Dr. Mustafa Sahin
Ankara Universitesi Tıp Fakültesi
Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı Dr. Mustafa Sahin
Ankara Universitesi Tıp Fakültesi
Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı
Healthy Nutrition
Healthy Nutrition
Nasıl prezente olur ? Nasıl prezente olur ?
• Çoğu asemptomatik
• Karında gaz
• Sağ üst kadranda hassasiyet
• Yorgunluk
• Obez, Tip 2 diyabet, HT
• Alkol çok az ya da yok
• Çoğu asemptomatik
• Karında gaz
• Sağ üst kadranda hassasiyet
• Yorgunluk
• Obez, Tip 2 diyabet, HT
• Alkol çok az ya da yok
Diabetes Type 2 is preventable!
Diabetes Type 2 is
preventable!
What is diabesity?
What is diabesity?
Because obesity and diabetes often go hand in hand, a new term has been
coined to describe America's current healthcare crisis: "the diabesity
epidemic.
Because obesity and diabetes often go hand in hand, a new term has been
coined to describe America's current healthcare crisis: "the diabesity
epidemic.
The number of cans of soda the average male teenager drinks each
year
The number of cans of soda the average male teenager drinks each
year
800
The bottom line is……
The bottom line is……
• There are many factors influencing obesity and diabetes rates.
Sedentary lifestyles, ubiquitous
junk food, the supersizing of meal portions, and "emotional eating"
are just a few!
• Too much sugar, too many trans fats, &
too many calories consumed!
• There are many factors influencing obesity and diabetes rates.
Sedentary lifestyles, ubiquitous
junk food, the supersizing of meal portions, and "emotional eating"
are just a few!
• Too much sugar, too many trans fats, &
too many calories consumed!
8
Recommendations to reduce your risk
Fruits &
veggies Fruits &
veggies Whole-grain, high fiber Whole-grain,
high fiber Oily fish Oily fish
Lean meats
Lean meats Fat-free, skim, low fat, 1% dairy
Fat-free, skim, low fat, 1% dairy
Reduce added sugars Reduce
added sugars
Little or no salt
Little or no
salt If alcohol,
moderation
If alcohol,
moderation
Metabolik Sendrom Metabolik Sendrom
Obezite
Diyabet Hipertansiyon
NAFLD
Dislipidemi
Metabolik Sendrom (Sendrom-X)
ATP III criteria : Aşağıdakilerden ≥ 3
Metabolik Sendrom (Sendrom-X)
ATP III criteria : Aşağıdakilerden ≥ 3
• Abdominal obezite : Etnik farklılık
• (Bel çevresi > 102 cm ♂, > 88 cm ♀)
• Trigliserid > 150mg/dl
• HDL < 40 mg/dl ♂, < 50 mg/dl ♀
• KB ≥ 130/85 mmHg
• AKŞ ≥ 110 mg/dl ?? 100 mg/dl
• Abdominal obezite : Etnik farklılık
• (Bel çevresi > 102 cm ♂, > 88 cm ♀)
• Trigliserid > 150mg/dl
• HDL < 40 mg/dl ♂, < 50 mg/dl ♀
• KB ≥ 130/85 mmHg
• AKŞ ≥ 110 mg/dl ?? 100 mg/dl
12
Recommendations to reduce your risk
Limit your intake of added sugars to no more than
½ of your daily discretionary calories Limit saturated fat to less than 7 % and trans fat to less than1 % of daily calorie intake
Limit cholesterol intake to less than 300 mg per day.
Limit sodium intake to 1,500 mg per day (this is about 1 teaspoon of salt).
1/2
<7%
<300 mg
1 tsp
So what should we eat and consume?
So what should we eat and consume?
• Basics of nutrition
• Nutrition for teens, adults,
pregnant women, and athletes
• Prevention of illness and disease
• Improve brain function and vitality
• Enhance skin, hair, and nails
• Repair, restore, and revitalize
• Basics of nutrition
• Nutrition for teens, adults,
pregnant women, and athletes
• Prevention of illness and disease
• Improve brain function and vitality
• Enhance skin, hair, and nails
• Repair, restore, and revitalize
Poor Diets and Asthma Poor Diets and Asthma
Teens with the lowest intake of fruit, vitamins C and E, and omega-3 fatty
acids had lower lung function and higher reports of respiratory symptoms such as cough and wheeze.
Teens who consumed less than 25
percent of one serving of fruit each day were more likely to have less efficient lung function than their peers.
Teens with the lowest intake of fruit, vitamins C and E, and omega-3 fatty
acids had lower lung function and higher reports of respiratory symptoms such as cough and wheeze.
Teens who consumed less than 25
percent of one serving of fruit each day
were more likely to have less efficient
lung function than their peers.
Never skip meals
All of my morbidly obese clients have one thing in common – skipping meals. The
moment you allow your blood sugar to drop (when you feel hunger pangs) you become a fat storing machine. You must eat small meals or snacks every few hours.
Never skip meals
All of my morbidly obese clients have one thing in common – skipping meals. The
moment you allow your blood sugar to drop
(when you feel hunger pangs) you become a
fat storing machine. You must eat small meals
or snacks every few hours.
Serving Size
Serving Size
Copyright British Nutrition Foundation
Mathers JC (2002) Br. J. Nutr. 88, (Suppl. 3), S273-S279
Nutrition interacts
with
genotype to influence health and
ageing
www.hsph.harvard.edu
Food Sources of Saturated Fat in the US
Based on NHANES 2005-06. From USDA Dietary Guidelines 2010
Micha et al., Circulation 2010
Food Sources: Meats & CHD
Unprocessed Red Meat (100 g/d)
RR = 1.00 (0.81, 1.23)
Processed Meat (50 g/d)
RR = 1.42
(1.07, 1.89)
Chowdury et al, Annals Intern Med 2014
Dietary Fats & CHD Events
Food Sources: Meats & CVD Mortality
Total Red Meat RR = 1.09 (0.93, 1.27)
Processed Meat RR = 1.17 (1.02, 1.33)
O’Sullivan et al., Am J Public Health 2013
P-trend=0.50
Adjusted for age, sex, center, education, smoking, physical activity, alcohol intake, and consumption of fruits, vegetables, red meat, processed meat, sugar sweetened beverages, coffee, cereals, and cerearl products.
Quintiles of Consumption
Dairy Foods & Diabetes
Sluijis et al., AJCN 2012
Among 340,234 Europeans from 8 countries, with 12,403 cases of incident diabetes
P-trend=0.06 P-trend=0.01 RR of
Diabetes
Estruch et al. NEJM 2013
Healthy Diet Patterns & CVD Events
HR = 0.70 (0.55, 0.89)
Randomized controlled trial among 7447 Spanish adults at higher risk
No change in
saturated fat.
Global Disease Burdens Due to Major Risk Factors in 2010
Lim et al, Lancet 2012 Diet high in SFA & low in PUFA
0.47
