饮食改善血糖，个体化干预比地中海饮食更有效 | 热心肠日报
个性化的餐后葡萄糖反应 - 靶向性饮食与地中海饮食对前驱糖尿病的血糖控制
10.2337/dc21-0162
07-23, Article
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OBJECTIVE : To compare the clinical effects of a personalized postprandial-targeting (PPT) diet versus a Mediterranean (MED) diet on glycemic control and metabolic health in prediabetes.
RESEARCH DESIGN AND METHODS : We randomly assigned adults with prediabetes (n = 225) to follow a MED diet or a PPT diet for a 6-month dietary intervention and additional 6-month follow-up. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses. During the intervention, all participants were connected to continuous glucose monitoring (CGM) and self-reported dietary intake using a smartphone application.
RESULTS : Among 225 participants randomized (58.7% women, mean ± SD age 50 ± 7 years, BMI 31.3 ± 5.8 kg/m2, HbA1c, 5.9 ± 0.2% [41 ± 2.4 mmol/mol], fasting plasma glucose 114 ± 12 mg/dL [6.33 ± 0.67 mmol/L]), 200 (89%) completed the 6-month intervention. A total of 177 participants also contributed 12-month follow-up data. Both interventions reduced the daily time with glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c levels, but reductions were significantly greater in PPT compared with MED. The mean 6-month change in “time above 140” was −0.3 ± 0.8 h/day and −1.3 ± 1.5 h/day for MED and PPT, respectively (95% CI between-group difference −1.29 to −0.66, P < 0.001). The mean 6-month change in HbA1c was −0.08 ± 0.19% (−0.9 ± 2.1 mmol/mol) and −0.16 ± 0.24% (−1.7 ± 2.6 mmol/mol) for MED and PPT, respectively (95% CI between-group difference −0.14 to −0.02, P = 0.007). The significant between-group differences were maintained at 12-month follow-up. No significant differences were noted between the groups in a CGM-measured oral glucose tolerance test.
CONCLUSIONS : In this clinical trial in prediabetes, a PPT diet improved glycemic control significantly more than a MED diet as measured by daily time of glucose levels >140 mg/dL (7.8 mmol/L) and HbA1c. These findings may have implications for dietary advice in clinical practice.
First Authors:
Orly Ben-Yacov
Correspondence Authors:
Eran Elinav,Eran Segal
All Authors:
Orly Ben-Yacov,Anastasia Godneva,Michal Rein,Smadar Shilo,Dmitry Kolobkov,Netta Koren,Noa Cohen Dolev,Tamara Travinsky Shmul,Bat Chen Wolf,Noa Kosower,Keren Sagiv,Maya Lotan-Pompan,Niv Zmora,Adina Weinberger,Eran Elinav,Eran Segal