Zusammenfassung
Prospektive Beobachtungs- und Interventionsstudien trugen entscheidend dazu bei, Zusammenhänge zwischen Ernährung und Diabetes zu identifizieren. So führt eine hyperkalorische Ernährung zum Gewichtsanstieg, der einen Hauptrisikofaktor für Typ-2-Diabetes darstellt. Ergebnisse randomisierter Interventionsstudien zur Gewichtsreduktion, wie das „Diabetes Prevention Program“, zeigten, dass eine Lebensstilmodifikation das Risiko für Personen mit Prädiabetes deutlich senken kann. Neben der Quantität der Nahrung spielt deren Qualität, also deren Zusammensetzung, eine unabhängige zusätzliche Rolle. In Kohortenstudien wurden Beziehungen sowohl für einzelne Nährstoffe (Magnesium, Getreideballaststoffe, an Hämoglobin gebundenes Eisen) als auch für einzelne Lebensmittel (u. a. Vollkornprodukte, Milchprodukte, rotes und prozessiertes Fleisch, Nüsse, Kaffee, Tee und zuckergesüßte Getränke) beobachtet. Zudem unterstützen sowohl Kohortenstudien als auch die PREDIMED-Interventionsstudie (PREDIMED: „Prevención con Dieta Mediterránea“) eine Risikosenkung durch die Wahl einer mediterranen Kost. Obwohl es Hinweise auf Modifikationen solcher Beziehungen durch unterschiedliche genetische Veranlagungen gibt, konnten derartige Gen-Ernährungs-Interaktionen bislang zumeist nicht repliziert werden. Demzufolge gibt es derzeit nur unzureichende Evidenz, auf einer unterschiedlichen genetischen Veranlagung basierende Ernährungsempfehlungen zu spezifizieren.
Abstract
Prospective observational and interventional studies have been instrumental in identifying relationships between diet and diabetes. On the one hand, a hypercaloric diet contributes to weight gain, which is a major risk factor for type 2 diabetes. Results of randomized weight loss intervention trials, such as the Diabetes Prevention Program, show that lifestyle modification can significantly reduce the risk for people with prediabetes. In addition to the quantity of food, quality, i. e. composition, plays an independent and additional role. In cohort studies, relationships have been observed for both single nutrients (magnesium, cereal fiber, hemoglobin-bound iron) and individual foods (including whole grains, dairy, red and processed meat, nuts, coffee, tea and sweetened beverages). In addition, both cohort studies and the PREDIMED (PREDIMED: “Prevención con Dieta Mediterránea”) intervention study support a risk reduction by choosing a Mediterranean diet. Although there are indications of modifications of such relationships due to different genetic predispositions, so far such gene–diet interactions could not be replicated in most cases. As a result, there is still insufficient evidence to specify dietary recommendations based on a different genetic predisposition.
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Schulze, M.B. Ernährung und Diabetesrisiko. Diabetologe 15, 230–236 (2019). https://doi.org/10.1007/s11428-018-0434-8
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DOI: https://doi.org/10.1007/s11428-018-0434-8