obesity has been a major factor in increasing the prevalence of insulin resistance.