期刊论文详细信息
Nutrition Journal
Relationships between glucose, energy intake and dietary composition in obese adults with type 2 diabetes receiving the cannabinoid 1 (CB1) receptor antagonist, rimonabant
Jamie C Smith1  Susan Bunce1  Charlotte Heppenstall1 
[1] Department of Diabetes & Endocrinology, Torbay Hospital, Lawes Bridge, Torquay, Devon, TQ2 7AA, UK
关键词: Diabetes;    Drug interventions;    Dietary intervention;    Dietary assessment;   
Others  :  824205
DOI  :  10.1186/1475-2891-11-50
 received in 2011-11-11, accepted in 2012-07-05,  发布年份 2012
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【 摘 要 】

Background

Weight loss is often difficult to achieve in individuals with type 2 diabetes and anti-obesity drugs are often advocated to support dietary intervention. Despite the extensive use of centrally acting anti-obesity drugs, there is little evidence of how they affect dietary composition. We investigated changes in energy intake and dietary composition of macro- and micronutrients following therapy with the endocannabinoid receptor blocker, rimonabant.

Methods

20 obese patients with type 2 diabetes were studied before and after 6 months dietary intervention with rimonabant. Dietary intervention was supervised by a diabetes dietician. Five-day food diaries were completed at baseline and at 6 months and dietary analysis was performed using computer software (Dietplan 6).

Results

After 6 months, (compared with baseline) there were reductions in weight (107 ± 21Kg versus 112 ± 21, p < 0.001, 4% body weight reduction), and improvements in HbA1c (7.4 ± 1.7 versus 8.0 ± 1.6%, p < 0.05) and HDL cholesterol. Intake of energy (1589 ± 384 versus 2225 ± 1109 kcal, p < 0.01), carbohydrate (199 ± 74 versus 273 ± 194 g, p < 0.05), protein (78 ± 23 versus 98 ± 36 g, p < 0.05), fats (55 ± 18 versus 84 ± 39 g, p < 0.01) and several micronutrients were reduced. However, relative macronutrient composition of the diet was unchanged. Improvement in blood glucose was strongly correlated with a reduction in carbohydrate intake (r = 0.76, p < 0.001).

Conclusions

In obese patients with type 2 diabetes, rimonabant in combination with dietary intervention led to reduced intake of energy and most macronutrients. Despite this, macronutrient composition of the diet was unaltered. These dietary changes (especially carbohydrate restriction) were associated with weight loss and favourable metabolic effects.

【 授权许可】

   
2012 Heppenstall et al.;

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【 参考文献 】
  • [1]Alexander CM, Landsman PB, Teutsch SM, Haffner SM: NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003, 52:1210-1214.
  • [2]Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, Ludwig DS: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005, 352:1138-1145.
  • [3]Buyken AE, Mitchell P, Ceriello A, Brand-Miller J: Optimal dietary approaches for prevention of type 2 diabetes: a life-course perspective. Diabetologia 2010, 53:406-418.
  • [4]Pagotto U, Pasquali R: Fighting obesity and associated risk factors by antagonising cannabinoid type 1 receptors. Lancet 2005, 365:1363-1364.
  • [5]Akbas F, Gasteyger C, Sjödin A, Astrup A, Larsen TM: A critical review of the cannabinoid receptor as a drug target for obesity management. Obes Rev 2009, 10:58-67.
  • [6]Scheen AJ, Finer N, Hollander P, Jensen MD, Van Gaal LF: RIO-Diabetes Study Group: Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. Lancet 2006, 368:1660-1672.
  • [7]Herling AW, Kilp S, Elvert R, Haschke G, Kramer W: Increased energy expenditure contributes more to the body weight-reducing effect of rimonabant than reduced food intake in candy-fed wistar rats. Endocrinology 2008, 149:2557-2566.
  • [8]Simiand J, Keane M, Keane PE, Soubrié P: SR 141716, a CB1 cannabinoid receptor antagonist, selectively reduces sweet food intake in marmoset. Behav Pharmacol 1998, 9:179-181.
  • [9]Gessa GL, Orrù A, Lai P, Maccioni P, Lecca R, Lobina C, Carai MA, Colombo G: Lack of tolerance to the suppressing effect of rimonabant on chocolate intake in rats. Psychopharmacology (Berl) 2006, 185:248-254.
  • [10]Elhayany A, Lustman A, Abel R, Attal-Singer J, Vinker S: A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes Obes Metab 2010, 12:204-209.
  • [11]Acheson KJ: Carbohydrate for weight and metabolic control: where do we stand? Nutrition 2010, 26:141-145.
  • [12]Sargrad KR, Homko C, Mozzoli M, Boden G: Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus. J Am Diet Assoc 2005, 105:573-580.
  • [13]Gannon MC, Nuttall FQ: Effect of a high protein, low carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes 2004, 53:2375-2382.
  • [14]Evangelista LS, Heber D, Li Z, Bowerman S, Hamilton MA, Fonarow GC: Reduced body weight and adiposity with a high-protein diet improves functional status, lipid profiles, glycemic control, and quality of life in patients with heart failure: a feasibility study. J Cardiovasc Nurs 2009, 24:207-215.
  • [15]Kirk JK, Graves DE, Craven TE, Lipkin EW, Austin M, Margolis KL: Restricted-carbohydrate diets in patients with type 2 diabetes: a meta-analysis. J Am Diet Assoc 2008, 108:91-100.
  • [16]Krebs JD, Elley CR, Parry-Strong A, Lunt H, Drury PL, Bell DA, Robinson E, Moyes SA, Mann JI: The diabetes excess weight loss (DEWL) trial: a randomised controlled trial of high-protein versus high-carbohydrate diets over 2 years in type 2 diabetes. Diabetologia 2012, 55:905-914.
  • [17]Nelson M, Atkinson M, Meyer J: A Photographic Atlas of Food Portion Sizes. London: MAFF Publications; 1997.
  • [18]Howlett AC, Breivogel CS, Childers SR, Deadwyler SA, Hampson RE, Porrino LJ: Cannabinoid physiology and pharmacology: 30 years of progress. Neuropharmacology 2004, 47(Suppl 1):345-358.
  • [19]Mathes CM, Ferrara M, Rowland NE: Cannabinoid-1 receptor antagonists reduce caloric intake by decreasing palatable diet selection in a novel dessert protocol in female rats. Am J Physiol Regul Integr Comp Physiol 2008, 295:R67-R75.
  • [20]Kirkham TC: Endocannabinoids in the regulation of appetite and body weight. Behav Pharmacol 2005, 16:297-313.
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