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发帖数: 23737 | 1 http://www.twvns.org/articles/research/16-2008-07-31-09-43-31
许多研究已经證实饮食对糖尿病人血糖，血脂肪及体重等控制有莫大的影响! 而营养师
与糖尿病卫教师，也总不忘一再叮咛且教导病友如何作醣类计算，与糖份斤斤计较!
2006年发表於糖尿照护(Diabetes Care)，比较全素低脂饮食计画与美国糖尿病学会所
推广的醣类计算饮食，发现，两种皆能够有效控制血糖，然而全素饮食对血糖的降低比
糖类计算来的更加有效。作者 Barnard et al. 表示，全素饮食有效控制血糖主要原因
可能来自较低的热量及脂肪，在此情况下，全素试验组的体重降低较多，可能因此增加
胰岛素敏感度。 此外，高脂饮食，在之前的研究发现，可能造成肌肉细胞及肝脏细胞
囤积较多的脂肪，导致细胞对胰岛素不敏感! 而胰岛素不敏感是导致第二型糖尿病重
要因子。
提高胰岛素敏感度最好的方法: 运动，减重。
此研究中，营养师卫教全素组受试者，选择低脂食物，在醣类方面则是尽量选择生糖指
数较低的食物，例如较粗糙，未经精緻的五穀根茎类。 然而并未在份量上加以限制。
在医院当营养师做糖尿病卫教时，常发现有些病人，虽然吃素，可是大多是不健康的素
食，不但以精緻白米等主食类为主，配菜也常是过度加工的素料，点心可能是精緻且含
反试脂肪酸的糕饼类，因此不难发现，胆固醇，叁酸甘油脂仍然过高! 吃全素控制糖尿
病是个不错的方法，但记得选择较粗超的五穀根茎以及五颜六色的蔬果类! 此外别忘了
减少油炸食品及过度加工的素料。 蛋白质来源建议也是越接近自然越好，选择新鲜的
豆类，除了蛋白质品质超高的豆腐豆浆，也别忘了多尝试其他乾豆类。 乾豆类的醣份
较高，在糖尿病饮食中，属於五穀根茎类，但乾豆类有非常高的可溶性纤维，因此也可
是健康饮食的一部份喔!
Reference:
Diabetes Care. 2006 Aug;29(8):1777-83.
本文作者: 邱雪婷 营养师
http://www.ncbi.nlm.nih.gov/pubmed/16873779?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Diabetes Care. 2006 Aug;29(8):1777-83.
A low-fat vegan diet improves glycemic control and cardiovascular risk
factors in a randomized clinical trial in individuals with type 2 diabetes.
Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B,
Seidl K, Green AA, Talpers S.
Department of Medicine, George Washington University School of Medicine,
Washington, DC, USA. n******[email protected]
Abstract
OBJECTIVE: We sought to investigate whether a low-fat vegan diet improves
glycemic control and cardiovascular risk factors in individuals with type 2
diabetes.
RESEARCH DESIGN AND METHODS: Individuals with type 2 diabetes (n = 99) were
randomly assigned to a low-fat vegan diet (n = 49) or a diet following the
American Diabetes Association (ADA) guidelines (n = 50). Participants were
evaluated at baseline and 22 weeks.
RESULTS: Forty-three percent (21 of 49) of the vegan group and 26% (13 of 50
) of the ADA group participants reduced diabetes medications. Including all
participants, HbA(1c) (A1C) decreased 0.96 percentage points in the vegan
group and 0.56 points in the ADA group (P = 0.089). Excluding those who
changed medications, A1C fell 1.23 points in the vegan group compared with 0
.38 points in the ADA group (P = 0.01). Body weight decreased 6.5 kg in the
vegan group and 3.1 kg in the ADA group (P < 0.001). Body weight change
correlated with A1C change (r = 0.51, n = 57, P < 0.0001). Among those who
did not change lipid-lowering medications, LDL cholesterol fell 21.2% in the
vegan group and 10.7% in the ADA group (P = 0.02). After adjustment for
baseline values, urinary albumin reductions were greater in the vegan group
(15.9 mg/24 h) than in the ADA group (10.9 mg/24 h) (P = 0.013).
CONCLUSIONS: Both a low-fat vegan diet and a diet based on ADA guidelines
improved glycemic and lipid control in type 2 diabetic patients. These
improvements were greater with a low-fat vegan diet. |
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