Varying the macronutrient composition of meals alters acute postprandial responses, but the effect sizes for specific macronutrient exchanges have not been quantified by systematic reviews. Therefore the aim is to quantify the effect size of exchanging fat for carbohydrates in mixed meals on postprandial glucose (PPG), insulin (PPI), triglycerides (PPTG), and free fatty acids (PPFFA) responses by performing a systematic review and meta-analysis of randomized controlled trials. A systematic literature search was undertaken on randomized controlled trials comparing isocaloric high fat with high carbohydrate meals, with comparable protein contents and at least one postprandial glycemic- and one lipid outcome. The outcome data were extracted and expressed as mean postprandial levels over 2 h. Ten studies involving 14 comparisons met the eligibility criteria. Data were available for meta-analysis from 347 participants, consuming mixed meals containing 250-1003 kcal, and total fat contents of 33.3-75.6 percentage of energy (en%) (intervention) versus 0-31.7 en% (control). Each 10en% increase in fat, replacing carbohydrates produced a mean reduction in PPG of 0.32 mmol/l (95% CI -0.64 to -0.00, p = 0.047), a reduction in PPI of 18.2 pmol/l (95% CI -24.86 to -11.54), an increase in PPTG of 0.06 mmol/l (95% CI 0.02 to 0.09, p = 0.004), with no statistically significant effect on PPFFA. Modest exchange of carbohydrates for fats in mixed meals significantly reduces PPG and PPI and increases PPTG responses. The quantitative relationships derived here may be applied to predict responses, and to design and optimize meal macronutrient compositions in dietary intervention studies.

中文翻译：

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碳水化合物等热量交换脂肪对餐后葡萄糖、胰岛素、甘油三酯和游离脂肪酸反应的影响——系统评价和荟萃分析。

改变膳食的常量营养素组成会改变急性餐后反应，但系统评价尚未量化特定常量营养素交换的影响大小。因此，目的是通过进行系统评价和荟萃分析，量化在混合膳食中以脂肪换碳水化合物对餐后葡萄糖 (PPG)、胰岛素 (PPI)、甘油三酯 (PPTG) 和游离脂肪酸 (PPFFA) 反应的影响大小。随机对照试验分析。对比较等热量高脂肪和高碳水化合物膳食的随机对照试验进行了系统的文献检索，具有可比的蛋白质含量和至少一种餐后血糖和一种血脂结果。提取结果数据并表示为 2 小时内的平均餐后水平。涉及 14 项比较的 10 项研究符合资格标准。数据可用于 347 名参与者的荟萃分析，他们食用含有 250-1003 kcal 的混合膳食，总脂肪含量为 33.3-75.6% 的能量 (en%)（干预）与 0-31.7 en%（控制）。脂肪每增加 10en%，替代碳水化合物，PPG 平均降低 0.32 mmol/l（95% CI -0.64 至 -0.00，p = 0.047），PPI 降低 18.2 pmol/l（95% CI -24.86至 -11.54），PPTG 增加 0.06 mmol/l（95% CI 0.02 至 0.09，p = 0.004），对 PPFFA 无统计学意义的影响。混合膳食中碳水化合物与脂肪的适度交换可显着降低 PPG 和 PPI 并增加 PPTG 反应。此处得出的定量关系可用于预测响应，