Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2007, vol. 16, nr 4, July-August, p. 577–588

Publication type: review article

Language: English

Dietary Carbohydrates in the Prevention and Treatment of Metabolic Diseases

Wpływ węglowodanów w diecie na profilaktykę i przebieg chorób metabolicznych

Małgorzata Gwóźdź1,, Bożena Regulska−Ilow1,, Rafał Ilow1,

1 Department of Food Science and Nutrition, Silesian Piasts University of Medicine in Wrocław, Poland

Abstract

Diets based on the glycemic index (GI) were developed for the first time in the early 1980s. The glycemic index ranks carbohydrate−containing foods according to their impact on postprandial glycemia. Ingestion of highglycemic−index products (most highly processed foods containing starch in the form of amylopectin and simple sugars) may raise the risk of metabolic disease by inducing insulin resistance. Low−glycemic−index diets, in contrast, contribute to a rise in insulin sensitivity. Constant presence of high postprandial glycemia (above 140 mg/dl two hours after a meal) causes oxidative stress, chronic capillaries damage, acute endothelial damage, a rise in protein glycation and adhesive molecules concentrations, and rise in blood clotting. These unfavorable processes lead to such diseases as type 2 diabetes, hypertension, and ischemic heart disease, and they are preceded by obesity. According to the findings of numerous studies, a low−GI diet contributes not only to lowering the amount of fatty tissue, but may also prevent metabolic diseases through its influence on blood glucose and lipoprotein concentrations. Due to the several advantages of a low−GI diet, it should be recommended especially to patients with diabetes, dyslipidemia, as well as healthy people to prevent metabolic diseases. The presence of low−GI foods in the diet is supported by such organization as the World Health Organization (WHO), the American Diabetes Association (ADA), and the Canadian Diabetes Association (CDA).

Streszczenie

W latach 80. XX w. opracowano po raz pierwszy diety dla chorych na cukrzycę oparte na indeksie glikemicznym. Koncepcja indeksu glikemicznego (IG) porządkuje produkty spożywcze zawierające węglowodany w zależności od ich wpływu na stężenie glukozy po posiłku. Produkty o wysokim IG są to na ogół wysoko przetworzone i oczyszczone produkty zawierające skrobię w postaci amylopektyny i cukry proste. Mogą zwiększać ryzyko chorób metabolicznych, wpływając na powstawanie oporności tkanek na insulinę. Dieta o małym IG poprawia wrażliwość komórek na insulinę. Stale utrzymujące się duże stężenie glukozy po posiłku (powyżej 140 mg/dl 2 godz. po posiłku) powoduje przewlekłe uszkodzenie naczyń, ostre uszkodzenie śródbłonka, nasilenie glikacji białek, zwiększenie stężenia cząstek adhezyjnych oraz stresu oksydacyjnego i krzepliwości krwi. Wymienione niekorzystne procesy toczące się w organizmie są przyczyną chorób cywilizacyjnych, takich jak: cukrzyca, nadciśnienie, niedokrwienna choroba serca, których ujawnienie poprzedza otyłość. Wyniki badań świadczą o tym, że dieta o małych indeksach glikemicznych przyczynia się nie tylko do zmniejszenia nadmiernej ilości tkanki tłuszczowej, ale także, wpływając na stężenie glukozy i lipidów, może chronić przed rozwojem innych chorób metabolicznych. Korzyści płynące z diety niskoglikemicznej przemawiają za stosowaniem jej zwłaszcza u osób chorych na cukrzycę, z zaburzeniem stężenia lipidów lub u otyłych, a także u zdrowych w celu zapobiegania chorobom o podłożu metabolicznym. Uwzględnienie w diecie produktów o małym indeksie i ładunku glikemicznym zalecają również takie organizacje jak: Światowa Organizacja Zdrowia, Amerykańskie Towarzystwo Diabetologiczne i Kanadyjskie Towarzystwo Diabetologiczne.

Key words

glycemic index, carbohydrates, metabolic diseases, diet

Słowa kluczowe

indeks glikemiczny, węglowodany, choroby metaboliczne, dieta

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