Plant-based diets high in carbs improve type 1 diabetes, according to new case studies 富含碳水化合物的植物性飲食可改善1型糖尿病

Editor’s comment: One big misconception about carbohydrates is that many organizations and individuals think carbohydrates mean sugars. Carbohydrates include sugars but also other macro-molecules like starches and fibers etc. purified sugars are not healthful but naturally occurring carbohydrates including sugars are actually good for your health.

編者按：關於碳水化合物的一個大誤解是許多組織和個人認為碳水化合物是糖。 碳水化合物包括糖，但也包括其他大分子，如澱粉和纖維等。純化的糖不健康，但天然存在的碳水化合物（包括糖）實際上對您的健康有益。

News Release 23-Jul-2020

Studies challenge misconception that carbs are bad for diabetes

Physicians Committee for Responsible Medicine

WASHINGTON–Plant-based diets rich in whole carbohydrates can improve insulin sensitivity and other health markers in individuals with type 1 diabetes, according to two case studies published by researchers from the Physicians Committee for Responsible Medicine in the Journal of Diabetes & Metabolism.

Both case studies followed individuals with type 1 diabetes who adopted plant-based diets rich in whole carbohydrates–including fruits, vegetables, whole grains, and legumes. The patients’ health care teams tracked their blood sugar control, heart disease risk factors, and other health measurements before and after the diet change.

One case study followed a female patient who was diagnosed with type 1 diabetes in 2018. At the time, her A1c was 8.7%. She initially adopted a low-carbohydrate (less than 30 grams of carbohydrate per day), high-fat diet that was high in meat and dairy. Her blood sugar stabilized, but she required more insulin per gram of carbohydrate consumed. Her total cholesterol also increased from 175 to 221 mg/dL. In January 2019, she switched to a plant-based diet, eliminating dairy products, eggs, and meat. The patient was able to decrease her insulin dosage, maintain her A1c level at 5.4%, and drop her cholesterol level to 158 mg/dL.

“This study challenges the misconception that carbs are the enemy when it comes to diabetes,” says study author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee. “The patient in this case study experienced the opposite: Adding more healthful carbohydrates to her diet stabilized her glycemic control, reduced her insulin needs, and boosted her overall health.”

The other individual–a 42-year-old man who had been diagnosed with type 1 diabetes at age 25–eliminated animal products from his diet and switched to a whole food, plant-based diet. He increased his consumption of carbohydrates from 150 grams to 400-450 grams per day. After adopting a carbohydrate-rich plant-based diet, he lost weight, required less insulin, and reduced his A1c–a measure of blood sugar levels over a 3-month period–from 6.2% to a range between 5.5-5.8%.

The authors note that a previous small study supported the case studies’ results, finding that a high-carbohydrate, high-fiber diet improved glycemic control in 10 people with type 1 diabetes. As a next step, the authors suggest that randomized clinical trials are needed to verify the case studies’ findings, assess their generalizability, and quantify the effectiveness of plant-based diets in the management of type 1 diabetes.

Previous studies have found that low-fat, plant-based diets can be beneficial for those with type 2 diabetes. Research has also shown that those eating a plant-based diet have approximately half the risk of developing type 2 diabetes, compared with non-vegetarians.

“Decades of research has proven that a plant-based diet can be beneficial for those with type 2 diabetes. Now, these groundbreaking case studies are offering hope that the same may be true for those with type 1 diabetes,” adds Dr. Kahleova.

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華盛頓–負責醫師醫學委員會研究人員在《糖尿病與代謝雜誌》上發表的兩個案例研究顯示，富含全糖的植物性飲食可以改善1型糖尿病患者的胰島素敏感性和其他健康指標。

這兩個案例研究均針對患有1型糖尿病的人，他們採用植物性飲食富含全碳水化合物，包括水果，蔬菜，全穀類和豆類。患者的醫療團隊跟踪他們在飲食改變前後的血糖控制，心髒病危險因素以及其他健康狀況。

一項案例研究追踪了一名女性患者，該女性患者於2018年被診斷患有1型糖尿病。當時，她的A1c為8.7％。她最初採用低碳水化合物（每天少於30克碳水化合物）的高脂肪飲食，富含肉類和奶製品。她的血糖穩定了，但是每克消耗的碳水化合物需要更多的胰島素。她的總膽固醇也從175毫克/分升增加到221毫克/分升。在2019年1月，她改用植物性飲食，淘汰了乳製品，雞蛋和肉類。該患者能夠減少胰島素劑量，將A1c水平維持在5.4％，並將膽固醇水平降至158 mg / dL。

“這項研究挑戰了人們誤以為碳水化合物是糖尿病的敵人，”研究作者內科醫生委員會臨床研究主任Hana Kahleova醫學博士說。 “在本案例研究中，患者經歷了相反的情況：在飲食中添加更多健康的碳水化合物可以穩定血糖控制，減少胰島素需求並改善整體健康狀況。”

另一個人-一名42歲的男性在25歲時被診斷出患有1型糖尿病-從飲食中淘汰了動物產品，轉而以植物性飲食為基礎。他每天的碳水化合物消費量從150克增加到400-450克。在採用富含碳水化合物的植物性飲食後，他減輕了體重，減少了胰島素的攝入，並降低了他的A1c（3個月內血糖水平的指標）從6.2％降至5.5-5.8％。

作者指出，先前的一項小型研究支持了該案例研究的結果，發現高碳水化合物，高纖維飲食可以改善10位1型糖尿病患者的血糖控制。下一步，作者建議需要進行隨機臨床試驗，以驗證案例研究的結果，評估其概括性並量化植物性飲食在治療1型糖尿病中的有效性。

先前的研究發現，低脂植物性飲食對2型糖尿病患者可能有益。研究還表明，與非素食者相比，那些食用植物性飲食的人罹患2型糖尿病的風險大約為一半。

數十年來的研究證明，植物性飲食對2型糖尿病患者有益。現在，這些開創性的案例研究為1型糖尿病患者帶來了希望。” Kahleova博士補充說。