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相同质量100g肥肉和100g碳水,哪个更长肉? 第1页

  

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小结

1、主流科学界的结论:决定肥胖的主要饮食因素是总热量,次要才是食物种类

2、如果热量不足,碳水和脂肪都不会让人长胖;

3、如果热量超标,脂肪比碳水更令人发胖;

4、就算没有胰岛素,人照样可以长胖,条条大路通肥胖,只要热量足够。

结论:“相同的额外热量,脂肪比碳水更容易让人发胖”。


一、总热量定胜负

1、主流学术界的结论非常明确:宏观上,肥胖主要取决于总热量

(1)国际运动营养学会(ISSN—The International Society of Sports Nutrition )2017年的声明[1]:减肥主要靠热量差,低脂和低碳饮食效果类似。

声明中还提到:“目前为止,高碳和低碳饮食的对比研究中,只要总热量摄入相同,低碳饮食没能带来更高的减脂效果[3,4,5,6,7,8],除极少数研究例外[2]”。

(2)美国国家脂肪协会2019年也发表过声明,同样提出低碳/极低碳水饮食并不比其他饮食更适合用于减肥[9];

(3)一项包含了107个相关研究的大型元分析[2]得出:减肥的效果不是因为饮食中的碳水减少,而是因总热量减少;另一项包含19个研究进行了荟萃分析的结论是,只要总热量相等,低碳与常规饮食的减肥效果一样[11]。大多数研究都得出类似结论[12,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40]。

(4)甚至于,对115名2型糖尿病人的研究也发现[13],低碳高脂饮食(碳水14%/脂肪58%)与低脂高碳饮食(53%碳水/30%脂肪)带来的体重减轻和血糖控制效果类似。


2、食物种类的影响也明显存在,但是相对于总热量的影响较为次要一些

证据表明,同样是碳水,来自于水果、谷物、粗粮、奶制品中的碳水与2型糖尿病风险是负相关,而甜食、甜饮料则正相关[47,48,49,50,51];增加水果/蔬菜/全谷类/豆类/家禽和鱼类的摄入,减少精制碳水/土豆/红肉/加工肉类,可能会降低冠心病的风险[53]。

护士健康研究对148.4万人随访接近20年的数据(1984-2008年)表明,高碳水化合物摄入量与二型糖尿病风险无关(相对风险-2%),高淀粉升高相应风险23%、高纤维降低相应风险20%、谷物降低相应风险29%、水果降低相应风险21%[52];

小结:总热量过高才是肥胖的主要原因,而非胰岛素和碳水。


二、如果热量过剩,脂肪比碳水更至胖

在不运动的状态下,如果热量吃超了,脂肪比碳水更令人发胖。

《美国临床营养学杂志》有一项研究[105],将35名正常和肥胖的受试者随机分配到持续15天【同等热量】的高碳水化合物(55%碳水)或高脂肪(50%脂肪)饮食中。

在前14天,调整了饮食量,保持他们的体重不变。第15天受试者在代谢房中静坐呆23小时,并吃了【同等热量的】超量的饮食。结果高碳水组的热量盈余约为1338千焦,高脂肪组热量盈余约为1728千焦。


所以原文结论是,对于经常久坐的人来说,长期食用高碳水化合物可以稍微少长胖一些


三、脂肪比碳水更至胖的原因一:糖缓冲系统

1、人有糖缓冲系统,没有脂肪缓冲系统,吃的糖先存起来,吃的脂肪直接长胖

人体的糖缓冲系统主要由肝脏和肌肉构成,它们像海绵一样,可吸收许多的糖,存起来。特别是骨骼肌,它是人体处理葡萄糖的主要器官[43,44,45]。葡萄糖一旦进入肌肉,就会被合成大分子肌糖原储存其中,作为肌肉的备用能量,不会再被身体挪作他用,也不会转化为脂肪。

一般人肝可容纳100g左右糖。有数据称骨骼肌储存糖的能力是12g/kg肌肉,所以普通人一般肌肉能存400g左右的糖。这些内容在各类教材上都有。

但是,人体没有脂肪缓冲系统。人吃下去的脂肪先在小肠消化,然后由肠细胞合成为甘油三酯,被脂载蛋白运输入血,全部吸收。


2、正常情况下人体对膳食脂肪会吸收95%左右,极少排泄

许多自媒体为了吸引眼球喜欢写类似于“吃肥肉不长胖,吃碳水才长胖”,一种理由就是人会排泄多余脂肪,碳水通过胰岛素使人发胖。这个问题下有些评论区也有人说脂肪大于多少多少g就排泄了

这种说法纯属扯蛋。任何一本生理/生物/营养方面的教材上都写的清清楚楚:脂肪从消化道进入血液循环,没有排泄这一说。


3、不纠结于各类特殊情况,不钻牛角尖

有些人说,吃了过多脂肪导致消化不良、从肠道排泄;或者有疾病导致脂肪从肠道排泄[46],这些都属于特殊情况,没有讨论意义。如果要扯特殊情况,吃成糖尿病之后碳水大部分从尿液排泄了,吃100g碳水可能只获得10-30g甚至更少。

值得一提的是中/短链脂肪,它们不会被储存,会被分解供能。但是它们也是热量,还是会间接导致人发胖。人体每天都要无时无刻分解脂肪来供能,有了这些中短链脂肪酸,人体可以减少分解自身的脂肪。再加上中/短链脂肪酸在一般食物中占比较少,没必要钻这个牛角尖。


四、脂肪比碳水更至胖的原因二:碳水会额外燃烧,脂肪不会

原因是,当摄入多余碳水时,身体会燃烧掉一部分;当摄入多余脂肪时身体不会燃烧它们。

早期的研究已经证实了上述观点:34名非糖尿病男性经过了10天测试,前4天限制食物,从第5天开始让他们放开吃,这导致他们摄入过多总热量(32%-54%)。结果发现碳水化合物摄入增加导致了额外的碳水化合物氧化(燃烧),但脂肪摄入增加不导致额外脂肪氧化[102]。

另一项研究的结论也一样:28名印第安土著妇女同样进行上述测试,前4天限制食物,从第5天开始让放开吃[103]。这导致她们摄入过多总热量,蛋白质摄入增加约11%,脂肪摄入增加约40%,碳水摄入增加约49%。过量摄入碳水化合物可导致碳水化合物氧化增加(r=0.51),而过量脂肪摄入则导致脂肪氧化减少(r=-0.53)。

两个研究,不同性别,不同人群,不同民族,不同体重,结论却相同:当总热量超标时,碳水摄入增加提升碳水的氧化(燃烧)水平;脂肪摄入增加则不提升脂肪的氧化水平。

这就是为什么,kevin等人观察到,摄入超量碳水化合物期间,受试者24小时的能量消耗增加了840大卡/日[104]。考虑到普通人每日的总热量消耗平均是2000千卡,相当于增加了35%的代谢,这个值相当可观。

这印证了我们之前的观点:如果热量吃超了,超标的部分是碳水,身体储存的脂肪没有那么多;而如果超量部分是脂肪,身体几乎是照单全收。所以则更令人发胖。


五、为什么碳水摄入增加会导致碳水氧化增加?

1、摄入碳水刺激胰岛素分泌,胰岛素促进碳水“燃烧”

生理上,胰岛素有3个主要生理作用:

(1)促进肌肉和肝脏吸收碳水(所谓的先补充糖库);

(2)【促进碳水糖酵解】(所谓“燃烧”掉一些)

(3)敦促脂肪细胞摄取葡萄糖和脂肪酸(所谓长胖)。

(还有抑制脂肪分解等,就不铺开说了)

关于第二点,在不同的生理和营养教材上都有描述,说法都相同,是共识,不是什么新鲜观点。


2、胰岛素如何促进碳水燃烧?答案是通过一种酶:PDC

多数情况下,人把碳水作为主要能量来源。

我们“燃烧”碳水释放能量,给ATP充能,细胞再利用ATP的能量。在运动强度低、或者静息状态,我们有充足的氧气供应,此时我们对碳水进行“有氧氧化”:也就是俗称的三羧酸循环(也叫柠檬酸循环,TC循环)。

它的大致步骤是这样的:

对于有基础知识的同学来说,这个图很熟悉,so easy。因为每个医学生都要背这个循环,好的老师会教会你如何轻松背诵。

但没有基础知识的同学就要崩溃了:完全看不懂。别急,它只是看起来复杂,简化一下就这样:

如图上所示,葡萄糖在人体内经过一些复杂而繁琐的反应,被转化为丙酮酸;丙酮酸氧化为乙酰COA[77],然后进入三羧酸循环彻底氧化分解,得到为二氧化碳、水和能量。

这样,大家就好理解PDC是什么了:PDC就是那个把丙酮酸氧化为乙酰COA的关键性角色,它叫丙酮酸脱氢酶复合物,英文名Pyruvate Dehydrogenase Complex。

这是它的照片:

PDC是糖酵解中的一种关键酶(的复合物)[78]。

肌肉处理、消耗葡萄糖,很大程度需要依赖并激活PDC[93]。PDC与全身最大摄氧量有很强的相关性[73,74,75],有运动经验的人比久坐的人更能氧化碳水/丙酮酸,而得到更多的能量。

那这和本文的关系在于,吃了碳水后分泌胰岛素,胰岛素能提升PDC活性[92,101,102];PDC活性提高了,碳水氧化增加,热量损耗增加。

92. Constantin-Teodosiu D, Constantin D, Stephens F, Laithwaite D, Greenhaff PL. The role of FOXO and PPAR transcription factors in diet-mediated inhibition of PDC activation and carbohydrate oxidation during exercise in humans and the role of pharmacological activation of PDC in overriding these changes. Diabetes. 2012;61:1017–1024.

101. Y Sakamoto, T Kuzuya.Stimulation of pyruvate dehydrogenase activity by insulin-dextran complex in mouse adipose tissue.iochem Biophys Res Commun. 1979 May 14;88(1):37-43. doi: 10.1016/0006-291x(79)91693-0.

102. M Cardell 1 , B K Siesjö, T Wieloch.Changes in pyruvate dehydrogenase complex activity during and following severe insulin-induced hypoglycemia.J Cereb Blood Flow Metab. 1991 Jan;11(1):122-8.

在这一点上上,文献和教材当然是同步的。因为好的书、教材就是文献的汇总和整理。

也就是说,作为多余热量时,碳水会有所损失,但脂肪不会——这就是为什么如果吃多了,脂肪比碳水更胖人。这才是题主的问题中真正包含的有价值回答信息,这才是我要写这个回答的目的。


六、高脂肪饮食还抑制PDC活性,抑制碳水燃烧

康斯坦丁等人证实,高脂肪饮食激活了PDK,抑制PDC的活性,减少了碳水的氧化[93]。Peters等人报告,3天的高脂肪饮食后没,PDK活性增加,碳水氧化减少[100]。这当然不是孤证,相应证据还有很多[87,88,89,90,91,94,5,96,97,9899]。

为什么高脂肪饮食会抑制PDC的活性呢?因为高脂肪饮食可以激活另一些酶(PDK),PDK会抑制PDC的活性,从而促进肥胖、糖尿病、非酒精性脂肪肝[79,80,81,82]。

如果对动物使用药物抑制PDK,则PDC的活性增加,碳水化合物燃烧增加,脂肪肝减弱[83];如果对动物进行基因编辑,让动物体内减少或者不产生PDK,则动物的葡萄糖氧化增加、糖耐受和胰岛素敏感性明显提高、体重减轻、肥胖程度下降、脂肪肝减少/改善[84,85,86]。

PDK对PDC的抑制机理就不细说了,下图(蓝圈)给大家看一眼即可。


七、只要脂肪吃够,哪怕没有胰岛素照样长胖

胰岛素不是长胖的必要条件。

知乎上许多人持有一种观点:觉得人长胖必须得有胰岛素参与,没有胰岛素人不能合成脂肪。


对于持有这种观点(没有胰岛素不能合成脂肪、不会长胖)的人,我觉得他们的脑袋里装的都是大头针和图钉。

因为胰岛素根本就不是合成脂肪的必要或前提条件。没有胰岛素,人体一样可以把膳食中吸收进血液的脂肪运输到脂肪组织,长胖,完全不影响。

证据在生理学上。

乙酰化刺激蛋白(acylation stimulation protein,简称ASP)[54],它是脂肪细胞分泌的一种因子。科研认为ASP储存脂肪的作用与胰岛素相当[59]。

它通过激活甘油三酯合成酶,促进脂肪细胞获得更多的脂肪酸[69]。跟胰岛素一样,它还能抑制抑制脂肪分解酶的活性(如HSL),减少脂肪分解[60]。

肥胖和高血脂体内ASP水平增加[59,62],ASP和腰臀比正相关(ASP水平越高,腰围越大)

ASP会响应于脂肪摄入。进食高脂肪食物后,乳糜微粒(半消化的食物脂肪微粒)能会刺激APS生成增加10-20倍,并且ASP水平升高与血脂升高正相关[63,64]。

注意,ASP可以独立于胰岛素发挥作用[61],所以我们说,不需要胰岛素,人体一样可以长胖。

有趣的是,类似于胰岛素抵抗这样的概念,ASP也可以被抵抗,ASP促进腹部脂肪堆积的能力会随肥胖逐渐变弱[65,66,67],ASP抵抗也被视为代谢综合征中的一种表现[69]。ASP在血脂异常[69]、多囊卵巢[70]、肾病[71]、非酒精性脂肪性肝[72]、胰岛素抵抗、肥胖和冠心病、心血管疾病中都发挥了一定作用[55,56],心肌梗死期间ASP的激活和刺激也被关注[57,58]。


八、题外话

仔细的看,我们所有的探讨前提都是“超出同样的热量”。实际上,由于高脂肪饮食具有抑制食欲的作用,往往总热量摄入低于正常饮食。

那这就意味着高脂肪低碳(或者生酮)饮食更利于常人减肥吗?

这没有答案。

1、高脂肪饮食具有抑制食欲的好处,但是它难以坚持。大量数据表明,低碳/生酮饮食是所有饮食方案中退出率最高的。结果大概率是爆碳、复胖——一夜回到解放前,比减肥之前更糟糕;

2、低碳/生酮饮食还有许多安全性方面的问题:酮作为一种酸性物质,会降低血液的PH值,这就需要考验人的酸碱缓冲系统。对于一些人能承受,而对于另一些遗传条件的人,可能会变成酸中毒甚至昏迷死亡,这有大量的案例;

3、生酮饮食对某些人群可能损伤肝、肾和骨密度,长期癫痫生酮的儿童肾结石发病率比正常人同高接近30倍,这些也需要引起注意;

4、医学上,低碳和生酮饮食已经被证实纳入治疗手段。这被很多生酮商用来做广告,但这不代表安全,更不代表适合大众自己操作:砒霜和吗啡也都是医学治疗手段。


扩展阅读

不健身直接吃蛋白粉会怎么样?

“肌肉在休息的时候超量生长”,其中关于“休息”的定义是睡觉吗?

当代年轻人为什么尿酸会高?


肉崽:训练后需要拉伸吗?(一)

肉崽:训练后需要拉伸吗?(二)

肉崽:训练后需要拉伸吗?(三)

肉崽:训练后需要拉伸吗:参考文献(1-200)

肉崽:训练后需要拉伸吗:参考文献(200-323)


肉崽:被误解最多的健美训练要素(一):轻重量精确刺激肌肉

肉崽:被误解最多的健美训练要素(二):慢速动作

肉崽:被误解最多的健美训练要素(三):孤立训练

肉崽:被误解最多的健美训练要素(四):变换动作给予肌肉新刺激

肉崽:被误解最多的健美训练要素(五):依据肌纤维类型针对训练

肉崽:“8-12次最佳增肌次数范围” 其实是个伪命题


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8. Hall K, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology. 2017;152(7):1718-27.

9. Carol F Kirkpatrick 1 , Julie P Bolick 2 , Penny M Kris-Etherton 3 , Geeta Sikand 4 , Karen E Aspry 5 , Daniel E Soffer 6 , Kaye-Eileen Willard 7 , Kevin C Maki 8.Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors: A scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force.J Clin Lipidol. Sep-Oct 2019;13(5):689-711.e1.

10. Dena M Bravata, Lisa Sanders, Jane Huang, Harlan M Krumholz, Ingram Olkin, Christopher D Gardner, Dawn M Bravata.Efficacy and safety of low-carbohydrate diets: a systematic review.JAMA. 2003 Apr 9;289(14):1837-50.

11. Celeste E. Naude, Anel Schoonees, Marjanne Senekal, Taryn Young, Paul Garner, 4and Jimmy Volmink.Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A Systematic Review and Meta-Analysis.PLoS One. 2014; 9(7): e100652

12. Michael L Dansinger 1 , Joi Augustin Gleason, John L Griffith, Harry P Selker, Ernst J Schaefer.Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial.JAMA. 2005 Jan 5;293(1):43-53.

13. Jeannie Tay, Campbell H Thompson, Natalie D Luscombe-Marsh, Thomas P Wycherley, Manny Noakes, Jonathan D Buckley, Gary A Wittert, William S Yancy Jr, Grant D Brinkworth.Effects of an energy-restricted low-carbohydrate, highunsaturatedfat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial.Diabetes Obes Metab. 2018 Apr;20(4):858-871.

14. Grant D Brinkworth 1 , Manny Noakes, Jonathan D Buckley, Jennifer B Keogh, Peter M Clifton.Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo.Am J Clin Nutr. 2009 Jul;90(1):23-32.

15. Alain J Nordmann 1 , Abigail Nordmann, Matthias Briel, Ulrich Keller, William S Yancy Jr, Bonnie J Brehm, Heiner C Bucher.Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials.Arch Intern Med. 2006 Feb 13;166(3):285-93.

16. Carolyn D Summerbell 1 , Cate Cameron, Paul P Glasziou.WITHDRAWN: Advice on low-fat diets for obesity.Cochrane Database Syst Rev. 2008 Jul 16;(3):CD003640.

17. Jeannie Tay 1 , Natalie D Luscombe-Marsh 2 , Campbell H Thompson 3 , Manny Noakes 4 , Jonathan D Buckley 5 , Gary A Wittert 3 , William S Yancy Jr 6 , Grant D Brinkworth 7.Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial.Am J Clin Nutr. 2015 Oct;102(4):780-90.

18. Vivian L Veum, Johnny Laupsa-Borge, ?yvin Eng, Espen Rostrup, Terje H Larsen, Jan Erik Nordrehaug, Ottar K Nyg?rd , J?rn V Sagen, Oddrun A Gudbrandsen, Simon N Dankel, Gunnar Mellgren.Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial.Am J Clin Nutr. 2017 Jan;105(1):85-99."

19. Carol S Johnston 1 , Sherrie L Tjonn, Pamela D Swan, Andrea White, Heather Hutchins, Barry Sears.Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.Am J Clin Nutr. 2006 May;83(5):1055-61.

20. H J van Wyk, R E Davis, J S Davies.A critical review of low-carbohydrate diets in people with Type 2 diabetes.Diabet Med. 2016 Feb;33(2):148-57.

21. Long Ge et al. Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials.BMJ. 01 April,2020.

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23. Alain J Nordmann 1 , Abigail Nordmann, Matthias Briel, Ulrich Keller, William S Yancy Jr, Bonnie J Brehm, Heiner C Bucher.Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials.Arch Intern Med. 2006 Feb 13;166(3):285-93.

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user avatar   UNSC711 网友的相关建议: 
      

去打游戏


user avatar   zhang-qi-ling-24-95 网友的相关建议: 
      

山东男人,180,抢答一波。

这又是一个挑动南北对立的问题,估计和那位说北方男人太高,作为劳动力不适合工业制造业经济发展的神贴一个作者。

什么时候身高成优越感了?

什么时候月匈大就成优越感了?

个体差异而已。

找对象又不是80年代集市上挑牲口,得看肩高,看牙口。

都2021年了,一个男人要是靠个头产生优越感,说明这个人基本就是个草包,长那么高个头白瞎了。

有的喜欢肤白貌美大长腿。

有的喜欢36D,锥子脸,水蛇腰。

有的喜欢小鸟依人,有的御姐控萝莉控,

还有的非得娶处女,还有的硕士以下学历不考虑。

但真没见几个执着于女孩子身高的,150—180的女孩子,我身边的北方男人都娶过。

另外,不是每个北方男人都高大魁梧,有40%的175以下。这种身高对于150—170的女士,都不算什么身高优势的。何况南方女士也有50%以上是身高高于160的。

男人最重要的是品行,修养,能力,责任感,而不是多大块头,毕竟现在农业也机械化了,重体力劳动,耐力劳动,已经占比极地了,高大魁梧,威猛彪悍,只具有审美价值和欣赏价值。

治安越来越好的今天,都市里面也不需要一个巨石强森一样的肌肉男来给予女士们安全感。

女人们也不用想太多,男人喜欢你,爱上你,想和你结婚,不会因为你个头矮点,罩杯小一个号而犹豫。

最后,这种南北对立的话题,就谈谈GDP房价和产业领域就行了。扯到男女身上,简直就是人为的撕裂。


user avatar   xiao-yu-42-42-67 网友的相关建议: 
      

山东男人,180,抢答一波。

这又是一个挑动南北对立的问题,估计和那位说北方男人太高,作为劳动力不适合工业制造业经济发展的神贴一个作者。

什么时候身高成优越感了?

什么时候月匈大就成优越感了?

个体差异而已。

找对象又不是80年代集市上挑牲口,得看肩高,看牙口。

都2021年了,一个男人要是靠个头产生优越感,说明这个人基本就是个草包,长那么高个头白瞎了。

有的喜欢肤白貌美大长腿。

有的喜欢36D,锥子脸,水蛇腰。

有的喜欢小鸟依人,有的御姐控萝莉控,

还有的非得娶处女,还有的硕士以下学历不考虑。

但真没见几个执着于女孩子身高的,150—180的女孩子,我身边的北方男人都娶过。

另外,不是每个北方男人都高大魁梧,有40%的175以下。这种身高对于150—170的女士,都不算什么身高优势的。何况南方女士也有50%以上是身高高于160的。

男人最重要的是品行,修养,能力,责任感,而不是多大块头,毕竟现在农业也机械化了,重体力劳动,耐力劳动,已经占比极地了,高大魁梧,威猛彪悍,只具有审美价值和欣赏价值。

治安越来越好的今天,都市里面也不需要一个巨石强森一样的肌肉男来给予女士们安全感。

女人们也不用想太多,男人喜欢你,爱上你,想和你结婚,不会因为你个头矮点,罩杯小一个号而犹豫。

最后,这种南北对立的话题,就谈谈GDP房价和产业领域就行了。扯到男女身上,简直就是人为的撕裂。




  

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