成人糖尿病患者管理的营养治疗建议.pptVIP

SubstitutionofsucroseforstarchRecommendationEvidenceratingWhilesubstitutingsucrose-containingfoodsforisocaloricamountsofothercarbohydratesmayhavesimilarbloodglucoseeffects,consumptionshouldbeminimizedtoavoiddisplacingnutrient-densefoodchoices.A含食品等热量蔗糖的其他碳水化合物食物可能产生相类似的血糖效应，应尽量避免选择营养密集的食物。FructoseRecommendationEvidenceratingFructoseconsumedas“freefructose”(i.e.,naturallyoccurringinfoodssuchasfruit)mayresultinbetterglycemiccontrolcomparedwithisocaloricintakeofsucroseorstarch,andfreefructoseisnotlikelytohavedetrimentaleffectsontriglyceridesaslongasintakeisnotexcessive(12%energy).B，C对于代糖品或甜味剂食品，以游离形式摄取的果糖（存在于天然水果中）和等能量的蔗糖、淀粉相比，有利于血糖控制，且不摄入过量（总能量12％）时，游离果糖不会对血清甘油三酯产生不利影响FructoseRecommendationEvidenceratingPeoplewithdiabetesshouldlimitoravoidintakeofSSBs(fromanycaloricsweetenerincludinghighfructosecornsyrupandsucrose)toreduceriskforweightgainandworseningofcardiometabolicriskprofile.B强调糖尿病患者应限制或避免摄入含糖饮料（即含有能量型甜味剂，包括高果葡糖浆和蔗糖），以降低体重增加的风险和心血管代谢的负担NNSsandhypocaloricsweetenersRecommendationEvidenceratingUseofNNSshasthepotentialtoreduceoverallcalorieandcarbohydrateintakeifsubstitutedforcaloricsweetenerswithoutcompensationbyintakeofadditionalcaloriesfromotherfoodsources.B在不从其他食物中摄取额外能量的情况下，使用非能量型甜味剂来替代能量型甜味剂，则有助于减少总能量和碳水化合物的摄人。对于肾功能正常的糖尿病患者，基于目前的研究证据，有利于血糖控制或降低心血管风险的理想蛋白质摄人量尚无定论，因此需结合个体情况制定蛋白质摄入目标。RecommendationEvidenceratingForpeoplewithdiabetesandnoevidenceofdiabetickidneydisease,evidenceisinconclusivetorecommendanidealamountofproteinintakeforoptimizingglycemiccontrolorimprovingoneormoreCVDriskmeasures;therefore,goalsshouldbeindividualized.C蛋白质对于糖尿病肾病患者（包括微量和大量蛋白尿），均不建议将蛋白质的摄入量减少至正常水平以下（0.8g/kg·d），因为目前证据未能证明单纯低蛋白饮食可改善血糖、降低心血管疾病风险及改善肾小球滤过率（GFR）RecommendationEvidenceratingForpeoplewithdiabetesanddiabetickidneydisease(eithermicro-or