Dietary carbohydrate does not pose an additional metabolic challenge, a response to Alberti et al. IDF: a consensus on type 2 diabetes prevention.

摘要

The recent International Diabetes Federation consensus document provides important recommendations for the prevention of Type 2 diabetes . However, the interventions are not weighted according to the quality of the evidence base. In particular, the influence of dietary carbohydrate is contentious, and to state that 'control of carbohydrate intake is also important' and that 'simple carbohydrates with a high glycaemic index (GI) exert an additional metabolic challenge to patients' is questionable and deserves qualification.Epidemiological studies have shown no association between total carbohydrate intake and risk of diabetes . Indeed, in studies focusing on restriction of fat, this inevitably results in a reciprocal increase in percentage of energy from carbohydrate, and this has been shown to improve insulin sensitivity . It is possible that dietary carbohydrate type may affect metabolic carbohydrate handling, and it is widely perceived that simple sugars are detrimental to health in general. However,the GI and metabolic responses attributable to some complex carbohydrates may be equivalent to simple carbohydrates; for example, a carbonated orange drink has a similar GI to mashed boiled potato. Furthermore, in evidence linking glycaemic load to diabetes risk, simple sugars were not the major determinants of glycaemic load .