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增加全麦食品摄入量可有效降低2型糖尿病风险
作者:小柯机器人 发布时间:2020/7/12 19:50:39

美国哈佛大学陈曾熙公共卫生学院Qi Sun团队分析了全谷物食品摄入量和2型糖尿病风险的相关性。该成果发表在2020年7月8日出版的《英国医学杂志》上。

为了探讨总全谷物饮食和单独全谷饮食的摄入量与2型糖尿病风险之间的关系,研究组进行了一项前瞻性队列研究,1984-2017年间,分批招募了158259名女性和36525名男性参与者,基线时均没有2型糖尿病、心血管疾病或癌症。主要结局指标为问卷确认的2型糖尿病事件自我报告。

在4618796人年的随访中,共确诊了18629名2型糖尿病参与者。对于这三个队列的参与者,每天全谷物总摄入分为五等份。在校正了糖尿病的生活方式和饮食风险因素后,全谷物总消费量最高组的参与者与最低组的参与者相比,2型糖尿病的发病率降低了29%。

对于单独的全谷物食品,每天摄入一份以上全谷物冷早餐、黑面包或爆米花的参与者,与每月摄入不足一份的参与者相比,汇总2型糖尿病的风险比分别为0.81、0.79和1.08。对于平均摄入水平较低的其他单独全谷物,每周摄入两份以上的燕麦、糙米、添加麸皮、小麦胚芽的参与者,与每月摄入不足一份的参与者相比,汇总2型糖尿病的风险比分别为0.79、0.88、0.85和0.88。

样条回归显示,全谷物摄入总量与2型糖尿病风险之间存在非线性剂量反应关系,其中每日摄入2份以上,患病风险平稳降低。对于全谷物冷早餐和黑面包,每天摄入约0.5份,风险可稳定降低。对于爆米花则呈现J型关联,每天摄入一份以上,2型糖尿病的发病率才显著增加。较瘦的参与者与超重或肥胖者相比,全谷物总摄入量较高与较低的2型糖尿病风险之间的相关性更强,但该相关性在体育活动程度、糖尿病家族史或吸烟状况等方面无显著变化。

总之,食用全麦谷物和几种较常食用的全麦食品,包括全麦早餐谷物、燕麦片、黑面包、糙米、添加麸皮和小麦胚芽,可显著降低2型糖尿病的患病风险。

附:英文原文

Title: Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies

Author: Yang Hu, Ming Ding, Laura Sampson, Walter C Willett, JoAnn E Manson, Molin Wang, Bernard Rosner, Frank B Hu, Qi Sun

Issue&Volume: 2020/07/08

Abstract: Objective To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes.

Design Prospective cohort studies.

Setting Nurses’ Health Study (1984-2014), Nurses’ Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States.

Participants 158259 women and 36525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline.

Main outcome measures Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire.

Results During 4618796 person years of follow-up, 18629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status.

Conclusion Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.

DOI: 10.1136/bmj.m2206

Source: https://www.bmj.com/content/370/bmj.m2206

期刊信息

BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。隶属于BMJ出版集团,最新IF:27.604
官方网址:http://www.bmj.com/
投稿链接:https://mc.manuscriptcentral.com/bmj