摘要
高胰岛素血症、胰岛素抵抗是慢性代谢性疾病的共同病理生理学机制,超重、肥胖是慢性代谢性疾病的共同病因学基础。碳水化合物-胰岛素模型提示,大量碳水化合物摄入,升高血糖,促进了胰岛素分泌,胰岛素促进能量在脂肪组织的储存,减少了代谢活跃组织的氧化利用,使代谢活跃细胞处于饥饿状态,食物摄入反应性增多,体重上升。将饮食中的碳水化合物减少到150g/d或26%以下,胰岛素分泌减少,可以改变机体的能量利用方式,促进脂肪燃烧,从而降低脂肪重量、使体重下降。低碳饮食不要求控制热量及蛋白质,依从性较其他饮食干预方法更好。大量研究证实,低碳饮食短期应用效果确切,不良反应远远少于药物,卫生经济学效益显著,是肥胖、2型糖尿病、非酒精性脂肪肝、代谢综合征等慢性代谢性疾病首选的解决方案,值得社会各界的广泛关注和深入研究。但是,必需清醒地认识到低碳饮食不是一种生理状态下的日常饮食,长期使用仍然有待进一步研究。
Hyperinsulinemia and insulin resistance are the common underlying physiopathological mechanisms for chronic metabolic disorders.Both overweight and obesity lay the foundation for the etiology of chronic metabolic disorders.The carbohydrate-insulin model indicates a high carbohydrate intake rises blood glucose level and promotes insulin secretion.Energy is stored as fat in adipose tissue under the direction of insulin.Consequently,the oxidation by metabolically active tissues is suppressed which leads to a cellular starvation state.In response,hunger and appetite are elevated and that results in an increased body weight.Restricting the dietary carbohydrate to 150g/d or below,or<26%of the total daily energy intake,decreases the insulin secretion,and it could change how the body utilizes energy to promote the oxidation of fat.The alteration may lead to a decreased body weight due to the loss of fat mass.The low-carbohydrate diet puts no restriction on total energy and protein intake;therefore,it has better compliance comparing with other dietary interventions.The short-term efficacy of low-carbohydrate diets is evident in previous literature since it has fewer adverse health effects than drugs,and it is also cost-efficient regrading health economics.The low-carbohydrate diet is viewed as the first approach for managing chronic metabolic disorders including obesity,type 2 diabetes,NAFLD,and metabolic syndrome.Therefore,the research into low-carbohydrate diets is of great importance.However,lowcarbohydrate diets should not be employed as an everyday diet under normal physiological state,and further research on its long-term effect is warranted.
作者
石汉平
于恺英
周华
SHI Han-ping;YU Kai-ying;ZHOU Hua(Beijing Shijitan Hospital,Capital Medical University/Department of Oncology,Capital Medical University,Beijing 100038,China;The Fifth Affiliated Hospital of Shenzhen University/Central Hospital of Baoan District,Shenzhen 518102,China)
出处
《肿瘤代谢与营养电子杂志》
2019年第1期1-6,共6页
Electronic Journal of Metabolism and Nutrition of Cancer
基金
国家重点研发计划项目(2017YFC1309200)
作者简介
通讯作者:石汉平,电子邮箱:shihp@ccmu.edu.cn.
