AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane ...AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes". Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss.展开更多
目的运用网状Meta分析评价5种不同饮食模式对2型糖尿病患者血糖和体重的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网和万方数据库中有关饮食模式对2型糖尿病患者血糖和体重影响...目的运用网状Meta分析评价5种不同饮食模式对2型糖尿病患者血糖和体重的影响。方法计算机检索PubMed、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网和万方数据库中有关饮食模式对2型糖尿病患者血糖和体重影响的随机对照试验。由两名研究者独立提取数据资料,根据Co⁃chrane偏倚风险评估标准,使用Review Manager 5.3软件进行质量评价,利用Stata 17.0软件进行数据分析。结果共纳入31项研究,糖化血红蛋白的网状Meta分析排序结果从优到劣依次为:生酮饮食>低血糖指数饮食>间歇性断食>常规糖尿病饮食>常规饮食;空腹血糖的网状Meta分析排序结果从优到劣依次为:生酮饮食>低血糖指数饮食>间歇性断食>常规糖尿病饮食>常规饮食;体重指数的网状Meta分析排序结果从优到劣依次为:生酮饮食>间歇性断食>低血糖指数饮食>常规糖尿病饮食>常规饮食;体重的网状Meta分析排序结果从优到劣依次为:生酮饮食>间歇性断食>低血糖指数饮食>常规糖尿病饮食>常规饮食。结论在5种饮食模式中,生酮饮食具有最优降血糖和降体重效应。展开更多
Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exer...Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.展开更多
目的:探讨“三低三不”饮食原则联合高强度间歇有氧运动对老年糖尿病伴高脂血症患者的影响。方法:选取2022年8月—2023年8月厦门大学附属第一医院收治的102例老年糖尿病伴高脂血症患者。随机将其分为对照组与观察组,各51例。对照组给予...目的:探讨“三低三不”饮食原则联合高强度间歇有氧运动对老年糖尿病伴高脂血症患者的影响。方法:选取2022年8月—2023年8月厦门大学附属第一医院收治的102例老年糖尿病伴高脂血症患者。随机将其分为对照组与观察组,各51例。对照组给予“三低三不”饮食原则联合中低强度持续有氧运动,观察组给予“三低三不”饮食原则联合高强度间歇有氧运动。比较两组干预前后的血糖指标、血脂指标、体格指标、血管内皮功能指标。结果:干预后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)均低于干预前,观察组FBG、2 h PG均低于对照组,差异有统计学意义(P<0.05)。干预后,两组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(lLDL-C)均低于干预前,HDL-C高于干预前,观察组TC、TG、LDL-C均低于对照组,HDL-C高于对照组,差异有统计学意义(P<0.05)。干预后,两组体重、体重指数及腰围均低于干预前,观察组体重、体重指数及腰围均低于对照组,差异有统计学意义(P<0.05)。干预后,两组内皮素(ET-1)低于干预前,一氧化氮(NO)高于干预前,观察组ET-1低于对照组,NO高于对照组,差异有统计学意义(P<0.05)。结论:“三低三不”饮食原则联合高强度间歇有氧运动能够降低老年糖尿病伴高脂血症患者的血糖血脂水平,降低其体格指标,改善其血管内皮功能。展开更多
This review will examine topical issues in weight loss and weight maintenance in people with and without diabetes. A high protein, low glycemic index diet would appear to be best for 12-mo weight maintenance in people...This review will examine topical issues in weight loss and weight maintenance in people with and without diabetes. A high protein, low glycemic index diet would appear to be best for 12-mo weight maintenance in people without type 2 diabetes. This dietary pattern is currently beingexplored in a large prevention of diabetes intervention. Intermittent energy restriction is useful but no better than daily energy restriction but there needs to be larger and longer term trials performed. There appears to be no evidence that intermittent fasting or intermittent severe energy restriction has a metabolic benefit beyond the weight loss produced and does not spare lean mass compared with daily energy restriction. Meal replacements are useful and can produce weight loss similar to or better than food restriction alone. Very low calorie diets can produce weight loss of 11-16 kg at 12 mo with persistent weight loss of 1-2 kg at 4-6 years with a very wide variation in long term results. Long term medication or meal replacement support can produce more sustained weight loss. In type 2 diabetes very low carbohydrate diets are strongly recommended by some groups but the long term evidence is very limited and no published trial is longer than 12 mo. Although obesity is strongly genetically based the microbiome may play a small role but human evidence is currently very limited.展开更多
文摘AIM To discuss type 2 diabetes mellitus(T2DM) medication changes required during the popular 5:2 intermittent energy restriction(IER) diet. METHODS A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets(VLCD) in people with T2 DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes". Reference lists of selected articles were also screened for relevant publications. Only research articles written in English, which also included an explanation of medication changes were included. A recent pilot trial using the 5:2 IER method, conducted by our research group, will also be summarized.RESULTS A total of 8 studies were found that investigated the use of VLCD in T2 DM and discussed medication management. Overall these studies indicate that the use of a VLCD for people with T2 DM usually require the cessation of medication to prevent hypoglycemia. Therefore, the 5:2 IER method will also require medication changes, but as seen in our pilot trial, may not require total cessation of medication, rather a cessation on the 2 IER days only. CONCLUSION Guidelines outlined here can be used in the initial stages of a 2-d IER diet, but extensive blood glucose monitoring is still required to make the necessary individual reductions to medications in response to weight loss.
文摘Nonalcoholic fatty liver disease (NAFLD) is emerging globally, while no therapeutic medication has been approved as an effective treatment to date, lifestyle intervention through dietary modification and physical exercise plays a critical role in NAFLD management. In terms of dietary modification, Mediterranean diet is the most studied dietary pattern and is recommended in many guidelines, however, it may not be feasible and affordable for many patients. Recently, a ketogenic diet and intermittent fasting have gained public attention and have been studied in the role of weight management. This article reviews specifically whether these trendy dietary patterns have an effect on NAFLD outcomes regarding intrahepatic fat content, fibrosis, and liver enzymes, the scientific rationales behind these particular dietary patterns, as well as the safety concerns in some certain patient groups.
文摘目的:探讨“三低三不”饮食原则联合高强度间歇有氧运动对老年糖尿病伴高脂血症患者的影响。方法:选取2022年8月—2023年8月厦门大学附属第一医院收治的102例老年糖尿病伴高脂血症患者。随机将其分为对照组与观察组,各51例。对照组给予“三低三不”饮食原则联合中低强度持续有氧运动,观察组给予“三低三不”饮食原则联合高强度间歇有氧运动。比较两组干预前后的血糖指标、血脂指标、体格指标、血管内皮功能指标。结果:干预后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)均低于干预前,观察组FBG、2 h PG均低于对照组,差异有统计学意义(P<0.05)。干预后,两组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(lLDL-C)均低于干预前,HDL-C高于干预前,观察组TC、TG、LDL-C均低于对照组,HDL-C高于对照组,差异有统计学意义(P<0.05)。干预后,两组体重、体重指数及腰围均低于干预前,观察组体重、体重指数及腰围均低于对照组,差异有统计学意义(P<0.05)。干预后,两组内皮素(ET-1)低于干预前,一氧化氮(NO)高于干预前,观察组ET-1低于对照组,NO高于对照组,差异有统计学意义(P<0.05)。结论:“三低三不”饮食原则联合高强度间歇有氧运动能够降低老年糖尿病伴高脂血症患者的血糖血脂水平,降低其体格指标,改善其血管内皮功能。
文摘This review will examine topical issues in weight loss and weight maintenance in people with and without diabetes. A high protein, low glycemic index diet would appear to be best for 12-mo weight maintenance in people without type 2 diabetes. This dietary pattern is currently beingexplored in a large prevention of diabetes intervention. Intermittent energy restriction is useful but no better than daily energy restriction but there needs to be larger and longer term trials performed. There appears to be no evidence that intermittent fasting or intermittent severe energy restriction has a metabolic benefit beyond the weight loss produced and does not spare lean mass compared with daily energy restriction. Meal replacements are useful and can produce weight loss similar to or better than food restriction alone. Very low calorie diets can produce weight loss of 11-16 kg at 12 mo with persistent weight loss of 1-2 kg at 4-6 years with a very wide variation in long term results. Long term medication or meal replacement support can produce more sustained weight loss. In type 2 diabetes very low carbohydrate diets are strongly recommended by some groups but the long term evidence is very limited and no published trial is longer than 12 mo. Although obesity is strongly genetically based the microbiome may play a small role but human evidence is currently very limited.
