Low-Fat Versus Low-Carbohydrate Weight Reduction Diets Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial
Low-Fat Versus Low-Carbohydrate Weight Reduction Diets Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial
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DOI：
10.2337/db09-0098
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发表时间：
2009-12-01
期刊：
影响因子：
7.7
通讯作者：
Hunter, Steven J.
中科院分区：
文献类型：
--
作者：
Bradley, Una;Spence, Michelle;Hunter, Steven J.
低脂低热量饮食可降低胰岛素抵抗，预防2型糖尿病的发生。低碳水化合物，高脂肪饮食提倡作为一种替代，但饮食脂肪的相互增加可能对胰岛素抵抗产生不利影响，并抵消减肥的好处。（20%脂肪，60%碳水化合物）与低碳水化合物在一项为期8周的随机对照试验中，24名超重/肥胖受试者（[平均+/- SDI BMI 33.6 +/- 3.7 kg/m2，年龄39 +/- 10岁]）接受了（60%脂肪，20%碳水化合物）减肥饮食。称量并分配所有食物，计算摄入量以产生500千卡/天的能量不足。胰岛素作用通过正葡萄糖钳夹试验进行评估，胰岛素分泌通过膳食耐量试验进行评估。通过脉搏波分析测量身体成分、脂肪因子水平和血管顺应性。结果：两组体重均显著减轻（P < 0.01），组间无差异（P = 0.40）。外周葡萄糖摄取增加，但组间无差异（P = 0.28），内源性葡萄糖产生的抑制也相似。膳食耐受相关的胰岛素分泌随着体重减轻而降低，组间无差异（P = 0.71）。然而，在整体全身动脉硬度的变化，饮食之间有显着差异（P = 0.04），这反映了一个显着的低脂肪饮食后的增强指数下降，与低碳水化合物group.CONCLUSIONS-This研究表明，胰岛素抵抗的低脂肪和低碳水化合物的饮食独立的宏量营养素含量的非显着增加。增加指数的差异可能意味着低碳水化合物饮食对血管风险的负面影响。糖尿病58：2741-2748，2009
OBJECTIVE-Low-fat hypocaloric diets reduce insulin resistance and prevent type 2 diabetes in those at risk. Low-carbohydrate, high-fat diets are advocated as an alternative, but reciprocal increases in dietary fat may have detrimental effects on insulin resistance and offset the benefits of weight reduction.RESEARCH DESIGN AND METHODS-We investigated a low-fat, (20% fat, 60% carbohydrate) versus a low-carbohydrate (60% fat, 20% carbohydrate) weight reduction diet in 24 overweight/obese subjects ([mean +/- SDI BMI 33.6 +/- 3.7 kg/m(2), aged 39 +/- 10 years) in an 8-week randomized controlled trial. All food was weighed and distributed, and intake was calculated to produce a 500 kcal/day energy deficit. Insulin action was assessed by the euglycemic clamp and insulin secretion by meal tolerance test. Body composition, adipokine levels, and vascular compliance by pulse-wave analysis were also measured.RESULTS-Significant weight loss occurred in both groups (P < 0.01), with no difference between groups (P = 0.40). Peripheral glucose uptake increased, but there was no difference between groups (P = 0.28), and suppression of endogenous glucose production was also similar between groups. Meal tolerance-related insulin secretion decreased with weight loss with no difference between groups (P = 0.71). The change in overall systemic arterial stiffness was, however, significantly different between diets (P = 0.04); this reflected a significant decrease in augmentation index following the low-fat diet, compared with a nonsignificant increase within the low-carbohydrate group.CONCLUSIONS-This study demonstrates comparable effects on insulin resistance of low-fat and low-carbohydrate diets independent of macronutrient content. The difference in augmentation index may imply a negative effect of low-carbohydrate diets on vascular risk. Diabetes 58:2741-2748, 2009