DİABETES MELLİTUS'UN TIBBİ BESLENME TEDAVİSİNDE YAĞLI TOHUMLARIN KULLANIMI

Year 2013, Volume: 1 Issue: 1, 73 - 82, 02.05.2013

Neslihan Çelik , Gamze Akbulut

Abstract

ÖZET

Yağlı tohumlar tekli ve çoklu doymamış yağ asitleri, posa ve bitkisel protein kaynağıdır. Genel olarak günlük beslenme örüntüsüne yağlı tohumların eklenmesi, beslenme örüntüsünün kalitesini yükseltir. Yağlı tohumların kan lipit profilini iyileştirme ve kalp ve damar hastalıklarını azaltma yönünde etkin olduğu bilinmektedir. Son yıllarda, diabetes mellitus (DM) hastalığını önleme ve kontrolünü sağlamada yağlı tohumların kullanılması gündemdedir. Kohort çalışmalarının sonuçları, yağlı tohumların tüketiminin, diyabet ve kalp ve damar hastalıklarının görülme riskini azalttığını ortaya koymuştur. Ancak, çok az sayıda randomize kontrollü çalışmada yağlı tohumların diyabetin kontrolü ve kan lipit profili üzerine etkileri incelenmiş, glisemik kontrol üzerine etkilerine ise değinilmemiştir. Diyabetin tıbbi beslenme tedavisinde, post prandiyal glisemik dalgalanmalar üzerinde durulan konulardan biridir. Tip II DM ve normoglisemik bireyler üzerinde yağlı tohumların tüketiminden hemen sonra kan glikoz düzeyine etkisini değerlendiren bazı çalışmalar, yalnızca yağlı tohumların tüketilmesinin; post prandiyal glisemik yanıt üzerinde minimal düzeyde etkisinin olduğunu, yağlı tohumların yüksek glisemik indeksli besinlerle birlikte tüketildiğinde ise post prandiyal glisemik yanıtı azalttığını ortaya koymuştur. Yağlı tohumların kalp damar hastalıklarını önlemede olası olumlu etkilerinin olduğu birçok çalışma ile desteklense de, diyabet üzerindeki etkilerini ortaya koyacak yeterli sayıda çalışma henüz bulunmamaktadır. Uzun dönemde, yağlı tohumların glisemik kontrol üzerine etkilerini araştıracak daha fazla sayıda çalışmaya ihtiyaç vardır.

Keywords

Diabetes Mellitus (DM), Glisemik yanıt, Yağlı tohumlar

References

• American Association of Cereal Chemists (AACC) Report. The definition of dietary fiber. 2001;46(3):112-26.
• Albert CM, Gaziano JM, Willett WC, et al. Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study. 2002;162:1382- 7.
• American Diabetes Association Nutrition recommendations and interventions for diabetes: A position statement of the American Diabetes Association (ADA). Diabetes Care 2007;30 Suppl (1):48-65.
• Ayaz A, Yağlı Tohumların Beslenmemizdeki Yeri. Ankara: Klasmat Matbaacılık; 200 Blomhoff R, Carlsen MH, Andersen LF, et al. Health benefits of nuts: potential role of antioxidants. Br J Nutr 2006; 96 Suppl (2):52-60.
• Bozzetto L, Prinster A, Annuzzi G, et al. Liver fat is reduced by an isoenergetic MUFA diet in a controlled randomized study in type 2 diabetic patients. Diabetes Care 2012;35:1429-35.
• Brehm BJ, Lattin BL, Summer SS, et al. One-year comparison of a high– monounsaturated fat diet with a highcarbohydrate diet in type 2 diabetes. Diabetes Care 2009; 32:215-20.
• Chen CY, Milbury PE, Lapsley K, et al. Flavonoids from almond skins are bioavailable and act synergistically with vitamins C and E to enhance hamster and human LDL resistance to oxidation. J Nutr 2005; 135:1366-73.
• Davidi A, Reynolds J, Njike VY, et al. The effect of the addition of daily fruit and nut bars to diet on weight, and cardiac risk profile, in overweight adults. J Hum Nutr Diet 2011;24(6):543-51.
• Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-403.
• Estruch R, Martinez-Gonzalez MA, Corella D, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 2006;145:1, Garg A, Bonanome A, Grundy SM, et al.
• Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. N Engl J Med 1988;319:829
• Griel AE, Kris-Etherton PM. Tree nuts and the lipid profile: a review of clinical studies. Br J Nutr 2006;96 Suppl (2):68-78.
• T.C. İstanbul Üniversitesi Tıp Fakültesi Türkiye Diyabet, Hipertansiyon, Obezite ve Endokrinolojik Hastalıklar Prevalans Çalışması (TURDEP) Sonuçları Erişim Tarihi: 2012, http://www.istanbul.edu.tr/itf/attachments/ 021_turdep.2.sonuclarinin.aciklamasi.pdf .
• Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998;317:1341- 5.
• Hyson DA, Schneeman BO, Davis PA. Almonds and almond oil have similar effects on plasma lipids and LDL oxidation in healthy men and women. J Nutr 2002;132:703-07.
• International Diabetes Federation Guideline for Management of Postmeal Glucose. Brussels: International Diabetes Federation; 2009.
• Jalali-Khanabadi BA, Mozaffari-Khosravi H, Parsaeyan N. Effects of almond dietary supplementation on coronary heart disease lipid risk factors and serum lipid oxidation parameters in men with mild hyperlipidemia. J Altern Complement Med 2010;16(12):1279-83.
• Jenkins DJA, Wolever TM, Taylor RH, et al. Glycemic index of foods: A physiological basis for carbohydrate exchange. Am J Clin Nutr 1981;34:362- 6.
• Jenkins DJA, Kendall CW, Marchie A, et al. Dose response of almonds on coronary heart disease risk factors:blood lipids, oxidized low-density lipoproteins, lipoprotein(a), homocysteine, and pulmonary nitric oxide: a randomized, controlled, crossover trial. Circulation 2002;106:1327-32.
• Jenkins DJA, Kendall CWC, Marchie A, et al. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA 2003;290:502-10.
• Jenkins DJA, Kendall CWC, Marchie A, et al. Direct comparison of dietary portfolio vs statin on C-reactive protein. Eur J Clin Nutr 2005;59:851-60.
• Jenkins DJA, Kendall CW, Josse AR, et al. Almonds decrease postprandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136:2987
• Jenkins DJA, Hu FB, Tapsell L, et al. Possible benefit of nuts in type 2 diabetes. J Nutr 2008;138:1752- 6.
• Jiang R, Manson JE, Stampfer MJ, et al. Nut and peanut butter consumption and risk of type 2 diabetes in women JAMA 2002; 288:2554-60.
• Jiang R, Jacobs DR Jr, Mayer-Davis E, et al. Nut and seed consumption and inflammatory markers in the multi-ethnic study of atherosclerosis. Am J Epidemiol 2006;163:222-31.
• Josse AR, Kendall CW, Augustin LS, et al. Almonds and postprandial glycemia: A dose-response study. Metabolism 2007; 56:400- 4.
• Jönsson T, Granfeldt Y, Ahren B, et al. Beneficial effects of a paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study. Cardiovasc Diabetol 2009; 8:35: doi:1186/1475-2840-8-35.
• Kendall CWC, Esfahani A, Truan J, et al. Health benefits of nuts in prevention and management of diabetes. Asia Pac J Clin Nutr 2010a;19 (1):110- 6.
• Kendall CWC, Josse AR, Esfahani A, et al. The impact of pistachio intake alone or in combination with high-carbohydrate foods on post-prandial glycemia. Eur J Clin Nutr 2011; 65:696-702.
• Kendall CWC, Josse AR, Esfahani A, et al. Nuts, metabolic syndrome and diabetes. British Journal of Nutrition 2010b; 104:465-73.
• Kochar J, Gaziano MJ, and Djoussé L. Nut consumption and risk of type 2 diabetes in the Physicians' Health Study. Eur J Clin Nutr 2010; 64(1):75-9.
• Kris-Etherton PM, Hu FB, E Ros, et al. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr 2008;138:1746-51.
• Li TY, Brennan AM, Wedick NM, et al. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr 2009;139:1333- 8.
• Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71:1455-61.
• Lopez S, Bermudez B, Ortega A, et al. Effects of meals rich in either monounsaturated or saturated fat on lipid concentrations and on insulin secretion and action in subjects with high fasting triglyceride concentrations. Am J Clin Nutr 2011; 93:494
• Lou H, Yuan H, Ma B, et al. Polyphenols from peanut skins and their free radicalscavenging effects. Phytochemistry 2004; 65:2391- 9.
• Magliano DJ, et al. Glucose indices, health behaviors, and incidence of diabetes in Australia. Diabetes Care 2008; 31(2):267–
• Meyer KA, Kushi LH, Jacobs Jr DR, et al. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr 2000; 71:921-30.
• Milbury P.E., Chen CY, Dolnikowski GG, et al. Determination of flavonoids and phenolics and their distribution in almonds J Agric Food Chem 2006; 54:5027-33.
• Onat A, Hergenç G, Uyarel H, et al. Prevalence, incidence, predictors and outcome of type 2 diabetes in Turkey. Anadolu Kardiyol Derg 2006; 6:314-21.
• Pan A, Sun Q, Manson JE, et al. Walnut consumption is associated with lower risk of type 2 diabetes in women. J Nutr. 2013 Apr; 143(4):512-28.
• Pohl M, Mayr P, Mertl-Roetzer M, et al. Glycaemic control in type II diabetic tubefed patients with a new enteral formula low in carbohydrates and high in monounsaturated fatty acids: a randomised controlled trial. Eur J Clin Nutr 2005; 59(11):1221
• Reaven PD, Witzum JL. Oxidized low density lipoproteins in atherogenesis: role of dietary modification. Annu Rev Nutr 1996; 16:51-71.
• Reiter RJ, Manchester LC, Tan DX. Melatonin in walnuts: influence on levels of melatonin and total antioxidant capacity of blood. Nutrition 2005; 21(9):920- 4.
• Ros E, Nunez I, Perez-Heras A, et al. A walnut diet improves endothelial function in hypercholesterolemic subjects. Circulation 2004; 109:1609-14.
• Ros E. Nuts and novel biomarkers of cardiovascular disease. Am J Clin Nutr 2009;89:1649-56.
• Sheridan MJ, Cooper JN, Erario M, et al. Pistachio nut consumption and serum lipid levels. J Am Coll Nutr 2007; 26(2):141- 8.
• Sloth B, Due A, Larsen TM, et al. The effect of a high-MUFA, low-glycaemic index diet and a low-fat diet on appetite and glucose metabolism during a 6-month weight maintenance period. Br J Nutr 2009; 101(12):1846-58.
• Steffen LM, et al. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2005; 82(6):1169–77.
• Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344:1343-50.
• Baysal A, Keçecioğlu S, Arslan P, ve ark. Besinlerin Bileşimleri. 3. Basım, Ankara: Türkiye Diyetisyenler Derneği Yayını; 19 Wien M, Bleich D, Raghuwanshi M, et al. Almond consumption and cardiovascular risk factors in adults with prediabetes. J Am Coll Nutr 2010; 29(3):189-97.
• Zhao G, Etherton TD, Martin KR, et al. Dietary alpha-linolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr 2004; 134:2991- 7.