The role of carbohydrates in insulin resistance
The role of carbohydrates in insulin resistance
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DOI：
10.1093/jn/131.10.2782s
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发表时间：
2001-10-01
影响因子：
4.2
通讯作者：
Bessesen, DH
中科院分区：
文献类型：
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作者：
Bessesen, DH
胰岛素抵抗是一种在世界范围内不断增加的代谢紊乱，并且与影响现代社会的一些最常见的疾病相关，包括糖尿病、高血压、肥胖和冠心病。虽然一些人提倡用药物方法来控制胰岛素抵抗，但涉及改变饮食和体力活动的公共卫生方法因其成本和风险较低而具有吸引力。我们简要地总结了一些新的信息的机制，介导胰岛素的许多生物作用，并检查饮食碳水化合物对胰岛素敏感性的影响。具体来说，我们总结了一些信息，简单的糖，复杂的碳水化合物，包括纤维，缓慢消化的淀粉和血糖指数的一般概念的影响。现有数据支持这样的观点，即与高脂肪饮食相比，摄入总碳水化合物含量高的饮食不会对胰岛素敏感性产生不利影响。动物数据表明，单糖，特别是果糖，对胰岛素的作用有不利影响，但在人类中的不利影响尚未得到最终证实。增加膳食纤维的摄入似乎可以改善胰岛素的作用，并可能防止糖尿病的发展。高血糖指数或低血糖指数的饮食对胰岛素作用的影响目前还存在争议。为了得出明确的结论，未来的研究必须持续合理的时间，在特定的人群中进行，并比较相关剂量的营养素对胰岛素作用特定终点的影响。
Insulin resistance is a metabolic disorder that is increasing worldwide and is associated with some of the most common diseases affecting modern societies including diabetes, hypertension, obesity and coronary heart disease. Although pharmacologic approaches to managing insulin resistance are being advocated by some, public health approaches involving changes in diet and physical activity are attractive because of their lower cost and risk. We briefly summarize some new information on the mechanisms that mediate insulin's many biological actions and examine the effects of dietary carbohydrates on insulin sensitivity. Specifically, we summarize some of the information available on the effects of simple sugars, complex carbohydrates including fiber, slowly digested starch and the general concept of glycemic index. The available data support the idea that consumption of diets high in total carbohydrate does not adversely affect insulin sensitivity compared with high fat diets. Animal data suggest that simple sugars, in particular fructose, have adverse effects on insulin action, but adverse effects have not been shown conclusively in humans. Increased intake of dietary fiber appears to improve insulin action and may protect against the development of diabetes. The effects of diets with high or low glycemic index on insulin action are controversial at this time. For firm conclusions to be reached, future studies must be of reasonable duration, be in defined populations and compare the effects of relevant doses of nutrients on specific endpoints of insulin action.