I-Q & A yengcali malunga nophando olutsha
Ngenye yemibuzo efunwa kakhulu xa ifika kwimpilo, i- blood glucose (ishukela yegazi), kunye nokulawulwa kwisisindo: xa usebenzisa izityalo zentshukela ezinokuthi zithandwa ngobuncwane, i-calorie ephantsi okanye i-sweeteners? Ngaba zikhuselekile kwaye zinokukunceda ulahlekelwe isisindo okanye unciphise ushukela wegazi?
Uhlolo loPhando
Kukho amashumi eminyaka yophando malunga nokukhuselwa kwamakhalori aphantsi (LCS) nokuba ingaba banceda abantu banciphise ubunzima okanye bafumane ukulawula i-glucose kalula.
Uphando luxutywe, ezinye zilungile kwaye ezinye ezimbi. Inyaniso kukuba ukulinganisa kwipatheni yokutya okunempilo yinto engagxininise kuphela kwisidlo esinye okanye umtya wokutya. Ukumodareyitha kukhiye.
Kwaye xa kuziwa ekulahlekelweni nokulawulwa kobunzima, ukunciphisa iikhalori ezivela kwishukela kunye ne-carbohydrates ecocekileyo kunokunceda abantu abanesifo sikashukela okanye baninzi kakhulu kunciphisa umzimba kwaye banciphise ushukela wegazi.
Ngoko ke, ukuba ukutshintsha ekusebenziseni ushukela okanye iziphuzo ezivuthayo rhoqo, ezifana ne-soda, kwiipakethi ze-LCS okanye iziyobisi zokutya kukunceda ulawule ubunzima bakho kwaye uphucule ushukela wegazi , uze ufune ukuziqwalasela.
Kwabo ababenokungathembeki kwi-LCS, ukufundiswa kweso sifundo kunye nokulinganisa i-pros and cons, kunokukunceda wenze ukhetho olufanelekileyo. Ukugqithisa kakhulu kunye nokuba nesifo sikashukela esingalawulwayo kuyisongelo kwimpilo yakho kwaye kunokuba luncedo ukusebenzisa iimveliso ezinokukunceda ufinyelele iinjongo zakho.
Uninzi lwezifundo zibonisa ukuba abantu abasebenzisa i-LCS banako ukunciphisa ubunzima, balondoloze ubunzima obunempilo, kwaye balawulwe amanqanaba eshukela egazi.
Ingxoxo Yengcali
Ithemba iWarsshaw, i-MMSc, i-RD, i-CDE, i-BC-ADM, iyanzima njengengcali ngesihloko.
I-Q: Ezinye iziphumo zibonisa ukuba i-LCS ikhuthaza ukutya ngokutya kunye nokugqibela ekufumaneni ubunzima kodwa abanye babonisa ukuba i-LCS isetyenziswe njengenxalenye yokutya okunempilo kunye neendlela zokuphila kwaye inokunceda ukulawula ubunzima. Inyaniso iphi na?
A: Ngaphambi kokukhangela izifundo ezizimeleyo, nantsi ingezantsi. Ekubukeni komzimba wophando nge-LCS kunye nobunzima bomzimba, imibutho eninzi yempilo kunye neengcali ziyavumelana nezigqibo ezivela kwisicatshulwa senzululwazi evela kwi-American Diabetes Association (ADA) kunye ne-American Heart Association (AHA):
I-LCS ayilona umlingo womlenze wokulahlekelwa kwesisindo, kodwa ingaba esinye sezixhobo ezininzi ongasisebenzisa njengenxalenye yesicwangciso esipheleleyo sokulawula isisindo. I-LCS inokunceda abantu banciphise i-calorie yabo yokungenayo xa bengathathi indawo iikhalori ezilondoloziweyo ngeekhalori ezivela kwezinye ukutya.
Kukho izifundo eziphikisanayo, kodwa nakwizinto ezichasene nezihloko. Kuphando lwe-LCS kunye nokulawulwa kobunzima-inani leentloko malunga ne-LCS, kunye neentlanzi ezidityanisiweyo zokutya eziqukethe enye okanye ngaphezulu kwe-LCS, ziye zaphuma kwizifundo ezibizwa ngokuba yi-observational studies. Ezi zifundo zihlalutya inani elikhulu leenkcukacha ezivela kwizifundo, eziqwalasela iqela elikhulu labantu kwaye zilandele izinto ezininzi zokuphila.
Ezi zifundo zingenza ukuqwalasela kodwa zingenakuqinisekisa isizathu nesiphumo, umzekelo, ukuba i-LCS kunye / okanye iziselo zokutya zenza ukuba uzuze umzimba. Inyani kukuba ezinye izinto ezininzi ekukhethweni kokutya komntu kunye nendlela yokuphila zingenza uzuze umzimba. Ngohlalutyo luka-2013 nguPereira eninzi yezifundo zokuqwalasela, waphetha ukuba abantu abasengozini yokufumana ubunzima, ukukhuluphala, kunye nohlobo lwesibini sikashukela (T2D) banokuthi banokunyusa ukondla kwabo iziyobisi zokutya ekuzameni ukunciphisa ingozi yesifo sikashukela kunye nesisindo- izifo ezihlobene.
Izilingo ezimbalwa ezilawulwe ngokulandelelana (RCT) zigqityiwe, ezibonisa ukuba i-LCS (ingakumbi xa izidyo zokutya zithatha i-sugar-sweetened drink (SSB)) kunokunceda abantu balahlekelwe ubuncinane besisindo. Ii-RCT zibhekwa njenge-standard standard ye-study apho abaphandi baqhathanisa ukulawulwa kwamanye amaqela okufunda ukuze bathathele impembelelo yenguqu ethile.
UPeter kunye nabanye abaphandi baqhuba iprogram yokulawula ubunzima beeveki ezili-12 kumadoda angama-300 nabasetyhini. Iqela lokufunda lalifundiswe ukusela ii-ounces ezingama-24 ngosuku lweentlanzi zokutya (nayiphi na uhlobo) kunye nokulawula kwakufuneka ukuphuze ii-ounces ezingama-24 ngosuku ngosuku kuphela.
Iziphumo zabonisa ukuba iqela lokusela lokutya lilahlekelwe ngumyinge weepounds ezili-13 okanye i-44 ekhulwini ngaphezu kwezifundo zeqela ezilawulayo ezilahlekelwa ngumyinge weepounds ezilisithoba.
Enye i-RCT yiTate kunye nabaphandi abaye babheka abantu abadala abangaphezulu kwama-300 ngaphezulu kweenyanga ezintandathu. Isiselo sokutya kunye namacandelo amanzi ashintshiwe okungenani amabini ama-servings ngosuku ngosuku lwe-SSB yabo kwisiselo sokutya okanye amanzi. Emva kweenyanga ezintandathu, abaphuza iziphuzo zokutya basebenzisa i-five percent loss losses.
Olunye uphando oluvela kwi-Registry National Weight Control Registry (NWCR) -rejistri yabantu abangaphezu kwe-10 000 abalahlekelwe ubuncinane ubunzima beepounds ezingama-30 kwaye bayigcina ubuncinane ubuncinane bonyaka-babhekise ekusebenziseni i-LCS iziphuzo ezinotywala ngaphezulu Amakhulu angama-400 abantu iminyaka eyisixhenxe. Ifumene ama-53 ekhulwini abathathi-nxaxheba bevame ukusela izidyo zokutya kunye neepesenti ezili-10 rhoqo zisebenzisa i-SSB. Phantse ama-80 ekhulwini abathathi-nxaxheba bachaza ukuba izidyo zokutya zancedisa ukuba zilawulwe i-calorie yazo.
Okokugqibela, ukuhlalutya kweemeta (ukuhlalutya kweengxelo ezininzi) ezanyatheliswa ngo-2014 nguMiller noPerez bafumene ukuba uLCS unciphise ubunzima bomzimba xa kuthelekiswa ne-placebo kwaye ngokuthobekileyo, kodwa ngokubalulekayo, isicatshulwa somzimba esincitshisiweyo (BMI), ubunzima beoli kunye nesinqe kwinqanaba. Kwintlanganiso ehamba nale ncwadi, uJames Hill, PhD, umphandi ohloniphekileyo ohloniphekileyo wathi:
Kuthetha ukuba i-LCS ibonakala yenza into eyenzelwe ukuyenza: ukuncedisa ukunciphisa i-energy total input while ngenkxaso inikezela ukuba sinokubaluleka ... Unokusebenzisa ngokuqinisekileyo eli sixhobo [LCS] ngaphandle kokukhathazeka ukuba unokungazibangi ngokungahambi kakuhle ukulawulwa kobunzima bakho imizamo.
Umbuzo: Ingaba uhlobo oluthile lwe-calorie low-sweetener isisindo somzimba ngokwahlukileyo kunomnye?
A: Akukho phando lokubonisa oku. Namhlanje, izidyo zokutya zidla ngokukhawuleka nge-aspartame (izikhuni kunye ne-bottled bottles), i-aspartame kunye ne-saccharin (iziphuzo ezinotywala), i-aspartame kunye ne-acesulfame-K, okanye i-sucralose. Esinye isizathu abenzi bokusela bangasebenzisa umxube we-LCSs kukusebenzisa amanqaku athile ahlukeneyo e-LCS eyahlukileyo ukuphucula umgangatho wonke wemveliso.
Umbuzo: Uphando luphetha ntoni malunga neLCS kunye neenqweno nokwandisa ukondla ukutya kokushukela kunye neesekese?
A: Oku kube yindawo enye yokuxabana malunga neLCS. Ingcamango ibonakala kukuba ngenxa yokuba i-LCS ibumnandi kuneshukela, inqabileyo i-sweet receptors kwaye yenza izifiso ezintle ezikhokelela abantu ukuba batye ngokutya kunye nokunyusa.
Izifundo ezininzi ziphikisa le ngcamango. Ngokomzekelo, u-Antenucci noHayes baqeshwe abantu abangaphezulu kwama-400 kwinqanaba leemvavanyo zengcamango. Abathathi-nxaxheba batywala phakathi kweesampuli ezihlukeneyo ezi-12 no-15 eziqulethe i-calen-containing container kunye neendawo ezahlukeneyo ze-LCS ezininzi. Abathathi-nxaxheba beSifundo bavakalise ukuthobeka okubonakalayo kwesampula ngasinye. Iziphumo zibonise ukuba abathathi-nxaxheba babone ubumnandi be-LCS kwiindawo ezingaphantsi kwee-sweeteners ezine-calories. Abaphandi baphetha ngelithi iziphumo azixhasi iibango lokuba i-LCS ivuselele-ivuselele i-receptors yabantu abathandekayo.
Ukongezelela, ezintathu zezifundo ezidlulileyo zibandakanya iziphumo zokunceda ukuphendula lo mbuzo. U-Peters wabonisa ukulamba kwindlala kwiiveki ezili-12 kwanda kancinci kwinqanaba lamanzi kwaye lahla kancane kwiqela lokuphuza lokutya okubangele ukulamba kakhulu. Uhlalutyo olongezelelweyo lwesifundo se-Tate nguPiernas lubonise ukuba ngelixa zombini abaphuza amanzi kunye nabanxilisayo bezonxila banciphisa iikhalori ezipheleleyo kunye ne-sugar added intake, iqela lokuphuza lokutya linciphisa ukusetyenziswa kwamadyulo ngaphezulu. Abaphandi bacacisa ukuba mhlawumbi izidlo zokutya ziyanelisa umnqweno wento enhle. Ucwaningo lwe-NWCR lubonise ukuba phantse ama-80 ekhulwini abathathi-nxaxheba bathi ukutya kotywala kwabanceda baphathe i-calorie yabo yokudla.
Ngaphantsi-kunokuba ukwandise izifiso, ukondla, kunye nendlala, ngokoqobo i-LCS (mhlawumbi njengomtsalane weshukela okanye ukutya kunye nesiselo) inokwanelisa iimfuno zeesweets kunye nokunciphisa indlala.
Umbuzo: Ngaba kunokwenzeka ukuba i-calorie ephantsi ye-calories iyakuthintela i-microbiome yamagciwane ngendlela engabangela ukunyuka kwamazinga e-glucose?
A: I- microbiome yamanzi iyintlobo ephakamileyo yamachiza amancinci ahlala kumaphecana okutya (amathumbu) ezilwanyana kunye nabantu. Uphando kulo mmandla uqokelela kwaye ukwanda. Ukucinga kukuba ukugcina i-microbiome yempilo enomdla kungabamba indima kwimpilo, ukukhusela izifo, nokugcina isisindo esifanelekileyo.
Uphononongo lukaSuez kunye nabaphandi abathandana nabo, olupapashwe kwiNdalo, lathintele ingqalelo yolwazi oluninzi kwaye lwenza izigqibo ezininzi ngokubanzi malunga nokusetyenziswa kwazo zonke i-LCS. Enyanisweni, uninzi lwezifundo eziphantsi kwiphepha elichazwe ligxile kwi-saccharin kwaye inani lazo laqhutyelwa kwiigundane. Kubalulekile ukuba uqaphele ukuba, nangona i-LCS iluhlu olufanayo, ahluke kwimvelaphi, ukubunjwa, kunye nendlela edibene ngayo. Leli phephancwadi elinzima kakhulu elinemixholo emininzi ngaphakathi. Kule ngongoma, ezinye zeziphumo eziphambili zophando ziye zachaswa yiingcali ezihlonelweyo. Njengokuba kunjalo ngophando oluninzi, uphando olongezelelweyo oluqhutywe kakuhle luya ku funeka lwenziwe ukuze kuqinisekiswe ukuba lolwalamano.
Iziphumo ezikulo cwaningo i-aspartame kunye ne-sucralose, i-calor-low calories ezisebenzisayo kakhulu, ziphakamisa amazinga e-glucose azivumelani nomzimba okhoyo ophando. Kuyafaneleka ukuphawula ukuba ukuba kuvunywe yi-US Food and Drug Administration (FDA) njengesongezelelo sokutya kunye nokusetyenziswa ngabantu abanesifo sikashukela (ukuba yiyiphi), uphando oluthunyelwe kwi-FDA ukuvunyelwa kufuneka lubandakanye uphando malunga nefuthe i-LCS kumazinga e-glucose. Uphando olungeniswe kwi-FDA ukuze luvunywe kunye nophando olongezelelweyo kwiminyaka elandelayo emva kokuvunywa akuvunyelwanga. Ngokubanzi, uphando oluqhutywe kwiminyaka embalwa edlulileyo lubonisa ukuba akukho-aspartame okanye i-aspartame ayitshintshe ngokuphawulekayo i-microbiome yamanzi okanye iphakamisa i-blood glucose level.
Uninzi lwezilwanyana kunye nolwazi olusenziwa ngabantu oluchazwe kwi- Nature study lujolise kwifuthe le-saccharin ekulawuleni i-glucose. Inomdla kubantu abanesifo sikashukela kukuba i-saccharin isetyenziswe iminyaka engaphezu kwe-100 kwaye iminyaka emininzi yayikuphela kokhetho olukhoyo. Okwangoku, kukho izifundo ezimbalwa zezilwanyana ezibonisa i-saccharin kumayeza aphezulu angatshintsha i-microbiome. Idatha kwizifundo zabantu kule sihloko ayinelanga kwaye ayicacile.
Ngaphantsi-Uphando olongezelelweyo lubalulekile, kodwa impembelelo enkulu ye-saccharin ekusebenziseni i-microbiome okanye i-glucose amazinga ayabonakala engenakwenzeka.
Q: Ziziphi iingcebiso malunga neLCS kwi-American Diabetes Association (ADA) kunye neminye imibutho?
A: NgoNovemba 2013, i-ADA yashicilele ukuhlaziywa kweziphakamiso zabo zondlo kubantu abadala abanesifo sikashukela. Kule nkcazo yesikhundla, ehlolisise izihloko ezininzi ezinxulumene nokutya, isitatimende se-ADA sifunda:
Ukusetyenziswa kwamakha amnandi [LCS] unako ukunciphisa i-calorie yonke kunye ne-carbohydrat intake xa ichithwa ngokuba yiphunga le-caloric ngaphandle kwembuyekezo ngokudla kweekhalori ezongezelelweyo ukusuka kwenye imithombo.
Ngokubhekiselele kwimpembelelo ye-LCS kumanqanaba e-glucose, i-ADA iqukumbele kule ngcebiso yokutya ekhoyo ukuba uphando olukhoyo lubonisa ukuba i-LCS ayibangeli ukunyuka kwe-glucose ngaphandle kokuba i-LCS isetyenziswe kwisidlo okanye isiphuzo kunye nezinye iikhalori ezinezithako. Ngokomzekelo, loo nto yayiza kuba i-yogurt okanye i-cocoa eshushu ifuthe nge-LCS. Ngokwahlukileyo, iziyobisi zokutya aziqukethe iikhalori.
Ngaphantsi-i-LCS ayibangeli ukuba i-glucose iphakame ngaphandle kokuba i-LCS idliwe kwisidlo okanye isiphuzo kunye nezinye iikhalori eziqukethe izithako.
Umbuzo: Bangakanani i-LCS eyenza abantu ngokubanzi kwaye abantu abanesifo sikashukela bayidla ngokukodwa?
A: Xa kuziwa kwiindawo "ezikhuselekileyo" ze-LCS zokudlisa, uphando lubonisa ukuba abantu, ngokuqhelekileyo, badla nantoni na kufuphi nento ebizwa ngokuba yi-Acceptable Daily Acake (ADI). Oku kubandakanya abantu abanesifo sikashukela, abasenokuba ngabasebenzisi abakhulu be-LCS. I-ADI ichazwa yi-FDA kunye nezinye i-arhente zokulawula emhlabeni jikelele njengemali ye-LCS umntu angayidla imihla ngemihla yobomi babo ngaphandle kokukhathazeka kokhuseleko. I-ADI isekelwe kwiinkalo ezahlukeneyo zezifundo zezilwanyana ezifunekayo ukuze kuvunywe kwaye zisekelwe kwinqanaba elikhuselekileyo lokukhusela kwizinto ezibizwa ngokuba yizona ziphezulu ezingekho nampembelelo.
Makhe sijonge i-aspartame ngomzekelo. I-FDA ADI ye-aspartame i-50 mg / kg yesisindo somzimba / imini. Le mali iya kulingana nokusebenzisa iipakethi eziyi-97 ze-aspartame ene-LCS imihla ngemihla ngobomi bomntu. Nangona kunjalo, i-Intake Daily Incake (EDI) ye-aspartame yafunyanwa ibe ngamaphesenti ayisithupha e-ADI kubantu abaninzi abadala. I-EDI ichazwa njengokuqikelelwa kwemali yesithako esetshenzisiweyo ukuba ifakwe kwishukela kwi-100 ekhulwini yazo zonke ukutya kunye nokusela.
I-FDA idinga uphando olunzulu kwi-LCS ngaphambi kokuvumela i-LCS kwimarike. Ngokuqhelekileyo, i-LCS ivunyelwe ukusetyenziswa ngabantu bonke. Oku kubandakanya abantwana, abhinqa abakhulelweyo nabancelisayo kunye nabantu abanesifo sikashukela.
Umbuzo: Yintoni eluncedo ngolwazi lomntu ogqithiseleyo kunye nomngcipheko wesifo sikashukela se-2 (T2D) okanye umntu ophethe i-T2D malunga nezenzo ezibalulekileyo abangayithatha malunga nesicwangciso sabo sokutya kunye nempilo yexesha elide?
I-A: Kucacile kwiphando kunye neengcebiso zondlo ezivela kwi-ADA ukuba izinto ezibaluleke kakhulu kumntu osengozini ye-T2D (i-prediabetes) okanye kunye ne-T2D inokuyenza ukukhusela okanye ukucotha ukuxilongwa (kwe-prediabetes) okanye ukunciphisa ukuqhubela phambili kwe-T2D okanye nje emva kokuxilongwa kukulahlekelwa malunga neesithoba okanye ezisixhenxe kweepesenti zokuqala kwesisindo somzimba kwaye ugcine ubunzima obunokuba lunokwenzeka-umsebenzi omde ngokuqinisekileyo!
Oku kufuneka kuphunyezwe ngokutya amancinci ambalwa, ukhethe ukutya okunempilo, kunye nokusebenza ngokusemzimbeni (oku kuquka umsebenzi osebenzayo, ukuqeqeshwa kokumelana nokunciphisa ukuziphatha komzimba). Ukongezelela, kubalulekile ukuba abantu bafumane kwaye bagcine i-glucose yabo, uxinzelelo lwegazi kunye negazi lwegazi liphantsi kokulawulwa kwangaphambili nangaphezulu kwexesha. Ukubethelwa kwezi thagethi okanye ezo zinto wena kunye nomnikezeli wakho anqumayo malunga nokwenza ukuba niphile kakuhle kwaye nciphise iingxaki kwixesha. Namhlanje, siyazi ukulawulwa kwesifo sikashukela kungaphezu kokulawula i-blood glucose level.
Ngokubhekiselele ekusebenziseni i-LCS, nokuba ithathe ishukela kwisiselo esishushu okanye esibandayo okanye ekudleni, isincomo sam kukusebenzisa le mveliso ukuxhasa imizamo yakho yokunciphisa umzimba. Gcina loo mapahla kwaye udle amancinci angama-carbohydrate angaphantsi (amancinci amancinci ahlambulukileyo, iiskese, kunye nokutya okushukela) kunye neeshukela ezongeziweyo, ngokukodwa kwiingxube.
Ngezantsi-Hamba ngaphaya kwezihloko! Qinisekisa ukuba ufunde iinkcukacha zoluphando olutsha kwi-LCS kwaye uvumelane neziphumo ezintsha ezivela kuloo sifundo kwiqela elikhoyo lophando. Gcina ukhumbule ukuba ii-LCS ziye zafundiswa amashumi eminyaka kwaye ezivunywa ukuba zisetyenziswe e-US nakwihlabathi jikelele ziye zahlolwa ngokubaluleka kolawulo ngaphambi kokuza kwiimarike. Ngaphezulu, ukuphonononga akupheli apho. Ii-arhente zokulawula emhlabeni wonke ziyaqhubeka ziphonononga uphando kunye nokusetyenziswa kwazo ngokuhamba kwesikhathi.
> Imithombo:
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