DİABETES MELLİTUSUN DİYET TEDAVİSİNDE POSA KAYNAKLARI, TÜRLERİ VE ETKİLERİ

Yıl 2018, Cilt: 5 Sayı: 1-2, 54 - 64, 28.12.2018

Neslihan Öner Yağmur Yaşar Fırat

Öz

Diyabet dünyada ve ülkemizde prevalansı artan kronik ve ilerleyici bir hastalıktır. Tedavisinin temelini oluşturan kan glikozunun düzenlenmesinde etkisi olan bir faktör de diyet posasıdır. Posa gastrointestinal yoldaki yerel ve sistemik etkileri nedeni ile beslenmede önemli bir yer tutmaktadır. Posayla ilgili çeşitli tanımlar bulunmakla birlikte genel ola-rak posa; besinlerin bir bileşeni olarak insan vücudunun sindiremediği veya kan dolaşımına emilimini yapamadığı kompleks karbonhidratlara verilen isim olarak tanımlanmak-tadır. Posanın hem hastalıklardan korunmada hem de bazı hastalıkların diyet tedavisinde önemli etkilere sahip olduğu bilinmektedir. Yapılan çalışmalarda posanın glisemik para-metrelerde iyileşme sağladığı gibi kan lipitlerini düzenlediği ve kan basıncı kontrolünün sağlanmasına yardımcı olduğu gösterilmiştir. Suda çözünen posanın etkisinin, çözünmeyen posaya göre daha etkili olduğu belirtilmiştir.

Anahtar Kelimeler

Diyabet, Posa, Sağlık

RESOURCES, TYPES AND EFFECTS OF FIBER IN DIABETES MELLITUS DIETARY THERAPY

Öz

Diabetes is a chronic and progressive disease that its preva-lance is increasing in the world and in our country. A factor affecting the regulation of blood glucose, which forms the basis of its treatment, is dietary fiber. Fiber has an important role in nutrition due to its local and systemic effects on the gastrointestinal tract. Although there are various definitions related to fiber, it is defined as the name given to complex carbohydrates that the human body can not digest or absorb into the bloodstream as a component of nutrients. It is known that fiber has important effects both in the protection from diseases and in the dietary treatment of some diseases. In studies, it has been shown that fiber improves glycemic parameters and regulates blood lipids and helps control blood pressure. It is stated that the effect of the water-soluble fiber is more effective than the insoluble fiber.

Anahtar Kelimeler

Diabetes, Fiber, Health

Kaynakça

• Abutair AS, Naser IA, Hamed AT. Soluble fibers from psyllium improve glycemic response and body weight among diabetes type 2 pa-tients (randomized control trial). Nutr J. 2016; 15 (1): 86.
• Abutair AS. Naser IA. Hamed AT. The effect of soluble fiber supplementation on metabolic syndrome profile among newly diagnosed Type 2 Diabetes patients. Clin Nutr Res. 2018; 7(1): 31-39.
• Ajani UA, Ford ES, Mokdad AH. Dietary fiber and C-Reactive protein: Findings from Na-tional Health and Nutrition Examination Survey Data. J Nutr. 2004; 134:1181-1185.
• Anderson JW, Akanji AO. Diatary fiber: An over-view. Diabetes Care. 1991;14(2):1126-1131.
• Bayraktar M. Oral hipoglisemikler. Türkiye Tıp Dergisi. 2001;8(1):35-44.
• Baysal A. Diyet Posası- Diyet Lifi. Beslen-me;2002, Hatipoğlu Yayınevi, Ankara.
• Brown L, Rosner B, Willett WW, et al. Choleste-rol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999; 69:30-42.
• Buhman KK, Furumoto EJ, Donkin SS, et al. Die-tary psyllium increases fecal bile acid excre-tion, total steroid excretion and bile acid bi-osynthesis in rats. J Nutr. 1998; 128:1199-1203.
• Chandalia M, Abhimanyu G, Lutjohann D, et al. Benefıcıal Effects of High Dietary Fiber In-take in Patients With Type 2 Diabetes Melli-tus. N Engl J Med. 2000; 342:1392-1398.
• Dietary Reference Intakes for Energy C, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). 2005.
• Gin H, Orgerie MB, Aubertin J. The influence of guar gum on absorption of metformin from the gut in healthy volunteers. Horm Metab Res. 1989;21(2):81-83.
• Glore SR, Treeck DV, Knehans AW, et al. Solub-le fiber and serum lipids: A literature review. Journal of the American Dietetic As-sociation. 1994;94(4):425-436.
• Hosseinpour-Niazi S, Mirmiran P, Sohrab G, et al. Inverse association between fruit, legume, and cereal fiber and the risk of metabolic syndrome: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract. 2011;94(2):276-283.
• Hottes J. Diabetes treatment with high dietary fiber and low glysemic index diet modifica-tions: A literature review. 2009.
• Hu FB, Manson JE, Stampfer MJ, et al. Diet, li-festyle, and the risk of Diabetes Mellitus in women. N Engl J Med. 2001; 345:790-797.
• James SL, Muir JG, Curtis SL, et al. Dietary fibre: A roughage guide. Intern Med J. 2003;33(7):291-296.
• Jenkins DJA, Wolever TMS, Leeds AR, et al. Dietary fibres, fibre analogues, and glucose tolerance: Importance of viscosity. British Meidcal Journal. 1978; 1:1392-1394.
• Kahlon TS, Chiu MC, Chapman MH. Steam coo-king significantly improves in vitro bile acid binding of collard greens, kale, mustard gre-ens, broccoli, green bell pepper, and cabba-ge. Nutr Res. 2008;28(6):351-357.
• Krishnan S, Rosenberg L, Singer M, et al. Glyce-mic index, glycemic load, and cereal fiber intake and risk of type 2 Diabetes in US Black women. Arch Intern Med. 2007;167(21):2304-2309
• Lattimer JM, Haub MD. Effects of dietary fiber and its components on metabolic health. Nutrients. 2010; 2:1266-1289.
• Lunn J, Buttriss JL. Carbohydrates and dietary fibre. British Nutrition Fundation Nutrition Bulletin. 2007; 32:21-64.
• Marlett JA, McBurney MI, Slavin JL, American Dietetic Association. Position of the Ameri-can Dietetic Association: health implications of dietary fiber. J Am Diet Assoc. 2002; 102(7): 993-1000.
• Matheson HB, Colon IS, Story JA. Cholesterol 7 alpha-hydroxylase activity is increased by dietary modification with psyllium hydro-colloid, pectin, cholesterol and cholestyra-mine in rats. J Nutr. 1995; 125:454-458.
• Matthias BS, Liu S, Rimm EB, et al. Glycemic index, glycemic load, and dietary fiber inta-ke and incidence of type 2 diabetes in youn-ger and middle-aged women. Am J Clin Nutr. 2004; 80:348-356.
• Meyer KA, Kushi LH, Jacobs DR. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr. 2000; 71:921-930.
• Montonen J, Knekt P, Järvinen R, et al. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr. 2003; 77:622-629.
• Riccardi GRA. Effects of dietary fiber and car-bohydrate on glucose and lipoprotein meta-bolism in diabetic patients. Diabetes Care. 1991; 14:1115-1125.
• Salmerón J, Ascherio A, Rimm EB, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care. 1997;20(4):545-550.
• Salmerón J, Manson JE, Stampfer MJ, et al. Die-tary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in wo-men. JAMA 1997;277(6):472-477.
• Samur G. Diyet posası ve kalp damar hastalıkları. Türk Kardiyoloji Seminerleri 2008;8(2):271-277.
• Sayar S, Jannink JL, White PJ. In vitro bile acid binding of flours from oat lines varying in percentage and molecular weight distribu-tion of beta-glucan. J Agric Food Chem. 2005;53(22):8797-8803.
• Schulze MB, Liu S, Rimm EB, et al. Glycemic index, glycemic load, and dietary fiber inta-ke and incidence of type 2 diabetes in youn-ger and middle-aged women. Am J Clin Nutr. 2004; 80:348-356.
• Seamus W, Amanda H, Bonnie P, et al. Effect of dietary fiber intake on blood pressure: a me-ta-analysis of randomized, controlled clini-cal trials. Journal of Hypertension. 2005;23(3):475-481.
• Seki T, Nagase R, Horimitsu M, et al. Insoluble fiber is a major constituent responsible for lowering the post-prandial blood glucose concentration in the pre-germinated brown rice. Biol Pharm Bull. 2005;28(8):1539-1541.
• Sierra M, Garcia JJ, Fernandez R, et al. Effects of ispaghula husk and guar gum on postpran-dial glucose and insulin concentrations in healthy subjects. European Journal of Clini-cal Nutrition. 2001; 55:235-243.
• Stevens J, Ahn K, Eri J, et al. Dietary fiber intake and glycemic index and incidence of diabe-tes in African-American and White adults: The ARIC study Diabetes Care. 2002; 25:1715-1721.
• Takashi T. Hydrolyzed guar gum decreases postp-randial blood glucose and glucose absorp-tion in the rat small intestine. Nutr Res. 2009;29(6):419-425.
• The Definition of Dietary Fiber. AACC Report 2001;46(3):112-126.
• Vinik IA, Jenkins DJA. Dietary fiber in manage-ment of diabetes. Diabetes Care. 1988; 11:160-173.
• Wahlqvist ML. Dietary fiber and carbohyrate me-tabolism. Am J Clin Nutr. 1987; 45:1232-1236.
• Weickert MO, Möhlig M, Schöfl C, et al. Cereal fiber improves whole-body insulin sensiti-vity in overweight and obese women. Dia-betes Care. 2006; 29:775-780.
• Williams JA, Charon-Si L, Corwin H, et al. Inclu-sion of guar gum and alginate into a crispy bar improves postprandial glycemia in hu-mans. J Nutr. 2004; 134:886-889.