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男士们,你想躲过糖尿病吗?有希望! (updated)

已有 1168 次阅读 2018-6-11 09:45 |个人分类:Scientific Translation|系统分类:科普集锦| 限时饮食(eTRF), 实间歇性禁食(IF), 心脏代谢, 糖尿病前期患者

关键词:

男士; 糖尿病前期患者   间歇性禁食;   限时饮食(eTRF;一天进食时间限于6小时,晚饭在下午3点吃完



https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30253-5

 

CLINICAL AND TRANSLATIONAL REPORT

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Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes

 

即使糖尿病前期男性患者体重没有减轻,限时饮食能够改善胰岛素敏感性、血压和氧化应激

 

Elizabeth F. Sutton, Robbie Beyl, Kate S. Early, William T. Cefalu, Eric Ravussin, Courtney M. Peterson5,

Correspondence information about the author Courtney M. Peterson

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DOI: https://doi.org/10.1016/j.cmet.2018.04.010 |

 

Highlights

 

Early time-restricted feeding (eTRF) increases insulin sensitivity

限时饮食(eTRF)可增加胰岛素敏感性


 

eTRF also improves β cell function and lowers blood pressure and oxidative stress

限时饮食(eTRF)还可以改善β细胞功能,降低血压和氧化应激


 

eTRF lowers the desire to eat in the evening, which may facilitate weight loss

限时饮食(eTRF)降低了晚上进食的欲望,这可能有助于减肥


 

Intermittent fasting can improve health even in the absence of weight loss

即使没有体重减轻,间歇性禁食也可以改善健康


 

Summary

Intermittent fasting (IF) improves cardiometabolic health; however, it is unknown whether these effects are due solely to weight loss. We conducted the first supervised controlled feeding trial to test whether IF has benefits independent of weight loss by feeding participants enough food to maintain their weight. Our proof-of-concept study also constitutes the first trial of early time-restricted feeding (eTRF), a form of IF that involves eating early in the day to be in alignment with circadian rhythms in metabolism. Men with prediabetes were randomized to eTRF (6-hr feeding period, with dinner before 3 p.m.) or a control schedule (12-hr feeding period) for 5 weeks and later crossed over to the other schedule. eTRF improved insulin sensitivity, β cell responsiveness, blood pressure, oxidative stress, and appetite. We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF’s effects are not solely due to weight loss.

间歇性禁食(IF)可改善心脏代谢健康;然而,这些影响是否仅仅归因于体重减轻尚不清楚。我们进行了第一次监督控制饮食试验,通过为参与者提供足够的食物来维持体重,从而检测间歇性禁食(IF)是否具有独立于体重减轻的益处。我们的(概念证明性)研究也构成了限时饮食(eTRF)的第一个试验,这是一种间歇性禁食(IF)的形式,涉及在白天早些时候进食以与新陈代谢中的昼夜节律相一致。将患有前期糖尿病的男性随机分为限时饮食(eTRF)(一天饮食时间限于6小时,下午3点前吃晚餐)或对照方案(12小时喂食期),一共5周;然后对换饮食方案。限时饮食(eTRF)改善了胰岛素敏感性、β细胞反应性、血压、氧化应激和食欲。我们首次用人(译注:而不是老鼠)证实限时饮食(eTRF)改善了心脏代谢健康的某些方面,并且证实间歇性禁食(IF)的效果不仅仅是由于体重减轻。


 

ps. I didn't read the whole paper when I wrote this Blog. I was too excited. Now, I read a little more, and hope other readers will read at least the following two paragraphs.

 

Feasibility and Acceptability

Although our study was an efficacy trial, we also collected preliminary data on feasibility and acceptability. As shown in Figure S3, participants reported that it took 12 ± 10 days (range: 2–35 days) to adjust to the eTRF schedule, and all but one participant adjusted within about 2 weeks. Participants also reported that the challenge of eating within 6 hr each day was more difficult than the challenge of fasting for 18 hr per day (difficulty scores: 65 ± 20 versus 29 ± 18 mm; p = 0.009). In fact, all but one participant reported that it was not difficult or only moderately difficult (<50 mm on a 100-mm scale) to fast for 18 hr daily. Based on their experiences in adhering to eTRF, participants thought that eating within a 7.8 ± 1.8-hr daily period (range: 4–10 hr) would be feasible for most people. At the end of the study, seven out of eight participants were willing to eat dinner earlier, based on their subjective experiences in the study, while all eight said they were willing to do so if it improved their health. Thus, while fasting for 18 hr per day is well tolerated and not difficult, the feasting aspect of eTRF is more difficult for participants, so TRF interventions with an 8-hr or longer eating period may be a better target for future effectiveness trials.

Limitations

This study has several limitations. First, our trial included only eight men. Although our sample size is similar to other extremely well-controlled or inpatient circadian trials, our results need to be replicated in a larger trial that also includes women. Second, we did not match the fasting duration prior to testing, which may have underestimated the improvements in insulin sensitivity and also likely explains the increase in triglycerides and total cholesterol. Although we suspect that the elevation in fasting triglycerides is a transient byproduct of eTRF’s extended daily fasting, future trials that measure lipid levels across the 24-hr day and/or that image plaque and ectopic fat depots are needed to confirm that this phenomenon is not pathophysiologic. Third, our trial did not measure glucose levels over a 24-hr period, so we were unable to investigate whether eTRF, by virtue of shifting the timing of lunch and dinner to earlier during the day, lowers mean 24-hr glucose levels as would be expected based on prior research (Poggiogalle et al., 2018). Along similar lines, since we did not measure blood pressure across the 24-hr day, measuring only morning fasting values may overestimate eTRF’s effects on blood pressure. Finally, since our trial was an efficacy trial designed to isolate and measure the physiologic effects of eTRF, our study does not provide any insight into feasibility. Future trials are needed to determine the optimal length and timing of the feeding period and whether eTRF is feasible and effective in the general population.





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