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Metabolik Sendromda Tıbbi Beslenme Tedavisi

Year 2022, Volume: 12 Issue: 2, 366 - 371, 17.05.2022
https://doi.org/10.33631/sabd.1115783

Abstract

Günümüzde sıklıkla karşılaşılan bir endokrin bozukluk olan metabolik sendrom (MetS), bozulmuş insülin direnci, adipoz dokuda artış (abdominal obezite, dislipidemi), hipertansiyon, koroner arter hastalığı, artmış sistematik inflamasyon gibi sistemik bozukluklarının tümünü birlikte kapsayan bir tablodur. Görülme sıklığı, dünyada ve ülkemizde giderek artan bu önemli halk sağlığı sorununda, tanı alan bireylerde sağlıklı beslenme ve yaşam biçimi ile pozitif yönde iyileşmeler sağlanabilmektedir. Genetik ve çevresel faktörlerin etkisiyle ortaya çıkan bir hastalık tablosu olan metabolik sendromda öncelikli tedavi, yaşam biçiminin sağlığı geliştirici şekilde düzenlenmesi olmalıdır. Sağlıklı beslenme önerileri arasında özellikle doymuş yağ alımının azaltılması, doymamış yağ alımının arttırılmasının yanı sıra kompleks karbonhidrattan zengin beslenmek, posa alımını arttırmak, bitkisel sterol ve/veya stanollere beslenmede yer vermek, tuz tüketimini sınırlandırmak gibi Akdeniz beslenme modeline uygun öneriler ön plana çıkmaktadır. Ayrıca diyetin glisemik indeks ve yükü, metabolik sendromun beslenme tedavisinde dikkate alınması gereken özelliklerdir. Düşük dansiteli lipoprotein düzeyi yüksekliğini düşürmeye yardımcı beslenme önerileri de mutlaka göz önünde bulundurulmalıdır.

References

  • Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US*. Journal of Diabetes. 2010; 2(3): 180-93.
  • Abacı A, Kılıckap M, Göksülük H, Karaaslan D, Barçın C, Kayıkçıoğlu M, ve ark. Türkiye’de metabolik sendrom sıklığı verileri: Kardiyovasküler risk faktörlerine yönelik epidemiyolojik çalışmaların sistematik derleme, meta-analiz ve meta-regresyonu. Turk Kardiyol Dern Ars 2018; 46(7): 591-601.
  • Eşer Durmaz S, Nişancı Kılıç F. Metabolik Sendrom ve Tıbbi Beslenme Tedavisi. Editör(ler): Şanlıer N. Vakalarla Öğreniyorum: Yetişkin Hastalıklarına Tıbbi Beslenme Tedavisi, dördüncü baskı. Ankara:Hedef CS Yayıncılık; 2021.s.460-69.
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285(19): 2486-97.
  • Finicelli M, Squillaro T, Di Cristo F, Di Salle A, Melone MAB, Galderisi U et al. Metabolic syndrome, Mediterranean diet and polyphenols: Evidence and perspectives. J Cell Physiol. 2019; 234(5): 5807-26.
  • Grundy SM, Hansen B, Smith SC. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109(4):551-57.
  • Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Metabolik Sendrom Kılavuzu. Ankara:2009.
  • Özgen AG. Metabolik sendrom ve dislipidemi. Turkiye Klinikleri J Int Med Sci. 2006;2 (3): 43-54.
  • Di Daniele N, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, et al. Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget. 2017; 8(5): 8947-79.
  • Balkan F. Metabolik sendrom. Ankara Medical Journal 2013; 13(2): 85-90.
  • Moreira GC, Cipullo JP, Ciorlia LAS, Cesarino CB, Vilela-Martin JF. Prevalence of metabolic syndrome: association with risk factors and cardiovascular complications in an urban population. PLoS One. 2014; 9(9): e105056.
  • Tüfekçi Alphan E. Metabolik Sendrom ve Tıbbi Beslenme Tedavisi. Editör(ler): Tüfekçi Alphan E. Hastalıklarda Beslenme Tedavisi, birinci baskı. Ankara: Hatipoğlu Yayınevi; 2013. s.385-409.
  • Gören B, Fen T. Metabolik sendrom. Turkiye Klinikleri J Int Med Sci. 2008; 28(5): 686-96.
  • Şendur MAN, Güven G. Güncel kılavuzlar eşliğinde hipertansiyon tedavisi. Hacettepe Tıp Dergisi. 2011; 42(3):5 3-64.
  • Blaslov K, Bulum T, Zibar K et al. Relationship between adiponectin level, insulin sensitivity, and metabolic syndrome in type 1 diabetic patients. Int J Endocrinol. 2013; 1-6.
  • Melanson KJ. Nutrition Review: Diet and metabolic syndrome. Am J Lifestyle Med. 2008; 2(2): 113-20.
  • Akbulut G, Rakıcıoğlu N. Derleme: Şismanlığın beslenme tedavisinde güncel yaklaşımlar. Genel Tıp Dergisi. 2010; 20(1): 35-42.
  • Türkiye Beslenme Rehberi (TÜBER) 2015. Ankara; Sağlık Bakanlığı Yayın No: 1031.
  • Delzenne NM, Cani PD. A place for dietary fibre in the management of the metabolic syndrome. Curr Op Clin Nutr Metab Care. 2005; 8(6): 636-40.
  • Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Experiment Biol Med. 2008; 233(6): 674-88.
  • Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Current Atherosclerosis Report. 2010; 12(6): 368-76.
  • Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis risk in communities study. Circulation. 2008; 117(6): 754-61.
  • Cuenca-García M, Artero EG, Sui X, Lee D, Hebert JR, Blair SN. Dietary indices, cardiovascular risk factors and mortality in middle-aged adults: findings from the Aerobics Center Longitudinal Study. Annals of Epidemiology. 2014; 24(4): 297-303.
  • Cho SS, Qi L, Fahey GC, Klurfeld DM. Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease. American Journal of Clinical Nutrition. 2013; 98(2): 594-619.
  • Cabello-Saavedra E, Bes-Rastrollo M, Martinez JA, Diez-Espino J, Buil-Cosiales P, Serrano-Martinez M, et al. Macronutrient intake and metabolic syndrome in subjects at high cardiovascular risk. Ann Nutr Metab. 2010; 56(2): 152-61.
  • Jones JM. Dietary fiber future directions: Integrating new definitions and findings to inform nutrition research and communication. Advances in Nutrition 2013; 4(1): 8-15.
  • Plat J, Mensink RP. Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 2005; 96(1): 15-22.
  • de la Iglesia R, Loria-Kohen V, Zulet MA, Martinez JA, Reglero G, de Molina AR. Dietary strategies implicated in the prevention and treatment of metabolic syndrome. Int J Mol Sci. 2016; 17(11): 1877.
  • Salas-Salvado J, Fernandez-Ballart J, Ros E, Martinez-Gonzalez MA, Fito M, Estruch R, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Archives of Internal Medicine. 2008; 168(22): 2449-58.
  • Kendall CW, Josse AR, Esfahani A, Jenkins DJA. Nuts, metabolic syndrome and diabetes. Br J Nutr. 2010; 104(4) :465-73.
  • Mozaffarian D. Nutrition and cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, editors. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier/Saunders; 2014. p.946-1030.
  • Kesse-Guyot E, Ahluwalia N, Lassale C. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovas Dis 2013; 23(7): 677-83.
  • Aslan, R. Vitaminler oksidan ve antioksidan dengeyi nasıl etkiliyor? Ayrıntı Dergisi 2018; 6(68): 1-5.
  • İriş C, Çınar M. Antioksidan vitaminler ve ağır metal toksisitesi üzerine etkileri. Veteriner Farmakoloji ve Toksikoloji Derneği Bülteni. 2019; 10(3): 135-51.
  • Bacanlı M, Başaran N, Başaran, AA. Lycopene: Is it beneficial to human health as an antioxidant? Turkish Journal of Pharmacological Science. 2017; 14(3): 311-19.
  • Hedayati N, Naeini MB, Nezami A, Hosseinzadeh H, Hayes AW, Hosseini S. et al. Protective effect of lycopene against chemical and natural toxins: A review. International Union of Biochemistry and Molecular Biology 2019;45(1):5-23.
  • Vecek NN, Mucalo L, Dragun R, Milicevic T, Pribisalic A, Patarcic I, et al. The association between salt taste perception, mediterranean diet and metabolic syndrome: A cross-sectional study. Nutrients. 2020; 12(4): 1164.
  • Grosso G, Buscemi S, Galvano F, Mistretta A, Marventano S, La Vela V, et al. Mediterranean diet and cancer: epidemiological evidence and mechanism of selected aspects. BMC Surg 2013; 13(2): 14.

Medical Nutrition Theraphy in Metabolic Syndrome

Year 2022, Volume: 12 Issue: 2, 366 - 371, 17.05.2022
https://doi.org/10.33631/sabd.1115783

Abstract

Metabolic syndrome (MetS), an endocrine disorder that is frequently encountered today, is a condition that includes all of the systemic disorders such as impaired insulin resistance, increase in adipose tissue (abdominal obesity, dyslipidemia), hypertension, coronary artery disease, and increased systematic inflammation. In this important public health problem, the incidence of which is increasing in the world and in our country, positive improvements can be achieved in individuals diagnosed with a healthy diet and lifestyle. In metabolic syndrome, which is a disease picture that occurs with the effect of genetic and environmental factors, the primary treatment should be regulation of lifestyle in a health-promoting way. Among the recommendations for healthy eating, especially the recommendations in accordance with the Mediterranean nutrition model, such as reducing saturated fat intake, increasing unsaturated fat intake, as well as nutrition rich in complex carbohydrates, increasing fiber intake, including plant sterols and / or stanols in nutrition, and limiting salt consumption, come into prominence. In addition, glycemic index and load are features that should be considered in the nutritional treatment of metabolic syndrome. Nutritional recommendations that help to lower higher low-density lipoprotein cholesterol levels should also be considered.

References

  • Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US*. Journal of Diabetes. 2010; 2(3): 180-93.
  • Abacı A, Kılıckap M, Göksülük H, Karaaslan D, Barçın C, Kayıkçıoğlu M, ve ark. Türkiye’de metabolik sendrom sıklığı verileri: Kardiyovasküler risk faktörlerine yönelik epidemiyolojik çalışmaların sistematik derleme, meta-analiz ve meta-regresyonu. Turk Kardiyol Dern Ars 2018; 46(7): 591-601.
  • Eşer Durmaz S, Nişancı Kılıç F. Metabolik Sendrom ve Tıbbi Beslenme Tedavisi. Editör(ler): Şanlıer N. Vakalarla Öğreniyorum: Yetişkin Hastalıklarına Tıbbi Beslenme Tedavisi, dördüncü baskı. Ankara:Hedef CS Yayıncılık; 2021.s.460-69.
  • Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285(19): 2486-97.
  • Finicelli M, Squillaro T, Di Cristo F, Di Salle A, Melone MAB, Galderisi U et al. Metabolic syndrome, Mediterranean diet and polyphenols: Evidence and perspectives. J Cell Physiol. 2019; 234(5): 5807-26.
  • Grundy SM, Hansen B, Smith SC. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109(4):551-57.
  • Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Metabolik Sendrom Kılavuzu. Ankara:2009.
  • Özgen AG. Metabolik sendrom ve dislipidemi. Turkiye Klinikleri J Int Med Sci. 2006;2 (3): 43-54.
  • Di Daniele N, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, et al. Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget. 2017; 8(5): 8947-79.
  • Balkan F. Metabolik sendrom. Ankara Medical Journal 2013; 13(2): 85-90.
  • Moreira GC, Cipullo JP, Ciorlia LAS, Cesarino CB, Vilela-Martin JF. Prevalence of metabolic syndrome: association with risk factors and cardiovascular complications in an urban population. PLoS One. 2014; 9(9): e105056.
  • Tüfekçi Alphan E. Metabolik Sendrom ve Tıbbi Beslenme Tedavisi. Editör(ler): Tüfekçi Alphan E. Hastalıklarda Beslenme Tedavisi, birinci baskı. Ankara: Hatipoğlu Yayınevi; 2013. s.385-409.
  • Gören B, Fen T. Metabolik sendrom. Turkiye Klinikleri J Int Med Sci. 2008; 28(5): 686-96.
  • Şendur MAN, Güven G. Güncel kılavuzlar eşliğinde hipertansiyon tedavisi. Hacettepe Tıp Dergisi. 2011; 42(3):5 3-64.
  • Blaslov K, Bulum T, Zibar K et al. Relationship between adiponectin level, insulin sensitivity, and metabolic syndrome in type 1 diabetic patients. Int J Endocrinol. 2013; 1-6.
  • Melanson KJ. Nutrition Review: Diet and metabolic syndrome. Am J Lifestyle Med. 2008; 2(2): 113-20.
  • Akbulut G, Rakıcıoğlu N. Derleme: Şismanlığın beslenme tedavisinde güncel yaklaşımlar. Genel Tıp Dergisi. 2010; 20(1): 35-42.
  • Türkiye Beslenme Rehberi (TÜBER) 2015. Ankara; Sağlık Bakanlığı Yayın No: 1031.
  • Delzenne NM, Cani PD. A place for dietary fibre in the management of the metabolic syndrome. Curr Op Clin Nutr Metab Care. 2005; 8(6): 636-40.
  • Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Experiment Biol Med. 2008; 233(6): 674-88.
  • Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Current Atherosclerosis Report. 2010; 12(6): 368-76.
  • Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis risk in communities study. Circulation. 2008; 117(6): 754-61.
  • Cuenca-García M, Artero EG, Sui X, Lee D, Hebert JR, Blair SN. Dietary indices, cardiovascular risk factors and mortality in middle-aged adults: findings from the Aerobics Center Longitudinal Study. Annals of Epidemiology. 2014; 24(4): 297-303.
  • Cho SS, Qi L, Fahey GC, Klurfeld DM. Consumption of cereal fiber, mixtures of whole grains and bran, and whole grains and risk reduction in type 2 diabetes, obesity, and cardiovascular disease. American Journal of Clinical Nutrition. 2013; 98(2): 594-619.
  • Cabello-Saavedra E, Bes-Rastrollo M, Martinez JA, Diez-Espino J, Buil-Cosiales P, Serrano-Martinez M, et al. Macronutrient intake and metabolic syndrome in subjects at high cardiovascular risk. Ann Nutr Metab. 2010; 56(2): 152-61.
  • Jones JM. Dietary fiber future directions: Integrating new definitions and findings to inform nutrition research and communication. Advances in Nutrition 2013; 4(1): 8-15.
  • Plat J, Mensink RP. Plant stanol and sterol esters in the control of blood cholesterol levels: mechanism and safety aspects. Am J Cardiol 2005; 96(1): 15-22.
  • de la Iglesia R, Loria-Kohen V, Zulet MA, Martinez JA, Reglero G, de Molina AR. Dietary strategies implicated in the prevention and treatment of metabolic syndrome. Int J Mol Sci. 2016; 17(11): 1877.
  • Salas-Salvado J, Fernandez-Ballart J, Ros E, Martinez-Gonzalez MA, Fito M, Estruch R, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Archives of Internal Medicine. 2008; 168(22): 2449-58.
  • Kendall CW, Josse AR, Esfahani A, Jenkins DJA. Nuts, metabolic syndrome and diabetes. Br J Nutr. 2010; 104(4) :465-73.
  • Mozaffarian D. Nutrition and cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, editors. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier/Saunders; 2014. p.946-1030.
  • Kesse-Guyot E, Ahluwalia N, Lassale C. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovas Dis 2013; 23(7): 677-83.
  • Aslan, R. Vitaminler oksidan ve antioksidan dengeyi nasıl etkiliyor? Ayrıntı Dergisi 2018; 6(68): 1-5.
  • İriş C, Çınar M. Antioksidan vitaminler ve ağır metal toksisitesi üzerine etkileri. Veteriner Farmakoloji ve Toksikoloji Derneği Bülteni. 2019; 10(3): 135-51.
  • Bacanlı M, Başaran N, Başaran, AA. Lycopene: Is it beneficial to human health as an antioxidant? Turkish Journal of Pharmacological Science. 2017; 14(3): 311-19.
  • Hedayati N, Naeini MB, Nezami A, Hosseinzadeh H, Hayes AW, Hosseini S. et al. Protective effect of lycopene against chemical and natural toxins: A review. International Union of Biochemistry and Molecular Biology 2019;45(1):5-23.
  • Vecek NN, Mucalo L, Dragun R, Milicevic T, Pribisalic A, Patarcic I, et al. The association between salt taste perception, mediterranean diet and metabolic syndrome: A cross-sectional study. Nutrients. 2020; 12(4): 1164.
  • Grosso G, Buscemi S, Galvano F, Mistretta A, Marventano S, La Vela V, et al. Mediterranean diet and cancer: epidemiological evidence and mechanism of selected aspects. BMC Surg 2013; 13(2): 14.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Nutrition and Dietetics
Journal Section Reviews
Authors

Hilal Hızlı Güldemir 0000-0002-3951-5023

Publication Date May 17, 2022
Submission Date February 10, 2021
Published in Issue Year 2022 Volume: 12 Issue: 2

Cite

Vancouver Hızlı Güldemir H. Metabolik Sendromda Tıbbi Beslenme Tedavisi. VHS. 2022;12(2):366-71.