心脏康复治疗糖尿病前期和代谢综合征缓解：DIABEPIC-1 研究中减少超加工食品摄入量和限制进食时间的影响

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2024-11-01 DOI:10.1016/j.cjco.2024.07.018

Josep Iglesies-Grau MD, PhD , Valérie Dionne NP , Élise Latour RD , Mathieu Gayda PhD , Florent Besnier PhD , Daniel Gagnon PhD , Amélie Debray PhD , Christine Gagnon PhD , Anne-Julie Tessier PhD , Andréanne Paradis , Chiheb Klai , Nicolas Martin , Véronique Pelletier MD , François Simard MD , Anil Nigam MD , Philippe L. L’Allier MD , Martin Juneau MD , Nadia Bouabdallaoui MD, PhD , Louis Bherer PhD

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引用次数: 0

摘要

背景心脏康复项目为促进动脉粥样硬化性心血管疾病（ASCVDs）和代谢合并症（包括代谢综合征和糖尿病前期）患者采用健康的生活方式提供了宝贵的机会。然而，扭转这些状况的策略仍有待探索。DIABEPIC-1研究旨在评估针对ASCVD患者的为期6个月的强化心脏康复计划的可行性，同时调查糖尿病前期和代谢综合征的缓解情况。方法该研究将运动训练与综合营养干预相结合，强调减少超加工食品的摄入、采用地中海饮食以及实施限时进食。基线、3 个月和 6 个月的评估包括分段身体构成测量、血液分析、最大运动量测试、Keenoa AI 应用程序记录的营养日记以及生活方式问卷。缓解标准包括 HbA1c 水平恢复到< 5.7% 和< 3 美国国家胆固醇教育计划成人治疗小组 III（NCEP/ATP-III）糖尿病前期和代谢综合征标准。研究显示，3 个月和 6 个月的完成率分别为 94.4% 和 88.9%，计划临床预约的平均符合率为 92.5%。观察到腰围（-9.2 厘米，P < 0.001）和体重（-8.0 千克，P < 0.001）显著下降。血糖和血脂状况、胰岛素抵抗标志物水平以及肝脏健康均有所改善。参与者增强了心肺功能，减少了超加工食品的摄入量，并更加坚持地中海饮食和限时进食。值得注意的是，50% 的糖尿病前期患者病情得到缓解，70% 基线患有代谢综合征的患者病情得到缓解。结论：该研究表明，通过强化营养干预加强心脏康复的可能性很大，可产生显著的临床效果，包括缓解大量 ASCVD 患者的主要危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Cardiac Rehabilitation for Prediabetes and Metabolic Syndrome Remission: Impact of Ultraprocessed Food–Intake Reduction and Time-Restricted Eating in the DIABEPIC-1 Study

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Cardiac Rehabilitation for Prediabetes and Metabolic Syndrome Remission: Impact of Ultraprocessed Food–Intake Reduction and Time-Restricted Eating in the DIABEPIC-1 Study

Background

Cardiac rehabilitation programs provide a valuable opportunity to promote the adoption of healthy lifestyle behaviors in patients with atherosclerotic cardiovascular diseases (ASCVDs) and metabolic comorbidities, including metabolic syndrome and prediabetes. However, strategies to reverse these conditions remain to be explored. The DIABEPIC-1 study aimed to assess the feasibility of an enhanced 6-month cardiac rehabilitation program for patients with ASCVD while investigating prediabetes and metabolic syndrome remission.

Methods

The study combined exercise training with a comprehensive nutritional intervention, emphasizing reduction in intake of ultraprocessed foods, adoption of a Mediterranean diet, and implementation of time-restricted eating. Baseline, 3-month, and 6-month assessments included segmental body-composition measurements, blood analysis, maximal exercise testing, nutritional diaries recorded with the Keenoa AI app, and lifestyle questionnaires. Remission criteria included a return to an HbA1c level of < 5.7%, and < 3 National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) criteria for prediabetes and metabolic syndrome, respectively.

Results

A total of 36 participants were recruited. The study demonstrated completion rates of 94.4% at 3 months, and 88.9% at 6 months, and a mean compliance rate of 92.5% for planned clinical appointments. Significant reductions in waist circumference (–9.2 cm, P < 0.001) and weight (–8.0 kg, P < 0.001) were observed. Improvement in glycemic and lipid profiles, insulin-resistance marker levels, and liver health were noted. Participants enhanced their cardiorespiratory fitness, reduced their consumption of ultraprocessed food, and increased their adherence to the Mediterranean diet and time-restricted eating. Notably, 50% achieved prediabetes remission, and 70% with metabolic syndrome at baseline achieved remission.

Conclusions

The study demonstrates the possibility of enhancing cardiac rehabilitation with an intensive nutritional intervention, yielding clinically significant outcomes, including remission of key risk factors in a substantial number of ASCVD patients.