治疗成人 2 型糖尿病的素食和纯素饮食模式：随机对照试验的系统回顾和元分析

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2024-10-01 DOI:10.1016/j.advnut.2024.100294

Nanci S Guest , Sudha Raj , Matthew J Landry , A Reed Mangels , Roman Pawlak , Katelyn E Senkus , Deepa Handu , Mary Rozga

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引用次数: 0

摘要

以植物为基础的饮食模式（包括素食和纯素饮食模式）有助于维持健康体重、改善血糖控制和降低糖尿病并发症风险，从而有助于控制 2 型糖尿病（T2DM）。一些糖尿病临床实践指南支持使用素食饮食模式，但最近尚未对随机对照试验（RCT）的证据进行系统性回顾（SR），以检查其疗效。本系统综述的主要目的是研究与荤食饮食模式相比，素食饮食模式对成人 T2DM 患者的影响。在 MEDLINE、CINAHL、Cochrane CENTRAL 对照试验数据库、Food Science Source 和 SportsDiscus 数据库中检索了 1998 年至 2023 年 5 月期间发表的 RCT。两位独立审稿人提取数据，并使用 Cochrane RoB 2 工具评估偏倚风险。数据采用 DerSimonian-Laird 随机效应模型进行汇总，并以平均差 (MD) 和 95% 置信区间 (CI) 表示。异质性采用 I2 统计量进行评估，证据的确定性采用推荐、评估、发展和评价分级法进行评估。本研究对 66 篇文章的全文进行了审查，并纳入了 7 项 RCT 研究（n = 770 名参与者）。素食饮食模式可降低血红蛋白 A1c [MD（95% CI）：-0.40% (-0.59, -0.21)]和体重指数 [MD（95% CI）：-0.96 kg/m2 (-1.58, -0.34)]（中等确定性证据）。34）]（中度确定性证据）；与非素食饮食模式相比，可减少糖尿病药物治疗（3 项纳入研究中的 2 项）（低确定性）；可改善葡萄糖代谢清除率（胰岛素敏感性）[MD（95% CI）：10%（1.86，18.14）]（极低确定性）。素食饮食模式对空腹血糖、空腹胰岛素或低密度脂蛋白胆固醇浓度没有影响。这些研究结果支持将素食或纯素饮食模式作为 T2DM 成人患者营养护理计划的选项。

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Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Plant-based dietary patterns, including vegetarian and vegan dietary patterns, may help to manage type 2 diabetes (T2DM) by contributing to maintenance of a healthy body weight, improved glycemic control, and reduced risk of diabetes complications. Several diabetes clinical practice guidelines support the use of vegetarian dietary patterns, but there has not been a recently updated systematic review (SR) of evidence from randomized controlled trials (RCTs) to examine efficacy. The primary objective of this SR was to examine the effect of vegetarian dietary patterns compared with nonvegetarian dietary patterns in adults with T2DM. MEDLINE, CINAHL, Cochrane CENTRAL Database of Controlled Trials, Food Science Source, and SportsDiscus databases were searched for RCTs published from 1998 to May 2023. Two independent reviewers extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Data were pooled using a DerSimonian–Laird random-effects model and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Full texts of 66 articles were reviewed, and 7 RCTs (n = 770 participants) were included in this SR. Vegetarian dietary patterns likely reduce hemoglobin A1c [MD (95% CI): –0.40% (–0.59, –0.21)] and body mass index [MD (95% CI): –0.96 kg/m² (–1.58, –0.34)] (moderate certainty evidence); may allow for reduced diabetes medication (in 2 of 3 included studies) (low certainty); and may improve metabolic clearance of glucose (insulin sensitivity) [MD (95% CI): 10% (1.86, 18.14)] (very low certainty), compared with nonvegetarian dietary patterns. There were no effects of vegetarian dietary patterns on fasting blood glucose, fasting insulin, or low-density lipoprotein cholesterol concentrations. These findings support the inclusion of vegetarian or vegan dietary patterns as options in nutrition care plans for adults with T2DM.

PROSPERO Registration

CRD42023396453.

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.