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Cell Metab:拜拜夜宵!Cell子刊证实限时饮食可显著改善代谢综合征患者健康指标!

2019-12-11 Walter 转化医学网

代谢综合症是导致2型糖尿病和心血管疾病的风险因素,其一线疗法为积极的饮食干预辅助药物治疗,促使患者减少热量摄入、增加体育锻炼。但由于缺乏自制力和依从性,患者往往不能真正回归到健康的生活方式中来。

代谢综合症是导致2型糖尿病和心血管疾病的风险因素,其一线疗法为积极的饮食干预辅助药物治疗,促使患者减少热量摄入、增加体育锻炼。但由于缺乏自制力和依从性,患者往往不能真正回归到健康的生活方式中来。



加州大学圣地亚哥分校(UCSD)的Pam R. Taub课题组,采用限时饮食(time-restricted eating, TRE)策略进行代谢综合症的临床干预,将患者饮食活动限制在日间10小时内,造成夜间14小时的禁食。在12周的药物治疗和TRE辅助治疗后,患者的健康指标显著提升,表现为体重减轻、体态健康化、血压血脂降低、睡眠质量提升等。这些结果最近发表在《Cell Metabolism》上,表明合理的TRE能够成为代谢综合症有效的临床干预手段。

限时饮食(time-restricted eating, TRE)是一种新兴的饮食干预措施,旨在顺应人体生物钟的前提下,将饮食时间严格限制在某一时间段内,维持稳定的饮食和禁食周期。内分泌系统、自主神经系统和营养物质的昼夜节律有助于代谢和生理的动态平衡,而不规律的进食则可能增加患代谢综合症的风险。

调查发现,50%以上普通人每天陆续进食的时间超过15小时。研究者对每天进食时间大于14小时的超重和肥胖者实行8-10小时的限时饮食策略,在几周内观察到受试者热量摄入减少,体重下降,血液中甘油三酸酯含量降低,以及平均空腹血糖降低等现象。因此,美国心脏协会(AHA)建议每晚空腹以降低心血管疾病的发病风险。

TRE不良反应很少见,通常与限制饮食的时间长度有关。一项交叉研究表明,相较于12小时,较短的6小时TRE更容易引起不适反应,包括呕吐、头痛、口渴和腹泻等。8小时TRE实验无显著不良反应产生。在TRE 13小时(上午6时至晚上19时)实验中,受试者相较于随意饮食时,疲劳感和早餐前饥饿感增加,但在实验结束后16周,受试者就寝前的饥饿感有所降低,早晨精力更加充沛。

限时饮食策略在健康人群中的效果立竿见影,但从未被用于代谢综合症患者的临床干预。因此,Pam R. Taub等人基于啮齿动物中饮食诱发肥胖模型的结果,探究对基础饮食时间超过14小时的代谢综合症患者采取10小时TRE干预,能否产生临床辅助治疗的效果。


10小时限时饮食干预策略
 
研究团队共招募35位正在接受药物治疗的代谢综合征患者,最终获得19例有效数据,包括13位男性受试者和6位女性受试者,平均年龄为59 ± 11.14岁,体重为97.84 ± 19.73 kg ,BMI指数为33.06 ± 4.76 kg/m2。实验要求受试者在手机应用软件myCircadianClock上记录每日摄入热量以及作息时间,包括TRE干预前两周的基线数据和干预后12周的饮食和睡眠情况。


TRE缩短受试者每天热量摄入时间
 
实验结果与研究者的预期类似,在只干预饮食模式而不增加运动量的情况下,受试者的体态更加健康,包括体重减轻(均值±SD,-3.3±3.20 kg [-3%]),腰围缩短(-4.5±6.72 cm [-4%]),体重指数(BMI)显着降低(p <0.05)。?1.1±0.97 kg / m2 [?3%]),体脂百分比降低(?1.0%±0.91%[?3%]),内脏脂肪等级降低(?0.6±0.77 [?3%])等。

受试者的心血管系统指标也得到显著改善,包括收缩期和舒张期血压降低(分别为?5.1±9.51 mmHg [?4%]和?6.5±7.94 mmHg [?8%]),总胆固醇降低(?13.2±24.29 mg / dL [?7%]),低密度脂蛋白胆固醇降低(-11.9±19.01 mg / dL [-11%])和非高密度脂蛋白胆固醇降低(-11.6±22.94 mg / dL [-9%])。

除此之外,受试者的平均血糖、空腹胰岛素、甘油三酸酯虽然没有发生显著性变化,但同样呈现改善的趋势。值得一提的是,10小时TRE受试者表现出一定程度的体力增加,睡眠质量提升,并且没有出现任何头痛、腹泻、疲劳等不良反应。


代谢综合症患者健康指标明显改善
 
Pam R. Taub组的10小时限时饮食研究结果表明,对于正在接受药物治疗和饮食建议的代谢综合症高危人群,通过智能手机app辅助记录的形式提高依从性,有望通过限时饮食策略改善患者的生活方式和昼夜节律,从而促进药物治疗的进程!
 
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    2020-11-21 仁心济世
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    2020-08-04 一闲
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    2020-02-09 guojianrong
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Metabolism:代谢综合征与银屑病风险增加有关

由此可见,银屑病与MetS及其几种成分之间呈显著正相关;在8年随访中,MetS严重程度和肥胖影响了这些关联,表明MetS是银屑病发生发展的危险因素。

JAMA:营养和行为干预对代谢综合征患者饮食习惯的影响

鼓励低能量的地中海饮食和体育活动的干预措施可提高低能量饮食依从性

BMJ:非诺贝特辅助他汀治疗可降低代谢综合征患者主要心血管事件风险

非诺贝特作为他汀治疗辅助药物显著降低了代谢综合征患者的主要心血管事件风险

调研:代谢综合征患者生活方式干预

代谢综合征患者生活方式干预问卷调研,快来参加吧!

Stroke:房颤患者代谢综合征与缺血性卒中风险

由此可见,在调整CHA2DS2-VASc变量后,MetS的存在与缺血性卒中没有显著相关性。考虑MetS不太可能改善AF患者的卒中预测。

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