• 碳水化合物-胰岛素模型(CIM)认为,高碳水化合物饮食导致餐后高血糖,刺激胰岛素分泌,促进了脂肪储存,使血液中糖、脂等供能分子不足,致使饥饿感和能量摄入增加、降低代谢率,从而导致肥胖;
  • 遗传学、动物实验、行为和观察研究、喂食研究等,均有证据支持CIM;
  • CIM的饮食建议:减少糖负荷(GL)高的碳水食物,多吃低GL的碳水食物,吃全谷,增加健康高脂食物,蛋白质摄入充足但不过量,代谢综合征患者可用膳食脂肪替代碳水。
JAMA Internal Medicine近期发表观点文章,并配发评论(查看文章)。该文章总结了肥胖的“碳水化合物-胰岛素模型”的要点和相关研究证据,并给出了基于该模型的饮食指导建议。虽然仍存在与现有证据相左的地方,但该模型纳入了人体生理过程和神经内分泌机制等因素,相比传统模型有独到之处,值得进一步探索和检验。

The Carbohydrate-Insulin Model of Obesity: Beyond "Calories In, Calories Out"



2018-07-02, Article

Abstract & Authors:展开

Despite intensive research, the causes of the obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According to the carbohydrate-insulin model (CIM) of obesity, recent increases in the consumption of processed, high-glycemic-load carbohydrates produce hormonal changes that promote calorie deposition in adipose tissue, exacerbate hunger, and lower energy expenditure. Basic and genetic research provides mechanistic evidence in support of the CIM. In animals, dietary composition has been clearly demonstrated to affect metabolism and body composition, independently of calorie intake, consistent with CIM predictions. Meta-analyses of behavioral trials report greater weight loss with reduced-glycemic load vs low-fat diets, though these studies characteristically suffer from poor long-term compliance. Feeding studies have lacked the rigor and duration to test the CIM, but the longest such studies tend to show metabolic advantages for low-glycemic load vs low-fat diets. Beyond the type and amount of carbohydrate consumed, the CIM provides a conceptual framework for understanding how many dietary and nondietary exposures might alter hormones, metabolism, and adipocyte biology in ways that could predispose to obesity. Pending definitive studies, the principles of a low-glycemic load diet offer a practical alternative to the conventional focus on dietary fat and calorie restriction.

First Authors:
David S Ludwig

Correspondence Authors:
David S Ludwig

All Authors:
David S Ludwig,Cara B Ebbeling