“禁食”改善糖尿病?JAMA子刊揭示:一周两天即可
2018/07/26
对于2型糖尿病,不少研究团队试图从“吃”上面找到对应之策。近日,《JAMA Network Open》期刊最新发表的一项研究表明,“间歇性禁食”可以达到减肥、控制血糖水平的效果。


图片来源:CC0 Public Domain

来自南澳大学(UniSA)的科学家们发现:与持续每天的饮食限制一样,一周按照5:2的节奏进行饮食控制,同样可以让2型糖尿病患者减肥、且血糖水平得到控制。

文章一作Sharayah Carter表示,这是首个比较2型糖尿病患者不同饮食习惯的长期试验,结果意味着间歇性禁食可能是糖尿病的一种解决方案。

研究团队对137名2型糖尿病患者进行了长达一年的临床试验,其中一半患者遵循5:2的饮食控制——患者会接受非连续两天的禁食(每天摄入500-600卡路里),之后的5天正常饮食;另一组患者则持续饮食控制(每天摄入1200- 1500卡路里)。

结果显示,间歇性禁食与持续性饮食控制在2型糖尿病患者血糖控制上效果是相当的。5:2间歇性禁食不仅仅能够减肥,还有助于改善血糖水平。


研究人员强调,禁食对于通过饮食控制的2型糖尿病病情的患者是安全的,但是对于使用胰岛素或者其他降糖药的患者而言,仍然需要监控血糖水平,并相应地改变用药剂量。

营养学教授Peter Clifton表示,全球与糖尿病有关的医疗费用正在增加,每年产生的医疗损失约为6,730亿美元。传统的饮食控制需要每天都做到能量限制,不少患者难以坚持。所以Peter Clifton希望借此找到替代方案。

责编:风铃

参考资料:

World-first study shows benefits of 5:2 diet for people with diabetes

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  • Effect of Intermittent Compared With Continuous Energy Restricted Diet on Glycemic Control in Patients With Type 2 Diabetes

    Importance Intermittent energy restriction is an alternative weight loss method that is becoming popular; however, to date, there are no long-term clinical trials of intermittent energy restriction in patients with type 2 diabetes. Objective To compare the effects of intermittent energy restriction (2 days per week) with those of continuous energy restriction on glycemic control and weight loss in patients with type 2 diabetes during a 12-month period. Design, Setting, and Participants Adult participants (N = 137) with type 2 diabetes were randomized 1:1 to parallel diet groups (intermittent energy restriction [n = 70] or continuous energy restriction [n = 67]) between April 7, 2015, and September 7, 2017, at the University of South Australia. Medications likely to cause hypoglycemia were reduced at baseline according to the medication management protocol. Interventions An intermittent energy restriction diet (500-600 kcal/d) followed for 2 nonconsecutive days per week (participants followed their usual diet for the other 5 days) or a continuous energy restriction diet (1200-1500 kcal/d) followed for 7 days per week for 12 months. Main Outcomes and Measures The primary outcome was change in hemoglobin A1c (HbA1c) level, with equivalence prespecified by a 90% CI margin of ±0.5%. The secondary outcome was weight loss with equivalence set at ±2.5 kg (±1.75 kg for fat mass loss and ±0.75 kg for fat-free mass loss). All other outcomes were tested for superiority. Results Of the 137 randomized participants (77 women and 60 men; mean [SD] age, 61.0 [9.1] years; mean [SD] body mass index, 36.0 [5.8] [calculated as weight in kilograms divided by height in meters squared]; and mean [SD] HbA1c level, 7.3% [1.3%]), 97 completed the trial. Intention-to-treat analysis showed similar reductions in mean (SEM) HbA1c level between the continuous and intermittent energy restriction groups (–0.5% [0.2%] vs –0.3% [0.1%]; P = .65), with a between-group difference of 0.2% (90% CI, –0.2% to 0.5%) meeting the criteria for equivalence. Mean (SEM) weight change was similar between the continuous and intermittent energy restriction groups (–5.0 [0.8] kg vs –6.8 [0.8] kg; P = .25), but the between-group difference did not meet the criteria for equivalence (–1.8 kg; 90% CI, –3.7 to 0.07 kg), nor did the between-group difference in fat mass (–1.3 kg; 90% CI, –2.8 to 0.2 kg) or fat-free mass (–0.5 kg; 90% CI, –1.4 to 0.4 kg). There were no significant differences between groups in final step count, fasting glucose levels, lipid levels, or total medication effect score at 12 months. Effects did not differ using completers analysis. Hypoglycemic or hyperglycemic events in the first 2 weeks of treatment were similar between the continuous and intermittent energy restriction groups (mean number [SEM] of events, 3.2 [0.7] vs 4.9 [1.4]; P = .28), affecting 35% of participants (16 of 46) using sulfonylureas and/or insulin. Conclusions and Relevance Intermittent energy restriction is an effective alternative diet strategy for the reduction of HbA1c and is comparable with continuous energy restriction in patients with type 2 diabetes.

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