饮食是影响糖尿病等慢性疾病进展的主要因素之一。以可可为主要原料生产的黑巧克力中,含有大量的黄烷醇,其可以通过改善内皮功能,改变葡萄糖代谢和减少氧化应激来提高人体胰岛素敏感性(即减少胰岛素抗性)。本文综述了可可和黑巧克力可用于减缓2型糖尿病发展、改善其代谢综合征中的胰岛素抵抗、心血管疾病方面的研究成果。认为应进行大型随机对照试验分析、论证、证实上述结果,以便在分子水平上明确其降低糖尿病危害与其并发症风险的保健作用。 The lifestyle may be one of the main influences of the progression of chronic diseases such as di-abetes. Recently, it had been shown that flavonols in the black choalate and cocoa had the de-creasing insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin re-sistance. It is reviewed that black choaclate and cocoa may be used for resistanting development of type 2 diabetes, improving insulin resistance and cardiovascular disease in its metabolic syn-drome. It is suggested that large randomized controlled trials should be carried out to analyze, prove and confirm the above results so as to clarify their health care role in reducing the risk of diabetes hazard and complications at the molecular level.
黑巧克力,心血管,营养,黄烷醇,糖尿病, Dark Chocolate Cardiovascular Nutrition Flavanol Diabetes黑巧克力食品用于糖尿病患者的文献综述
李明标,黄雪松. 黑巧克力食品用于糖尿病患者的文献综述 Review of Dark Chocolate on Diabetic Patients[J]. 食品与营养科学, 2018, 07(04): 344-349. https://doi.org/10.12677/HJFNS.2018.74042
参考文献ReferencesEyre, H., Kahn, R. and Robertson, R.M. (2004) Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. CA: A Cancer Journal for Clinicians, 54, 190-207. <br>https://doi.org/10.3322/canjclin.54.4.190Hertog, M.G., Feskens, E.J. and Kromhout, D. (1997) Antioxidant Flavonols and Coronary Heart Disease Risk. Lancet, 349, 699. <br>https://doi.org/10.1016/S0140-6736(05)60135-3Knekt, P., Kumpulainen, J., Jarvinen, R., et al. (2002) Flavonoid Intake and Risk of Chronic Diseases. The American Journal of Clinical Nutrition, 76, 560-568. <br>https://doi.org/10.1093/ajcn/76.3.560Zamora-Ros, R., Forouhi, N.G., Sharp, S.J., et al. (2014) Dietary Intakes of Individual Flavanols and Flavonols Are Inversely Associated with Incident Type 2 Diabetes in European Populations. The Journal of Nutrition, 144, 335-343.
<br>https://doi.org/10.3945/jn.113.184945Palma-Duran, S.A., Vlassopoulos, A., Lean, M., et al. (2015) Nutritional Intervention and Impact of Polyphenol on Glycohaemoglobin (HgA1c) in Non-Diabetic and Type 2 Diabetic Subjects: Systematic Review and Meta-Analysis. Critical Reviews in Food Science and Nutrition, 55, 975-986.Dillinger, T.L., Barriga, P., Escarcega, S., et al. (2000) Food of the Gods: Cure for Humanity? A Cultural History of the Medicinal and Ritual Use of Chocolate. The Journal of Nutrition, 130, 2057S-7072S.
<br>https://doi.org/10.1093/jn/130.8.2057SSeligson, F.H., Krummel, D.A. and Apgar, J.L. (1994) Patterns of Chocolate Consumption. The American Journal of Clinical Nutrition, 60, 1060S-1064S. <br>https://doi.org/10.1093/ajcn/60.6.1060SCAOBISCO (2010) Ranking of Consumption (Chocolate Confectionery).
www.caobisco.com/doc_uploads/Charts/ranking_of_consumption_chocolate_confectionery_2007.pdfCooper, K.A., Donovan, J.L., Waterhouse, A.L., et al. (2008) Cocoa and Health: A Decade of Research. British Journal of Nutrition, 99, 1-11. <br>https://doi.org/10.1017/S0007114507795296Ceriello, A. and Motz, E. (2004) Is Oxidative Stress the Pathogenic Mechanism Underlying Insulin Resistance, Diabetes, and Cardiovascular Disease? The Common Soil Hypothesis Revisited. Arteriosclerosis, Thrombosis, and Vascular Biology, 24, 816-823. <br>https://doi.org/10.1161/01.ATV.0000122852.22604.78Miller, K.B., Stuart, D.A., Smith, N.L., et al. (2006) Antioxidant Activity and Polyphenol and Procyanidin Contents of Selected Commercially Available Cocoa-Containing and Chocolate Products in the USA. Journal of Agricultural and Food Chemistry, 54, 4062-4068. <br>https://doi.org/10.1021/jf060290oHanhineva, K., Törrönen, R., Bondia-Pons, I., et al. (2010) Impact of Dietary Polyphenols on Carbohydrate Metabolism. International Journal of Molecular Sciences, 11, 1365-1402. <br>https://doi.org/10.3390/ijms11041365Johnston, K., Sharp, P., Clifford M., et al. (2005) Dietary Polyphenols Decrease Glucose Uptake by Human Intestinal Caco-2 Cells. FEBS Letters, 579, 1653-1657. <br>https://doi.org/10.1016/j.febslet.2004.12.099Chakravarthy, B.K., Gupta, S. and Gode, K.D. (1982) Functional Beta Cell Regeneration in the Islets of Pancreas in Alloxan Induced Diabetic Rats by (-)-Epicatechin. Life Sciences, 31, 2693-2697.
<br>https://doi.org/10.1016/0024-3205(82)90713-5Hii, C.S. and Howell, S.L. (1985) Effects of Flavonoids on Insulin Secretion and 45Ca2+ Handling in Rat Islets of Langerhans. Journal of Endocrinology, 107, 1-8. <br>https://doi.org/10.1677/joe.0.1070001Ruzaidi, A., Amin, I., Nawalyah, A.G., et al. (2005) The Effect of Malaysian Cocoa Extract on Glucose Levels and Lipid Profiles in Diabetic Rats. Journal of Ethnopharmacology, 98, 55-60. <br>https://doi.org/10.1016/j.jep.2004.12.018Jalil, A.M., Ismail, A., Pei, C.P., et al. (2008) Effects of Cocoa Extract on Glucometabolism, Oxidative Stress, and Antioxidant Enzymes in Obese-Diabetic (Ob-db) Rats. Journal of Agricultural and Food Chemistry, 56, 7877-7884.
<br>https://doi.org/10.1021/jf8015915Kim, J.A., Montagnani, M., Koh, K.K., et al. (2006) Reciprocal Relationships between Insulin Resistance and Endothelial Dysfunction: Molecular and Pathophysiological Mechanisms. Circulation, 113, 1888-1904.
<br>https://doi.org/10.1161/CIRCULATIONAHA.105.563213Sydow, K., Mondon, C.E. and Cooke, J.P. (2005) Insulin Resistance: Potential Role of the Endogenous Nitric Oxide Synthase Inhibitor ADMA. Vascular Medicine, 10, S35-S43. <br>https://doi.org/10.1177/1358836X0501000106Hollenberg, N. (2006) Vascular Action of Cocoa Flavanols in Humans: The Roots of the Story. Journal of Cardiovascular Pharmacology, 47, S99-S102.McCullough, M.L., Chevaux, K., Jackson, L., et al. (2006) Hypertension, the Kuna, and the Epidemiology of Flavanols. Journal of Cardiovascular Pharmacology, 47, S103-S109. <br>https://doi.org/10.1097/00005344-200606001-00003Hollenberg, N.K., Fisher, N.D. and McCullough, M.L. (2009) Flavanols, the Kuna, Cocoa Consumption, and Nitric Oxide. Journal of the American Society of Hypertension, 3, 105-112. <br>https://doi.org/10.1016/j.jash.2008.11.001Grassi, D., Desideri, G., Necozione, S., et al. (2008) Blood Pressure Is Reduced and Insulin Sensitivity Increased in Glucose-Intolerant, Hypertensive Subjects after 15 Days of Consuming High-Polyphenol Dark Chocolate. The Journal of Nutrition, 138, 1671-1676. <br>https://doi.org/10.1093/jn/138.9.1671Davison, K., Coates, A.M., Buckley, J.D., et al. (2008) Effect of Cocoa Flavanols and Exercise on Cardiometabolic Risk Factors in Overweight and Obese Subjects. International Journal of Obesity (London), 32, 1289-1296.
<br>https://doi.org/10.1038/ijo.2008.66Almoosawi, S., Fyfe, L., Ho, C., et al. (2010) The Effect of Polyphe-nol-Rich Dark Chocolate on Fasting Capillary Whole Blood Glucose, Total Cholesterol, Blood Pressure and Glucocorticoids in Healthy Overweight and Obese Subjects. British Journal of Nutrition, 103, 842-850. <br>https://doi.org/10.1017/S0007114509992431Puupponen-Pimiä, R., Nohynek, L., Hartman Schmidlin, S., et al. (2005) Berry Phenolics Selectively Inhibit the Growth of Intestinal Pathogens. Journal of Applied Microbiology, 98, 991-1000.
<br>https://doi.org/10.1111/j.1365-2672.2005.02547.xKemperman, R.A., Bolca, S., Roger, L.C., et al. (2010) Novel Approaches for Analysing Gut Microbes and Dietary Polyphenols: Challenges and Opportunities. Microbiology, 156, 3224-3231. <br>https://doi.org/10.1099/mic.0.042127-0Haslam, E., Lilley, T.H., Warminski, E., et al. (1992) Polyphenol Complexation. A Study in Molecular Recognition. ACS Symposium Series, 506, 8-50. <br>https://doi.org/10.1021/bk-1992-0506.ch002Hattori, M., Kusumoto, I.T., Namba, T., et al. (1990) Effect of Tea Polyphenols on Glucan Synthesis by Glucosyltransferase from Streptococcus mutans. Chemical and Pharmaceutical Bulletin, 38, 717-720.
<br>https://doi.org/10.1248/cpb.38.717Tombola, F., Campello, S., De Luca, L., et al. (2003) Plant Polyphenols Inhibit VacA, a Toxin Secreted by the Gastric Pathogen Helicobacter pylori. FEBS Letters, 543, 184-189. <br>https://doi.org/10.1016/S0014-5793(03)00443-5Cardona, F., Andrés-Lacueva, C., Tulipani, S., et al. (2013) Benefits of Polyphenols on Gut Microbiota and Implications in Human Health. The Journal of Nutritional Biochemistry, 24, 1415-1422.Curtis, P.J., Sampson, M., Potter, J., et al. (2012) Chronic Ingestion of Flavan-3-Ols and Isoflavones Improves Insulin Sensitivity and Lipoprotein Status and Attenuates Estimated 10-Year CVD Risk in Medicated Postmenopausal Women with Type 2 Diabetes: A 1-Year, Double-Blind, Randomized, Controlled Trial. Diabetes Care, 35, 226-232.
<br>https://doi.org/10.2337/dc11-1443Grassi, D., Desideri, G., Necozione, S., et al. (2015) Cocoa Consumption Dose-Dependently Improves Flow-Mediated Dilation and Arterial Stiffness Decreasing Blood Pressure in Healthy Individuals. Journal of Hypertension, 33, 294-303. <br>https://doi.org/10.1097/HJH.0000000000000412Farhat, G., Drummond, S., Fyfe, L., et al. (2014) Dark Chocolate: An Obesity Paradox or a Culprit for Weight Gain? Phytotherapy Research, 28, 791-797. <br>https://doi.org/10.1002/ptr.5062Tey, S.L., Brown, R.C., Gray, A.R., et al. (2012) Long-Term Consumption of High Energy-Dense Snack Foods on Sensory-Specific Satiety and Intake. The American Journal of Clinical Nutrition, 95, 1038-1047.
<br>https://doi.org/10.3945/ajcn.111.030882