2型糖尿病古今饮食管理研究述评
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摘要
历代医家认为,饮食过量是致消渴的重要因素,过食肥甘与消渴关系密切。现代饮食管理方式主要有:①地中海饮食:泛指地中海沿岸各区域的饮食习俗,可抑制代谢综合征进展,降低内脏脂肪,维护心脑血管功能等;②高血压防治饮食:源自美国的高血压防治方案,可降低患者肝转移酶、超敏C反应蛋白、血浆纤维蛋白原、低密度脂蛋白及总胆固醇水平,改善患者的心血管事件风险因素,提升胰岛素敏感性;③生酮饮食:也被称为低碳水化合物饮食,可明显改善患者血糖、糖化血红蛋白水平,降低体质量,提升机体内部酮体含量,可改善瘦素抵抗,降低胰岛素样生长因子1水平;④冲绳饮食:是冲绳岛一带地区居民的饮食方式,可显著降低胆固醇,提高胰岛素敏感指数,降低血糖,增强超氧化物歧化酶活性,保护胰岛β细胞功能;⑤素食饮食:是以果蔬谷物及坚果豆制品为主,切断动物性食物摄入源,可改善胰岛素抵抗,抗炎、抗氧化,调节血脂紊乱,降低2型糖化血红蛋白水平,维持机体内部酸碱平衡。
Doctors from ancient times to the present believe that excessive diet is an important factor leading to consumptive thirst.Overeating is closely related to consumptive thirst.Modern dietary management programs mainly include:①Mediterranean diet:it enerally refers to the dietary customs of the Mediterranean coastal areas,which can inhibit the progress of metabolic syndrome,reduce visceral fat,maintain cardiovascular and cerebrovascular functions,etc.②Diet for prevention and treatment of hypertension:it comes from the prevention and treatment of hypertension in the United States.It can reduce the levels of liver transferase,hypersensitive C-reactive protein,plasma fibrinogen,low-density lipoprotein and total cholesterol,improve the risk factors of cardiovascular events,and enhance insulin sensitivity.③Ketogenic diet:it is also known as a low-carbohydrate diet,which can significantly improve blood sugar,glycosylated hemoglobin levels,reduce body mass,increase the body′s ketone content,improve leptin resistance,and reduce insulin-like growth factor-1 levels.④Okinawa diet:it is the dietary pattern of residents in Okinawa,which can significantly reduce cholesterol,increase insulin sensitivity index,reduce blood sugar,enhance superoxide dismutase activity and protect the function of islet beta cells.⑤Vegetarian diet:it is mainly made of fruits,vegetables,grains and nuts and beans.It can cut off the source of animal food intake,improve insulin resistance,anti-inflammation,anti-oxidation,regulate blood lipid disorders,reduce the level of type 2 glycosylated hemoglobin,and maintain internal acid-base balance.
Doctors from ancient times to the present believe that excessive diet is an important factor leading to consumptive thirst.Overeating is closely related to consumptive thirst.Modern dietary management programs mainly include:①Mediterranean diet:it enerally refers to the dietary customs of the Mediterranean coastal areas,which can inhibit the progress of metabolic syndrome,reduce visceral fat,maintain cardiovascular and cerebrovascular functions,etc.②Diet for prevention and treatment of hypertension:it comes from the prevention and treatment of hypertension in the United States.It can reduce the levels of liver transferase,hypersensitive C-reactive protein,plasma fibrinogen,low-density lipoprotein and total cholesterol,improve the risk factors of cardiovascular events,and enhance insulin sensitivity.③Ketogenic diet:it is also known as a low-carbohydrate diet,which can significantly improve blood sugar,glycosylated hemoglobin levels,reduce body mass,increase the body′s ketone content,improve leptin resistance,and reduce insulin-like growth factor-1 levels.④Okinawa diet:it is the dietary pattern of residents in Okinawa,which can significantly reduce cholesterol,increase insulin sensitivity index,reduce blood sugar,enhance superoxide dismutase activity and protect the function of islet beta cells.⑤Vegetarian diet:it is mainly made of fruits,vegetables,grains and nuts and beans.It can cut off the source of animal food intake,improve insulin resistance,anti-inflammation,anti-oxidation,regulate blood lipid disorders,reduce the level of type 2 glycosylated hemoglobin,and maintain internal acid-base balance.
引文
[1]郭葛春.黄帝内经素问校注[M].北京:人民卫生出版社,1992.
[2]巢元方.诸病源候论[M].北京:人民卫生出版社,1982.
[3]张海岑,赵法新.孺门事亲校注[M].郑州:河南科学技术出版社,1984.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南[J].中华糖尿病杂志,2014,6(7):447-489.
[5]WANG L,GAO P,ZHANG M,et al.Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J].JAMA,2017,317(24):2515-2523.
[6]MILLER C K,EDWARDS L,KISSLING G,et al.Nutrition education improves metabolic outcomes among older adults with diabetes mellitus:results from arandomized controlled trial [J].Prev Med,2002,34(2):252-259.
[7]FRANZ M J,MONK A,BARRY B,et al.Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus:a randomized,controlled clinical trial[J].J Am Diet Assoc,1995,95(9):1009-1017.
[8]龙烨,陶秀凤.“地中海饮食”对2型糖尿病患者的影响[J].齐齐哈尔医学院学报,2015,36(14):2157-2158.
[9]SORIGUER F,ESTEVA I,ROJO-MARTINEZ G,et al.Oleic acid from cooking oilsis associated with lower insulin resistance in the general population(Pizarra study) [J].Eur J Endocrinol,2004,150(1):33-39.
[10]BOS M B,DE VRIES J H,FESKENS E J,et al.Effect of a high monounsaturated fatty acids diet and a Mediterranean diet on serum lipds and insulin sensitivity in adults with mildabdominal obesesity [J].Nutr Metab Cardiovasc Dis,2010,20(8):591-598.
[11]MCINTOSH M,MILLER C.A diet containing food rich in soluble and insoluble fiber improves glycemic control and reduces hyperlipidemia among patients with type 2 diabetes mellitus[J].Nutr Rev,2001,59(2):52-55.
[12]KHARROUBI I,LADRIERE L,CARDOZO AK,et al.Free fatty acids and cytokines induce pancreatic beta-cell apoptosis by different mechanisms:Role of nuclear factor 2 kappaβ and endoplasmic reticulum stress[J].Endocrinology,2004,145(11):5087-5096.
[13]WANG L,FOLSOM A R,ZHENG Z J,et al.Plasma fatty acid composition and incidence of diabetes in middle-aged adults:The atherosclerosis risk in communities(ARIC)study[J].Am J Clin Nutr,2003,78(1):91-98.
[14]SACKS F M,OBARZANEK E,WINDHAUSER M M,et al.Rationale and design of the Dietary Approaches to Stop Hypertension trial(DASH).A multicenter controlled-feeding study of dietary patterns to lower blood pressure [J].Ann Epidemiol,1995,5(2):108-118.
[15]洪忠新,丁冰杰.平衡膳食是防治原发性高血压病的基石[J].中国全科医学,2017,20(3):283-289.
[16]AZADBAKHT L,SURKAN P J,ESMAILLZADEH A,et al.The Dietary Approaches to Stop Hypertension eating plan affects C-reactive protein,coagulation abnormalities,and hepatic function tests among type 2 diabetic patients [J].Nutr,2011,141(6):1083-1088.
[17]LIESE A D,NICHOLS M,SUN X,et al.Adherence to the DASH Diet is inversely associated with incidence of type 2 diabetes:the insulin resistance atherosclerosis study [J].Diabetes Care,2009,32(8):1434-1436.
[18]CONSORTIUM I.Adherence to predefined dietary patterns and incident type 2 diabetes in European populations:EPIC-Inter Act Study[J].Diabetologia,2014,57(2):321-333.
[19]朱登娜,谢蒙蒙,王俊辉,等.生酮饮食添加治疗儿童难治性癫痫的前瞻性研究[J].中国当代儿科杂志,2004,16(5):513-517.
[20]DE SOUZA ZAGO V H,TANUS-SANTOS J E,GARDIN DANELON M R,et al.Chemical modification of high density lipoprotein subfractions-HDL2 and HDL3-after use of atorvastatin [J].Int J Clin Pharmacol Ther,2014,52(4):277-283.
[21]邱晴,都健,杨晶,等.血清性激素结合球蛋白水平对2型糖尿病患者合并代谢综合征的影响研究[J].中国全科医学,2016,19(10):1151-1154.
[22]曹爱华,孙丽珍,崔静稳,等.低碳水化合物和低脂肪饮食对2型糖尿病患者体质量及血糖的影响[J].中国全科医学,2011,14(1):52-56.
[23]LAST A R,M P H,WILSON S A,et al.低碳水化合物饮食[J].中国实用乡村医生杂志,2007,14(1):40-42.
[24]刘仁杰,王月娇,郭宏伟,等.荞麦蛋白复合物对糖尿病小鼠降血糖作用的研究[J].吉林农业大学学报,2009,31(1):102-104.
[25]王毅,齐红霞,谷斌斌,等.苦荞麦蛋白提取物对2型糖尿病大鼠治疗作用研究[J].浙江预防医学,2009,21(1):4-14
[26]IIMURO S,YOSHIMURA Y,UMEGAKI H,et al.Dietary pattern and mortality in Japanese elderly patients with type 2 diabetes mellitus:does a vegetable-and fish-rich diet improve mortality An explanatory study [J].Geriatrics & Gerontology International,2012,12(s1):59-67.
[27]JOHNSTON K,SHARP P,CLIFFORD M.Dietary poly phenols decrease glucose uptake by human intestinal Caco-2 cells[J].Febs Lett,2005,579(7):1653-1657.
[28]李莉,李百花,张秋香,等.素食营养与健康[J].中华健康管理学杂志,2015,9(3):230-233.
[29]MATHIS K R.The effects of a vegetarian diet[D].America:Murray State University,2016.
[30]KAHLEOVA H,MATOULEK M,MALINSKA H,et al.Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes [J].Diabetes Mellitus,2011,28(5):549-559.
[31]PRAHARAJ A B,GOENKA R K,DIXIT S,et al.Lacto-vegetarian diet and correlation of fasting blood sugar with lipids in population practicing sedentary lifestyle[J].Ecol Food Nutr,2017,56(5):351-363.
[32]陈国芳,李春睿,茅晓东,等.短期限食对代谢综合征患者胃肠激素及脂肪分泌激素的影响 [J].中华内分泌代谢杂志,2015,31(3):205-209.
[2]巢元方.诸病源候论[M].北京:人民卫生出版社,1982.
[3]张海岑,赵法新.孺门事亲校注[M].郑州:河南科学技术出版社,1984.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南[J].中华糖尿病杂志,2014,6(7):447-489.
[5]WANG L,GAO P,ZHANG M,et al.Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013[J].JAMA,2017,317(24):2515-2523.
[6]MILLER C K,EDWARDS L,KISSLING G,et al.Nutrition education improves metabolic outcomes among older adults with diabetes mellitus:results from arandomized controlled trial [J].Prev Med,2002,34(2):252-259.
[7]FRANZ M J,MONK A,BARRY B,et al.Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus:a randomized,controlled clinical trial[J].J Am Diet Assoc,1995,95(9):1009-1017.
[8]龙烨,陶秀凤.“地中海饮食”对2型糖尿病患者的影响[J].齐齐哈尔医学院学报,2015,36(14):2157-2158.
[9]SORIGUER F,ESTEVA I,ROJO-MARTINEZ G,et al.Oleic acid from cooking oilsis associated with lower insulin resistance in the general population(Pizarra study) [J].Eur J Endocrinol,2004,150(1):33-39.
[10]BOS M B,DE VRIES J H,FESKENS E J,et al.Effect of a high monounsaturated fatty acids diet and a Mediterranean diet on serum lipds and insulin sensitivity in adults with mildabdominal obesesity [J].Nutr Metab Cardiovasc Dis,2010,20(8):591-598.
[11]MCINTOSH M,MILLER C.A diet containing food rich in soluble and insoluble fiber improves glycemic control and reduces hyperlipidemia among patients with type 2 diabetes mellitus[J].Nutr Rev,2001,59(2):52-55.
[12]KHARROUBI I,LADRIERE L,CARDOZO AK,et al.Free fatty acids and cytokines induce pancreatic beta-cell apoptosis by different mechanisms:Role of nuclear factor 2 kappaβ and endoplasmic reticulum stress[J].Endocrinology,2004,145(11):5087-5096.
[13]WANG L,FOLSOM A R,ZHENG Z J,et al.Plasma fatty acid composition and incidence of diabetes in middle-aged adults:The atherosclerosis risk in communities(ARIC)study[J].Am J Clin Nutr,2003,78(1):91-98.
[14]SACKS F M,OBARZANEK E,WINDHAUSER M M,et al.Rationale and design of the Dietary Approaches to Stop Hypertension trial(DASH).A multicenter controlled-feeding study of dietary patterns to lower blood pressure [J].Ann Epidemiol,1995,5(2):108-118.
[15]洪忠新,丁冰杰.平衡膳食是防治原发性高血压病的基石[J].中国全科医学,2017,20(3):283-289.
[16]AZADBAKHT L,SURKAN P J,ESMAILLZADEH A,et al.The Dietary Approaches to Stop Hypertension eating plan affects C-reactive protein,coagulation abnormalities,and hepatic function tests among type 2 diabetic patients [J].Nutr,2011,141(6):1083-1088.
[17]LIESE A D,NICHOLS M,SUN X,et al.Adherence to the DASH Diet is inversely associated with incidence of type 2 diabetes:the insulin resistance atherosclerosis study [J].Diabetes Care,2009,32(8):1434-1436.
[18]CONSORTIUM I.Adherence to predefined dietary patterns and incident type 2 diabetes in European populations:EPIC-Inter Act Study[J].Diabetologia,2014,57(2):321-333.
[19]朱登娜,谢蒙蒙,王俊辉,等.生酮饮食添加治疗儿童难治性癫痫的前瞻性研究[J].中国当代儿科杂志,2004,16(5):513-517.
[20]DE SOUZA ZAGO V H,TANUS-SANTOS J E,GARDIN DANELON M R,et al.Chemical modification of high density lipoprotein subfractions-HDL2 and HDL3-after use of atorvastatin [J].Int J Clin Pharmacol Ther,2014,52(4):277-283.
[21]邱晴,都健,杨晶,等.血清性激素结合球蛋白水平对2型糖尿病患者合并代谢综合征的影响研究[J].中国全科医学,2016,19(10):1151-1154.
[22]曹爱华,孙丽珍,崔静稳,等.低碳水化合物和低脂肪饮食对2型糖尿病患者体质量及血糖的影响[J].中国全科医学,2011,14(1):52-56.
[23]LAST A R,M P H,WILSON S A,et al.低碳水化合物饮食[J].中国实用乡村医生杂志,2007,14(1):40-42.
[24]刘仁杰,王月娇,郭宏伟,等.荞麦蛋白复合物对糖尿病小鼠降血糖作用的研究[J].吉林农业大学学报,2009,31(1):102-104.
[25]王毅,齐红霞,谷斌斌,等.苦荞麦蛋白提取物对2型糖尿病大鼠治疗作用研究[J].浙江预防医学,2009,21(1):4-14
[26]IIMURO S,YOSHIMURA Y,UMEGAKI H,et al.Dietary pattern and mortality in Japanese elderly patients with type 2 diabetes mellitus:does a vegetable-and fish-rich diet improve mortality An explanatory study [J].Geriatrics & Gerontology International,2012,12(s1):59-67.
[27]JOHNSTON K,SHARP P,CLIFFORD M.Dietary poly phenols decrease glucose uptake by human intestinal Caco-2 cells[J].Febs Lett,2005,579(7):1653-1657.
[28]李莉,李百花,张秋香,等.素食营养与健康[J].中华健康管理学杂志,2015,9(3):230-233.
[29]MATHIS K R.The effects of a vegetarian diet[D].America:Murray State University,2016.
[30]KAHLEOVA H,MATOULEK M,MALINSKA H,et al.Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes [J].Diabetes Mellitus,2011,28(5):549-559.
[31]PRAHARAJ A B,GOENKA R K,DIXIT S,et al.Lacto-vegetarian diet and correlation of fasting blood sugar with lipids in population practicing sedentary lifestyle[J].Ecol Food Nutr,2017,56(5):351-363.
[32]陈国芳,李春睿,茅晓东,等.短期限食对代谢综合征患者胃肠激素及脂肪分泌激素的影响 [J].中华内分泌代谢杂志,2015,31(3):205-209.