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糖尿病的营养疗法. Nutrition and Diabetes. Zhaoping Li, MD, PhD Professor of Medicine Center for Human Nutrition David Geffen School of Medicine, UCLA. 1. Obesity. Diabetes. Inflammation. Insulin Resistance. Ascorbic Acid. Rich source for vitamins and minerals, low calorie, high fiber. - PowerPoint PPT Presentation
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1
Zhaoping Li, MD, PhDProfessor of Medicine
Center for Human NutritionDavid Geffen School of Medicine, UCLA
Nutrition and Diabetes
糖尿病的营养疗法
Ascorbic Acid
Rich source for vitamins and minerals, low calorie, high fiber
Phytochemicals/Phytonutrients
Non-nutrient plant compounds
Provide health benefits against certain chronic human illnesses such as cancer, heart disease, neurodegenerative diseases, etc.
5Surh, Nature Reviews Cancer 3:768, 2003
Lycopen
• β-carotene, lycopene
• Ability to neutralize harmful byproducts of photooxidation
• Act as powerful antioxidants in humans– quenching singlet oxygen– scavenging free radicals
Bartley, G.E. and P.A. Scolnik. 1995. Plant carotenoids: pigments for photoprotection, visual attraction, and human health. The Plant Cell 7:1027–1038.Clinton, S.K. 1998. Lycopene: chemistry, biology, and implications for human health and disease. Nutrition Reviews 56(2):35–51.
Carotenoids
Pomegranate: Ellagitannin
Henning et al. 2009
OH
O
O
HO
OH
OHHO
HO
OH
OH
OO OO
CH2
O
O
OH
OHOH
OH
HO
O
O
HO
O
OO
MW = 1084
OH
OH
HO
Ellagic acid(MW = 302)
Pomegranate: Ellagitannin
Pentuk et al. 2006
•Antioxidant•Anti inflammation•Inhibit Angiogenesis•Anti-aromatase•Anti-proliferation
•Antioxidant•Anti inflammation•Inhibit Angiogenesis•Anti-aromatase•Anti-proliferation
Cruciferous Vegetables
• Sulforaphane (SFN), a prominent isothiocyanate
Increased nasal cell counts in response to DEP exposure are attenuated with BSE treatment
0.0
100.0
200.0
300.0
400.0
500.0
600.0
700.0
800.0
900.0
1000.0
0 6 24
Time Post-DEP (Hrs)
% o
f B
as
elin
e
Screen
Control
BSE
*
**
Sources of Resveratrol
• Resveratrol is found in– Grapes (only in skin)– Wine– Grape Juice– Peanuts– Blueberries– Bilberries– Cranberries
Benefits of Resveratrol• Induces apoptosis
(programmed cell death) in unhealthy cells
• Promotes normal nuclear factor kappa B and cyclooxygenase-2 activity
• Promotes normal activity of the SIRT-1 gene (involved in calorie restriction, fat mobilization, mitochondrial function, longevity)
• Promotes cardiovascular health – Normal platelet
activity– Normal
vasorelaxation– Antioxidant
protection of LDL particles
• Possibly Neuroprotective
14
Spices on Lipid Oxidation in Meat Patty
Li et al, ACJN April 2010
15
Spices on Lipid Oxidation in Plasma
Li et al, ACJN April 2010
16
Spices on Lipid Oxidation in Urine
Li et al, ACJN April 2010
Graph of normal endothelial function PAT signal tracings. The Endo–PAT2000 provides a very high degree of sensitivity and specificity as compared to the current Gold Standard of coronary artery endothelial function assessment – the coronary blood flow response to intra-coronary acetylcholine-infusion.
Assessing Endothelial Function
PAT
P=0.02
Urine MDA
P<0.001
Urine NOx
P=0.05
21
Dihydrocapsiate on Energy Expenditure
Lee et al, Experimental Biology 2010
Avocado
PAT
A.
B.
*
Inflammatory Markers
A. IL-6
B. TNF-alpha
TURMERIC
Historical Uses:• Used as a condiment, healing remedy, and
textile dye• Used in Indian and Chinese medical systems
as an anti-inflammatory agent
AP-1
-catenin
CREB-BP
EGR-1
Notch-1
ERE
NF-B
HIF-1 WT-1
Nrf-2
PPAR-
STAT-1
STAT-3
STAT-4 STAT-5
Curcumin
Transcriptional factors
IL-1
IL-2
IL-5
IL-6
IL-8
IL-12
MCP
MIP
MaIP
TNF-α
IL-18
AATF-1
ATFase
ATPase
COX-2
5-LOX
Desaturase
DNA pol
FPT
GST
GCL
iNOS
MMP
NQO-1
ODC
PhP D
Src-2
Telomerase
TMMP-3
GlCL
AAPKCa2+PK
EGFR-K
ERK
FAK
IL-1R AK
JAK
JNK
MAPKPhK
PAK PKAPKB
Pp60c-tk
PTK
CTGF
EGF
FGF
HGF
NGFPDGF
TF
TGF-1
VEGF
AR
AHR
CXCR4
EGFR
EPCR
ER-αFas R
H2R
HER-2
IL-8 R
ITR
IR
LDLR
DR-5
ELAM-1
ICAM-1
VCAM-1
Bcl-2
Bcl-xL
IAP-1
Cyclin D1
Hsp-70
MDRP
uPA
DEF-40
p53
Inflammatory cytokines
Kinases
EnzymesGrowthfactors
Receptors
Others
Molecular targets upregulated
Molecular targetsdownregulated
Anand etal, CL, 2008
Piperine Enhance Curcumin Bioavailability
Planta Med. 1998 May;64(4):353-6.
Lipid Peroxide(nmoles/ml)
Total Cholesterol(mg/100ml)
7
6
5
4
3
2Pre Post Pre Post
250
220
190
160
130
100Pre Post
100
90
80
70
60
50
HDL-C(nmoles/ml)
Triglycerides(nmoles/ml)
300
260
220
180
140
100Pre Post
Changes in serum lipid levels in healthy subjects by curcumin
Ser
um
Lip
id l
evel
Sony & Kuttan, 1992
500 mg/day x 7days; N=10
31
Pistachio
•Monounsaturated fatty acids
•Antioxidants
•Plant sterols
•Lutein
•Anthocyanins
•Resveratrol
32
Calories and Fats not Equal
56 grams pistachios
=
53 grams pretzel
33
Pistachios Lower Triglycerides
* *
Base line 6 weeks 12 weeks
Pist
achi
os
Pret
zels
34
BMI
*
35
Tea
•NO Calories
•Tea Catechins
Green Tea Catechins
Green Tea Increases Metabolic Rate
•Increase metabolic rate
•Promotes fat oxidation
•Inhibit pancreatic lipase
•
Weight Loss by Green Tea
•Meta-analysis with 15 studies
•GTCs with caffeine reduce •BMI•Body weight•WC
Green Tea Effects on Diabetes
•1 - 2 cups/day
•Reduced incidence of Diabetes by 70%
•Decreased fasting glucose
Yonsei Med J. 2009 Feb 28;50(1):31-8. Epub 2009 Feb 24.
Cell. 2010 Sep 3;142(5):687-98
Macrophage Infiltration
: Decreased macrophages on HFD+ω3
HFD HFD+ω3
Supplements
Unknown: optimal therapeutic dosage, Unknown: optimal therapeutic dosage, effects of chronic use, potential toxicityeffects of chronic use, potential toxicity
Single compound works differently from Single compound works differently from whole foodwhole food
False sense of healthy life styleFalse sense of healthy life style