Purpose of Review

In this narrative review, we discuss the current evidence related to the role of dietary interventions to prevent and treat type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). We also propose alternative therapeutic strategies other than weight loss in this population, namely, improvements in cardiorespiratory fitness and its determinants.

Recent Findings

While weight loss has been consistently associated with the prevention of T2DM and improvements in glycemic control in those with established diseases, its role in preventing and treating CVD is less clear. In fact, in this setting, improvements in diet quality have provided greater benefits, suggesting that this might represent an alternative, or an even more effective strategy than energy-restriction.

Summary

Improvements in diet quality, with and without caloric restriction have been shown to improve CVD risk and to prevent the development of T2DM in individuals at risk; however, with regard to glycemic control in patients with T2DM, any dietary intervention resulting in significant weight loss may produce clinically meaningful benefits. Finally, dietary interventions with and without energy restriction that can improve cardiorespiratory fitness, even in absence of weight loss in patients with obesity, should be encouraged.

中文翻译：

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心血管疾病和 2 型糖尿病的营养方面

审查目的

在这篇叙述性综述中，我们讨论了与饮食干预在预防和治疗 2 型糖尿病 (T2DM) 和心血管疾病 (CVD) 中的作用相关的当前证据。我们还提出了该人群除减肥之外的替代治疗策略，即改善心肺健康及其决定因素。

最近的发现

虽然减肥一直与预防 T2DM 和改善已患有疾病的血糖控制相关，但其在预防和治疗 CVD 方面的作用尚不清楚。事实上，在这种情况下，饮食质量的改善带来了更大的好处，这表明这可能是一种替代方案，甚至是比限制能量更有效的策略。

概括

改善饮食质量（无论是否限制热量）已被证明可以降低 CVD 风险并预防高危个体患 T2DM；然而，对于 T2DM 患者的血糖控制，任何导致体重显着减轻的饮食干预都可能产生具有临床意义的益处。最后，应鼓励进行有或没有限制能量的饮食干预，即使肥胖患者体重没有减轻，也可以改善心肺健康。