Effects of high vs low glycemic index of dietary carbohydrate on cardiovascular disease risk factors and insulin sensitivity: the OmniCarb randomized clinical trial.
Effects of high vs low glycemic index of dietary carbohydrate on cardiovascular disease risk factors and insulin sensitivity: the OmniCarb randomized clinical trial.
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DOI：
10.1001/jama.2014.16658
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发表时间：
2014-12-17
影响因子：
120.7
通讯作者：
Appel, Lawrence J.
中科院分区：
文献类型：
--
作者：
Sacks, Frank M.;Carey, Vincent J.;Anderson, Cheryl A. M.;Miller, Edgar R., III;Copeland, Trisha;Charleston, Jeanne;Harshfield, Benjamin J.;Laranjo, Nancy;McCarron, Phyllis;Swain, Janis;White, Karen;Yee, Karen;Appel, Lawrence J.
碳水化合物含量相似的食物，其血糖升高的程度也不同。这种被称为升糖指数的特性对心血管疾病和糖尿病危险因素的影响尚不清楚。目的：探讨血糖指数和膳食碳水化合物总量对心血管疾病和糖尿病危险因素的影响。在学术医疗中心的研究单位进行的随机交叉对照喂养试验中，163名超重成年人（收缩压120-159毫米汞柱）被给予4种完整的饮食，包括他们所有的正餐、零食和含卡路里的饮料，每种饮食持续5周，并完成至少2种研究饮食。第一名参与者于2008年4月1日注册；最后一名参赛者于2010年12月22日结束。对于这四种饮食中的任何一对，有135至150名参与者至少贡献了一项主要结果测量。(1)高血糖指数（葡萄糖值65%），高碳水化合物饮食（能量58%）；(2)低血糖指数（40%）、高碳水化合物饮食；(3)高血糖指数、低碳水化合物饮食（40%能量）；(4)低血糖指数、低碳水化合物饮食。每种饮食都是基于健康的dash型饮食。5个主要结局是胰岛素敏感性，由口服葡萄糖耐量试验时葡萄糖和胰岛素水平曲线下的面积决定；低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇和甘油三酯水平；还有收缩压。在高碳水化合物饮食中，与高血糖指数水平相比，低血糖指数水平将胰岛素敏感性从8.9降至7.1单位（- 20%,P = 0.002）；LDL胆固醇从139 mg/dL增加到147 mg/dL (6%, P≤0.001)；并且不会影响高密度脂蛋白胆固醇、甘油三酯或血压的水平。在低碳水化合物含量时，低血糖指数水平与高血糖指数水平相比，除了将甘油三酯从91 mg/dL降至86 mg/dL外，对结果没有影响（- 5%,P = 0.02）。在初级饮食对比中，低血糖指数、低碳水化合物饮食与高血糖指数、高碳水化合物饮食相比，不影响胰岛素敏感性、收缩压、低密度脂蛋白胆固醇或高密度脂蛋白胆固醇，但将甘油三酯从111降低到86 mg/dL （- 23%, P≤0.001）。在这项为期5周的对照喂养研究中，与饮食中碳水化合物升糖指数高的饮食相比，饮食中碳水化合物升糖指数低的饮食并没有改善胰岛素敏感性、血脂水平或收缩压。在整体dash型饮食的背景下，使用血糖指数来选择特定的食物可能不会改善心血管危险因素或胰岛素抵抗。clinicaltrials.gov标识符：NCT00608049
Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120–159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. (1) A high–glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low–glycemic index (40%), high-carbohydrate diet; (3) a high–glycemic index, low-carbohydrate diet (40% energy); and (4) a low–glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. At high dietary carbohydrate content, the low– compared with high–glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (−20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ≤ .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the low– compared with high–glycemic index level did not affect the outcomes except for decreasing triglycerides from 91 to 86 mg/dL (−5%, P = .02). In the primary diet contrast, the low–glycemic index, low-carbohydrate diet, compared with the high–glycemic index, high-carbohydrate diet, did not affect insulin sensitivity, systolic blood pressure, LDL cholesterol, or HDL cholesterol but did lower triglycerides from 111 to 86 mg/dL (−23%, P ≤ .001). In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance. clinicaltrials.gov Identifier: NCT00608049
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影响因子：
5.4
作者：
Mirrahimi A;de Souza RJ;Chiavaroli L;Sievenpiper JL;Beyene J;Hanley AJ;Augustin LS;Kendall CW;Jenkins DJ
通讯作者：
Jenkins DJ
DOI：
10.1046/j.1440-1681.2000.03223.x
发表时间：
2000-03-01
影响因子：
2.9
作者：
Ludbrook, J
通讯作者：
Ludbrook, J
影响因子：
4.2
作者：
Hartman, Terryl J.;Albert, Paul S.;Lanza, Elaine
通讯作者：
Lanza, Elaine
影响因子：
3.6
作者：
Dong, Jia-Yi;Zhang, Lijun;Qin, Li-Qiang
通讯作者：
Qin, Li-Qiang
DOI：
10.1161/01.atv.12.8.911
发表时间：
1992-08-01
期刊：
ARTERIOSCLEROSIS AND THROMBOSIS
影响因子：
--
作者：
MENSINK, RP;KATAN, MB
通讯作者：
KATAN, MB