Anyanzvi Q & A pane tsvakurudzo yezvino
Ndiyo imwe yemibvunzo inowanzobvunzwa kana ichiuya kune utano, ropa rekuropa (shuga yeropa), uye kumira kwekusimudza: iwe unoshandisa shuga vashandisi aka zvinotapira zvinonhuwira, zvishoma-calori zvinotapira, kana zvisiri zvekudya zvinotapira? Ivo vakachengeteka here uye vanogona kukubatsira kuti uremerwe uremu kana kuderedza shuga yeropa here?
Kutsvakurudza Kwazvo
Pakave nemakumi emakore ekutsvakurudza pamusoro pekuchengetedzwa kwema-calorie sweeteners (LCS) uye kana vachigona kubatsira vanhu kuderedza uremu kana kuti nyore nyore kuwana glucose control.
Tsvakurudzo yave yakavhenganiswa, imwe yakanaka uye imwe yakaipa. Ichokwadi ndechokuti kuenzanisira kwemaitiro ekudya kudya kwakanaka ndeimwe isingatarisiri chete pane chimwe chekudya kana chikafu chekudya. Kuenzanisa kunokosha.
Uye kana zvasvika pakurasikirwa nekudzora uremu, kuderedza makirori kubva kune shuga uye yakanatswa kabhaidhirati inogona kubatsira vanhu vane chirwere cheshuga kana kuti vanodarika kuwedzera kushaya uremu uye kuderedza ropa rehuga.
Saka, kana kushanduka kubva kushandisa shuga kana kunwa zvinonwiwa nguva dzose, zvakadai soda, mapaketi eLCS kana zvinwiwa zvekudya zvinokubatsira kudzora uremu hwako nekuvandudza shuga yako yeropa , uye iwe unogona kuzvifunga.
Kune avo vese vanokakavadzana veLCS, kuve vakadzidza pamusoro penyaya uye kuenzanisa zvibatsiro nehana zvinogona kukubatsira kuti uite zvisarudzo zvakanaka. Kunyanya kuwandisa uye kutadza kusadzora chirwere cheshuga kune ngozi kune utano hwako uye zvingave zvakakosha kushandisa michina inokubatsira iwe kuzadzisa zvinangwa zvako.
Ongororo dzakawanda dzinoratidza kuti vanhu vanoshandisa LCS vanogona kukanda uremu hureruka, kuchengetedza hutano hwakanaka, uye kutarisa mashiga eropa.
An Expert Discussion
Hope Warshaw, MMSc, RD, CDE, BC-ADM, inorema semudzidzi wehurukuro.
Mubvunzo: Zvimwe zvidzidzo zvinoratidza kuti LCS inokurudzira kudya kwekudya uye pakupedzisira kuwedzera kuwedzera asi mamwe anoratidza apo LCS inoshandiswa sechikamu chekudya kwakanaka uye mararamiro ehupenyu uye inogona kubatsira kudzora uremu. Ichokwadi kuti nhema dzipi?
A: Usati watarisisa pane zvidzidzo zvega, tarira apa. Mukuona mutumbi wekutsvakurudza pamusoro peLCS uye uremu hwemuviri, masangano akawanda ehutano uye nyanzvi anobvumirana nemhedziso kubva pasayenzi yesayenzi inobva kuAmerican Diabetes Association (ADA) uye American Heart Association (AHA):
LCS haisi yemashiripiti ekurasikirwa kwemazivi, asi inogona kuva imwe yezvigadzirwa zvakawanda zvaungashandisa sechikamu chepurogiramu yakakwana yekugadzirisa uremu. LCS inogona kubatsira vanhu kuti vaderedze koriori yavo kudya kana vasina kutora makirogiramu akachengetedzwa nemaekori kubva kune zvimwe zvokudya.
Pakave nedzimwe dzidzo dzinopesana, asi kunyangwe zvinyorwa zvinopesana. Kune tsvakurudzo pamusoro peLCS nekudzivirira kuyerwa-nhamba dzezvinyorwa pamusoro peLCS, uye kunyanya kudya zvinwiwa zvinosanganisira imwe kana kupfuura LCS, zvakabva kune izvo zvinonzi zvidzidzo zvekucherechedza. Idzo zvidzidzo dzinongororedza zvakawanda zvakadhindwa kubva kune zvidzidzo, izvo zvinocherechedza boka guru revanhu uye kutevera maitiro ehupenyu hwakawanda.
Izvi zvidzidzo zvinogona kuita zvinyorwa asi hazvigone kusimbisa chikonzero nemigumisiro, somuenzaniso, kuti LCS uye / kana zvinwiwa zvekudya zvinoita kuti uwedzere kuwedzera. Ichokwadi ndechokuti zvimwe zvinhu zvakawanda muzvokudya zvevanhu uye mararamire zvinogona kuita kuti uwedzere kuwedzera. Muna 2013 kuongorora na Pereira pane zvimwe zvidzidzo zvekucherechedza, akagumisa kuti vanhu vari panjodzi yekuwedzerwa uremu, kuneta, uye rudzi rwechipiri chirwere cheshuga (T2D) zvingangowedzera kuwedzera kudya kwavo kwezvinwiwa zvekudya mukuedza kuderedza dambudziko ravo rechirwere cheshuga uye uremu- zvirwere zvakabatana.
Maitiro mashomanana akachengeterwa maitiro (RCT) apera, anoratidza kuti LCS (kunyanya kana zvinwiwa zvekudya zvinoshandisa shuga-zvinobata zvinwiwa (SSB) zvinogona kubatsira vanhu kurasika shoma shoma. RCTs inonzi ndiyo yegoridhe yemhando yekudzidza umo vanotsvakurudza vanofananidza kutonga kune imwe kana mamwe mapoka ekudzidza kuti aone kuchinja kweshanduko.
Peters uye vatsvakurudzi pamwe chete vakaita chirongwa chemavhiki gumi nemaviri ekudzivirira uremu mune varume vanenge 300 nevakadzi. Boka rekudzidza rakarayirwa kunwa maawa 24 pazuva rekudya zvinwiwa (chero rudzi rwepi) uye kuraira kwaiva kunwa maawa 24 pazuva pazuva chete.
Mhinduro yakaratidza kuti chirwere chinokanganisa chikafu chakasara chikamu chema 13 pounds kana 44 muzana kupfuura boka rekutonga boka avo vakarasikirwa nevhareji yemapfumbamwe mapfumbamwe.
Imwe RCT naTate uye vatsvakurudzi pamwe chete vakatarisa vanhu vanopfuura 300 vane uremu hwepamusoro pamwedzi mitanhatu. Zvokudya zvinodhaka uye mapoka emvura anoshandiswa maitiro maviri kana maviri pazuva reSBB yavo yekudya zvinodhaka kana mvura. Mushure memwedzi mitanhatu, vanodya zvinwiwa vanonwa doro vaikwanisa kusvika kusvika ku5 muzana kurasikirwa kwehuwandu kupfuura vanonwa mvura.
Chimwe chekudzidza kubva kunonyanya kuzivikanwa National Weight Control Registry (NWCR) -a registry yevanhu vanopfuura 10 000 avo vakarasikirwa makirogiramu makumi matatu uye vakaichengetedza kwegore rimwe chete-vakatarisa kushandiswa kweLCS zvinonwiwa zvakapfuura kupfuura Mazana mana vanhu kwemakore manomwe. Yakawana 53 kubva muzana yevatori vechikamu nguva dzose vaidya zvokudya zvinwiwa uye 10 muzana nguva dzose vaishandisa SSB. Inenge 80 muzana yevatori vechikamu vakataura kuti soro rekudya yakavabatsira kudzora marori avo.
Pakupedzisira asi kwete, meta-analysis (tsvakurudzo yezvidzidzo zvakawanda) yakabudiswa muna 2014 naMiller naPerez vakawana kuti LCS yakaderedza uremu hwemuviri zvichienzanisa ne placebo uye zvine mwero, asi zvakakosha, kuderedza muviri mashoma index (BMI), mafuta akawanda, uye chiuno circumference. Mune mharidzo inoenderana nebhuku rino, James Hill, PhD, tsvakurudzo inoremekedzwa zvikuru yakati:
Zvinoreva kuti LCS inoratidzika iri kuita zviri izvo zvavakagadzirirwa kuita: kubatsira kuderedza kushandiswa kwesimba kwese nekupa ruzivo runotapira rusingakoshe ... Unogona kushandisa nechivimbo chiridzwa ichi [LCS] usingatyi kuti iwe ungave usina kukuvadza kukuvadza kutakura kwako-kutarisira miedzo.
Mubvunzo: Pane imwe nzira yakaderera-calorie sweetener inobatsira kusiyanisa kune imwe?
A: Hapana tsvakurudzo yokuratidza izvi. Nhasi, kudya zvinwiwa zvinowanzotapira ne aspartame (makinheni uye mabhodhoro), aspartame uye saccharin (fountain soft drink), aspartame uye acesulfame-K, kana sucralose. Chimwe chikonzero nei vaiti vekuswa vangashandisa musanganiswa weLCSs ndeyekuti vashandise mararamiro akasiyana-siyana emaLCS akasiyana-siyana kuti vawedzere kugadzikana kwechigadzirwa.
Mubvunzo: Ko kutsvakurudza kunopedzisai pamusoro peLCS nekuchiva uye kuwedzera kudya kwekudya kwesukari uye masipi?
A: Ichi chave chiri imwe nzvimbo yekukakavara pamusoro peLCS. Pfungwa iyi inoita seyokuti nokuti LCS inotapira kupfuura shuga, inodarika zvinotapira zvinonaka zvinogamuchirwa uye inokonzera zvinodikanwa zvinotungamirira vanhu kuti vadye uye vakure.
Dzidzo dzinoverengeka dzinopikisa pfungwa iyi. Semuenzaniso, Antenucci naHayes vakakurudzira vanhu vanopfuura 400 kuti vakwanise kuongororwa. Vatori vechikamu vainwa kubva pakati pe12 kusvika ku15 sampuli dzakasiyana dzakagadzirwa nekoriori-ine sweeteners uyewo zvakasiyana-siyana zveLCS dzinoverengeka. Vadzidzi vadzidza vakaverenga kuonekwa kwakanaka kwemuenzaniso mumwe nomumwe. Zvigumisiro zvakaratidza kuti vatori vechikamu vakaona kutapira kweLCS pane zvakaderera zvakanyanya kupfuura zvinokonzerwa nekoriori zvine sweeteners. Vatsvakurudzi vakagumisa kuti zvigumisiro hazvibatsiri zvinonzi LCS pamusoro-inokurudzira vanhu 'sweet taste receptors.
Mukuwedzera, zvitatu zvezvidzidzo zvekare zvakanyatsotsanangurwa zvinosanganisira zviwanikwa zvekubatsira kupindura mubvunzo uyu. Peters akaratidzira nzara yemaawa masvondo gumi nemaviri akawedzera zvishoma muboka remvura uye akaramba zvishoma muboka rekudya rekudya iro rakazoita kuti nzara isanyanya kuderera. Chimwe chiongorudzo cheTate chidzidzo naPiernas chakaratidza kuti nepo zvose mvura neyekudya zvinwiwa zvinwiwa zvinoderedza zvakakwana calori uye yakawedzerwa shuga yekudya, chikafu chinokanganisa boka chinoderedza kushandiswa kwezvokudya zvakawanda. Vatsvakurudzi vakafungidzira kuti zvichida kudya kwekumwa kunogutsa chido chechimwe chinhu chinotapira. Ongororo yeWNCR yakaratidza kuti vanenge 80 muzana yevatori vechikamu vakataura kuti zvinwiwa zvekudya zvakavabatsira kudzora marori avo.
Pasi pepamusoro-Pane kukura kuchiva, kudya, uye nzara, chaizvoizvo LCS (zvichida sechinotsigira shuga kana zvokudya uye chinwiwa) inogona kugutsa zvido zvevanhu zvemasipi uye kuparadza nzara yavo.
Mubvunzo: Zvinokwanisika here kunotora-calori sweeteners kunokonzera chirwere che microbiome nenzira inogona kukonzera kubuda kwemazinga emaglucose?
A: Mvura inonzi microbiome ndiyo yakasiyana-siyana yemakiromita anogara mumatakiti ekudya (matumbo) emhuka nevanhu. Kutsvakurudza munharaunda iyi kuwedzera uye kuwedzera. Kufunga ndechokuti kuchengetedza utano hwakanaka hwema microbiome kunogona kuita basa muhutano, kudzivirira zvirwere, nekuchengetedza hutano hwakanaka.
Chidzidzo chaSuez uye vaongorori pamwe chete navo, chakabudiswa muChitubu, chakatora mhando dzakawanda dzevhidhiyo uye chakaita maitiro akawanda akawandisa bhurststroke kutsvaga maererano nekushandiswa kweLCS yose. Muzvokwadi, ruzhinji rwezvidzidzo zvinyorwa mumapepa ezvinyorwa zvakarondedzerwa nezve saccharin uye dzakawanda dzazvo dzaiitwa mumakonzo. Zvakakosha kucherechedza kuti, kunyange zvazvo LCS iri muboka rimwechete, ivo vakasiyana zvakasikwa, kuumbwa, uye kuti vanogadziriswa sei. Iyi yaiva mapepa akaoma kwazvo uye akawanda akadzidza mukati. Parizvino, mamwe emigumisiro yekudzidza yakakonzerwa nevadzidzisi vanoremekedzwa. Sezvakakonzerwa nekutsvakurudza kwakawanda, zvidzidzo zvepamusoro zvakanyatsotarisirwa zvinoda kuitwa kuti urambe uchisimbisa hukama uhwu.
Zvakawanikwa munyaya ino aspartame uye sucralose, iyo yakaderera-calori inotapira mukushandiswa kukuru, kusimudza mazinga eaglucose haabvumirane neboka riripo rekutsvakurudza. Zvakakodzera kucherechedza, kuti kugamuchirwa neU.S. Food and Drug Administration (FDA) sekuwedzera kwezvokudya uye kushandiswa nevanhu vane chirwere cheshuga (izvo zvavari), tsvakurudzo inowanikwa kune FDA kuti inogamuchirwe inofanira kusanganisira zvidzidzo pamusoro pemigumisiro iyo LCS pamashamba eglucose. Kutsvakurudza kwakaendeswa kune FDA kuti inogamuchirwe pamwe nekutsvakurudza kwakawedzerwa mumakore akatevera mushure mvumo isingagumi. Kakawanda, zvidzidzo zvakaitwa mumakumi mashoma mashoma apfuura zvinoratidza kuti aspartame kana sucralose haisi kuchinja marimi microbiome kana kusimudzira ropa glucose.
Zvizhinji zvemhuka uye zvidzidzo zvevanhu zvakashumwa muChidzidzo chezvisikwa zvakaratidza kuti zvinokonzerwa nechigadzirwa cheglucose. Chinofadza vanhu vane chirwere cheshuga ichocho icho saccharin chave chiri kushandiswa kwemakore anopfuura zana uye kwemakore akawanda ndiyo ndiyo chete yeruzivo rwaivepo. Kusvika iye zvino, pane zvidzidzo zvishomanana zvemhuka izvo zvinoratidza saccharin mumakirwe akareba zvinogona kuchinja chirwere chinonzi microbiome. Dhiyabhorosi kubva kune zvidzidzo zvevanhu panyaya iyi haina kukwana uye haina kujekesa.
Pasi pepamusoro-Kuwedzera kutsvakurudza kunokosha, asi kukanganisa kunokonzera kunyange kuenzanisa kushandiswa kwechashcharin pamakumbo emakirini microbiome kana glucose kunowanikwa zvikuru.
Mubvunzo: Ndezvipi zvinorumbidzwa pamusoro peLCS kubva kuAmerican Diabetes Association (ADA) nemamwe masangano?
A: MunaNovember 2013, ADA yakabudisa zvinyorwa kune zvinorayira kudya kwevanhu vakuru vane chirwere cheshuga. Mutsara uyu wepamusoro, uyo wakaongorora nyaya dzakawanda dzine chokuita nekudya, mutemo weAAD unoti:
Kushandiswa kwezvinotapira zvisingagadziriswi [LCS] zvine simba rekudzikisa huwandu hwekoriori nemafuta emaginhaidhyrate kana akatsiviwa nekodoric sweeteners pasina kubhadharwa nokuwana kwekoriyamu yakawedzerwa kubva kune dzimwe nzvimbo.
Nezvemigumisiro yeLCS pamakwikwi emaglucose, ADA yakagumisa mune zvinorayira zvekudya izvo zvakarongeka zvinotsvakurudza zvinoratidza kuti LCSs hadzina kukonzera glucose kusimuka kunze kwekuti LCS inopedzerwa mune zvekudya kana kunwa kune imwe koriori ine zvigadzirwa. Somuenzaniso, iyo ingadai iri yogashi kana kuti inopisa kakao inotapira neLCS. Kusiyana neizvi, zvinwiwa zvekudya zvinowanzo husina makori.
Pasi payo-LCS haiti kukonzera glucose kunze kwekuti LCS inopedzerwa mune zvekudya kana kunwa neimwe koriori ine zvigadzirwa.
Mubvunzo: Ko LCS yakawanda yakaita sei vanhu vose uye vanhu vane chirwere cheshuga vanonyanya kudya?
A: Kana paine "kuchengeteka" mararamiro eLCS kuti adye, tsvakurudzo inoratidza kuti vanhu, pamwero wega, havatongopfuuri kune izvo zvinonzi Acceptable Daily Intake (ADI). Izvi zvinosanganisira vanhu vane chirwere cheshuga, avo vanogona kunge vari ivo vanonyanya kushandisa vatengi veLCS. ADI inotsanangurwa neDFA nedzimwe sangano rinotungamirira pasi rose sehuwandu hweLCS iyo munhu anogona kudya zuva rehupenyu hwavo pasina hunovanda. IAI inobva pane zvakasiyana-siyana zvezvidzidzo zvemhuka zvinodiwa kuti zvigamuchirwe uye zvinoenderana nezana zana chekuchengeteka kubva kune izvo zvinonzi yakakwirira kupfuura nharo yakaipa.
Ngatitarise paAsuptame kune muenzaniso. Iyo FDA ADI yeAasitartame ndiyo 50 mg / kg yehutano hwemuviri / zuva. Iyi mari yaizove yakaenzana nekushandisa mapaketi 97 eAsartame-ine LCS zuva rimwe nerimwe pamusoro pehupenyu hwomunhu. Kunyange zvakadaro, Kuongorora Kwemazuva ose (EDI) yeAsartameki yakawanikwa kuine zvikamu zvitanhatu zveADI mune vanhu vakawanda vakuru. EDI inotsanangurwa sechiyero chemuwandu wezvigadzirwa zvinoshandiswa kana zvakatsiviwa neshuga mu 100 muzana yezvokudya zvose zvinogoneka uye zvinwiwa.
Iyo FDA inoda kutsvakurudza kwakawanda paLCS isati yatendera LCS pamusika. Kazhinji kutaura, LCS inobvumidzwa kuti ishandiswe nehuwandu hwevanhu vose. Izvi zvinosanganisira vana, vakadzi vane pamuviri uye vanoyamwisa uye vanhu vane chirwere cheshuga.
Mubvunzo: Chii chinobatsira ruzivo rwemumwe munhu ane simba guru uye ari pangozi yerudzi rwechipiri chirwere cheshuga (T2D) kana mumwe munhu ane T2D pamusoro pezviito zvakakosha zvavanogona kutora maererano neurongwa hwavo hwekudya uye hutano hurefu kwenguva refu?
A: Zvakajeka kubva pakutsvakurudza uye kupiwa kwekudya kunobva kune ADA kuti zviito zvakakosha kune munhu ari pangozi yeT2D (prediabetes) kana neT2D inogona kuita kudzivirira kana kuderedza kuongororwa (ye prediabetes) kana kuderedza kufambira mberi kweT2D pa kana kuti mushure mekunge uongororwe ndeye kurasikirwa anenge anenge mashanu kana manomwe kubva muzana kubva pakukura kwemuviri wekutanga uye kuramba uine huwandu huwandu hwacho sezvaunogona-basa rakakura kwazvo!
Izvi zvinofanira kuwanikwa kuburikidza nokudya zvishoma maekori, kusarudza kudya kwakanaka, nekuve wakashanda (izvi zvinosanganisira basa reeserobic, kudzidzira kudzivisa, uye kuderedza tsika dzekugara). Mukuwedzera, zvakakosha kuti vanhu vawane uye vachengetedze glucose, ropa ravo, uye ropa lipids pasi pekutonga pakutanga nekupedza nguva. Kurova zvinangwa izvi kana izvo iwe nemubatsiri wako musarudzo zvingakupa pfupa yako yakanakisisa yekugara uine hutano uye kuderedza zvinetso pamakore. Nhasi, tinoziva kudzora chirwere cheshuga zvinopfuura kungochera mazinga eropa.
Kana iri kushandiswa kweLCS, kuti iite kuti shuga inopisa kana inotonhorera kana muzvokudya, zvandinokurudzira ndezvokushandisa zvishandiso izvi kuti zvibatsire kuedza kwako kuderedza uremu. Chengetedza mapaundi acho uye udye zvishomanana magiramu emakrohydrates (zvishomanana zvakanatswa, masipi, uye soda) uye akawedzera shuga, kunyanya kubva kunwiwa.
Pasi pepamusoro-Endai mberi kwezvinyorwa! Iva nechokwadi chekuverenga tsanangudzo yezvimwe zvidzidzo zvitsva paLCS uye unokodzera zvitsva zvitsva kubva pane izvo zvidzidzo kupinda mune imwe boka rekutsvakurudza. Ramba uchifunga kuti LCSs yakadzidzwa kwemakumi emakore uye iyo inobvumidzwa kushandiswa muU.S. uye pasi rose yakapfuura nekuongorora kukuru kwekutanga kusati kwasvika pamusika. Uyezve, kudzokorora hakuperi ipapo. Mahofisi ehurumende anotarisana nenyika yose anoramba achiongororazve kutsvakurudza uye kushandiswa kwavo kwemazuva.
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