编者按
2020年6月,美国盐城湖山间医学中心的Benjamin Horne教授在JAMA杂志发表了一篇的观点文章,阐述了间歇性禁食对2型糖尿病患者的健康影响和以及其安全性。JAMA杂志的主编Howard Bauchner博士就该话题对Benjamin Horne教授进行了专访。上一期我们聆听了第一部分,本期继续。
Howard Bauchner博士(左一),JAMA杂志主编;
Benjamin Horne教授(右一),美国盐城湖山间医学中心
Now, how long do you have to fast to have these effects?
That's an open question right now. And I think it partly relates to the frequency of the fasting. So, the more intense regimens tend to reduce weight much more quickly. And presumably are reducing the risk factors for cardiometabolic disease, chronic diseases, much more quickly. It's not really clear though, because there's not a consistent finding that cardiac risk factors, for example, are reduced, or that the markers of cognitive function, like brain derived neurotrophic factor, are altered. So, there are some issues with steady designs. For example, most clinical trials of intermittent fasting have been conducted in people who are apparently healthy, they may be overweight or obese. But generally, people who have normal cardiac and metabolic risk factor levels are those who have been involved in studies. So, there may not be much room for those risk factors to be improved, because there are already quite good in most of the studies..
And so, the effects that they are looking for and that have been studied are primarily related to weight loss or reduction of risk factors that could lead you to chronic disease for people that have developed chronic disease. However, the risks are higher, both in terms of going on to have sequelae related to their disease, but then also safety issues. And so, these studies looking at people who have diagnosed type 2 diabetes are relatively small.
目前有大量针对具有糖尿病危险因素的人群的研究。但我们只确定了7项研究,其研究对象是确诊为2型糖尿病的患者。这些研究涉及到很多不同的禁食方案。实际上,所有研究中只有一点具有一致性,即每周2天禁食疗法。这7项研究中有3项观察了每周2天禁食疗法,其余的都有自己的治疗方案,他们发现了一些非常有趣的结果。如你所预料,他们的体重减轻了。对健康人群的研究也主要关注减肥方面,结果发现,体重减少量与持续的能量或热量限制量相似。对2型糖尿病患者的研究,也发现其血糖控制得到改善,同时还发现糖化血红蛋白降低。这与热量限制量是相似的。
There are a plethora of studies looking at people who have risk factors for developing diabetes. But we've only been able to identify 7 studies where the study population, where people who have diagnosed type 2 diabetes. And among those, there are quite a number of different fasting regimes that have been looked at. Only one, actually, those consistent across any of the studies, was a 2-day-perweek fasting regimen, where 3 of those 7 studies looked at that twice weekly fasting regimen. All the others had their own regimen, and they have found some very interesting outcomes. As you might expect, they all found that weight was reduced. And studies among apparently healthy people have primary also addressed weight loss and found that it's very similar amount of weight loss to continuous energy restriction, or caloric restriction. These studies of people with type 2 diabetes also have found that the glycemic control improves. And they have found that includes reduction in hemoglobin A1c. Again, it's been similar amount of reduction to, what we say, with the caloric restriction.
事实上,这7项研究中规模最大的一项研究,评估了137例受试者,其热量限制量相当于每周禁食两次。结果发现,这些受试者的血糖、生活质量和血压都有改善。此外,对受试者而言还有很多其他潜在的获益,其中一些与情绪和抑郁有关。关于间歇性禁食的报道,很多都显示其有益于代谢健康和糖尿病风险改善。我们研究糖尿病患者是有意义的,因为似乎很多益处都显现在间歇性禁食的糖尿病患者中。
And in fact, in in one study, the largest study of these 7, where they evaluated 137 individuals, they found that it was equivalent reduction to what was found for people engaging in caloric restriction that was twice a week fasting. There also are improvements in glucose and quality of life and blood pressure. And they're variety of other benefits that are potential, some of them related to mood and depression. A lot of the benefits that are reported for intermittent fasting center on metabolic health and diabetes risk, and so it makes sense that we study people with diabetes. Because it seems like probably a lot of the benefits are focused on that population for intermittent fasting.
相关单词学习:
open question
待解决的问题
禁食越严格,减重速度越快
脑源性神经营养因子
虽然,尽管,固然
n. 后遗症;结果(sequela的复数,sequela /sɪ'kwilə/ )
过剩,过多,过量,多血症
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