Diyet Kalitesi ve Sedanter Geçirilen Süre Obez Fenotiplerinde Metabolik Sağlığı Etkiler mi?

Yıl 2019, , 39 - 54, 26.04.2019

Pelin Bilgiç , Sümeyra Öteleş

https://doi.org/10.21020/husbfd.541591

Cited By: 1

Öz

Amaç: Obezite son yıllarda hızla artmakla birlikte önemli fenotipik
varyasyonları olan kompleks ve heterojen bir durumdur. Obezite kardiyovasküler
hastalıklar (KVH), tip 2 diyabet, dislipidemi ve hipertansiyon gibi birçok metabolik
komplikasyonlarla ilişkilidir. Ancak bu komplikasyonların gelişimine dirençli
olan obez alt grubu tanımlanmakta ve “metabolik olarak sağlıklı (MS) obez”
şeklinde adlandırılmaktadır. Bu çalışmanın amacı diyet kalitesi ve sedanter
geçirilen sürenin obez fenotipleri arasında karşılaştırılmasıdır.

Gereç ve Yöntem: Çalışmaya diyabet, hipertansiyon ve
dislipidemi tanısı almayan, gebe ve menopoz döneminde olmayan beden kütle
indeksine göre hafif şişman/obez (BKİ ≥25,00 kg/m²) 19-50 yaş arası
57 gönüllü premenopoz kadın katılmıştır. Bireylere genel özelliklerinin
sorgulandığı bir anket uygulanmış, antropometrik ölçüm ve vücut bileşimi
verileri alınmıştır. Bireylerden bir gün hafta içi, bir gün hafta sonu olmak
üzere toplam iki günlük geriye dönük besin tüketimi alınarak Sağlıklı Yeme
İndeksi-2005 (SYİ-2005) ölçeği ile diyet kaliteleri hesaplanmıştır. Bireylerin
fiziksel aktivite ile sedanter geçirilen süreleri ise Uluslararası Fiziksel
Aktivite Kaydı ile saptanmıştır. Katılımcılar yüksek kan basıncı, trigliserit,
glukoz, düşük yüksek yoğunluklu lipoprotein ve insülin direnci (MSO≥2; MS<2)
dahil olmak üzere kardiyometabolik risk faktörlerine göre sınıflandırılmıştır.

Bulgular: Araştırma sonucunda hafif şişman/obez bireylerin %56’sının (n=32)
metabolik olarak sağlıklı olduğu saptanmıştır. Metabolik olarak sağlıklı (MS)
hafif şişman/obez bireylerin SYİ puanının metabolik olarak sağlıklı olmayan
(MSO) hafif şişman/obez bireylerin puanından daha yüksek olduğu bulunmuştur
(p<0.05). MS grubunun tam meyve, tam tahıl, süt ve et/kurubaklagil diyet
kalitesi skorlarının MSO grubuna göre daha yüksek olduğu saptanmıştır (p>0.05). MS grubun MSO gruba göre
sedanter geçirilen sürenin daha az olduğu görülmüştür (p> 0.05).

Sonuç: Obezitenin metabolik risk faktörlerine karşı dirençli olan MS fenotipinin
gelişiminde altta yatan faktörler son yıllarda tartışılmakta ve yaşam tarzı
faktörlerinin ayırıcı bir etken olabileceği vurgulanmaktadır. Sağlıklı beslenme
ve hareketli yaşam gibi yaşam tarzı faktörlerinin MS obez fenotipinin
gelişiminde olası etkilerinin aydınlatılması, obezitenin tedavisinde yararlı
olacaktır.

Anahtar Kelimeler

Obezite, Metabolik sağlık, Diyet kalitesi, Sedanter süre

Is Metabolic Health Affected From Dietary Quality and Sedentary Time in Obesity Phenotypes?

Öz

Objectıves: Obesity is a complex and heterogeneous condition with rapidly increasing
phenotypic variations in recent years. Obesity is associated with many metabolic
complications such as cardiovascular disease (CVD), type 2 diabetes,
dyslipidemia and hypertension. However, the obese subgroup that is resistant to
the development of these complications is defined and is called metabolically
healthy obese (MHO). The aim of this study was to compare dietary quality and
sedentary duration between obese phenotypes.

Materıals and Methods: A total of 57 voluntary women aged between 19 and 50
years, who did not have diabetes, hypertension or dyslipidemia and were not pregnant
and in the non-menopausal period having overweight/obese (BKİ ≥25 kg/m²)
were included in the study. A questionnaire was performed to examine the
overall characteristics of the individuals, and the data of the
anthropometrical measurements and body composition were obtained. The dietary
quality of individuals was assessed using the Healthy Eating Index-2005
(HEI-2005) scale according to a 24-hour retrospective food consumption record
form that was used to evaluate a total of two-day food consumption, one day on
weekdays and the other day on weekends. Duration of physical activity and
sedentary periods were evaluated using the International Physical Activity
Questionnaire (IPAQ). Participants were classified by cardiometabolic risk
factors, including elevatted blood pressure, trygliceride, glucose, low high
density lipoprotein and insülin resistance (MU≥2; MH<2).

Results: Based on our study results, 56% (n=32) of
overweight/obese individuals were found to be metabolically healthy.
Metabolically healthy (MH) overweight/obese individuals were found to have a
higher HEI score than that of the overweight/obese metabolically unhealthy (MU)
participants (p<0.05). It was found that the MS group had higher total
fruit, whole grains, milk and meat / bean scores than the MU group.
(p>0.05). MH group had less sedentary time compared with MU group
(p>0.05).

Conclusion: The underlying factors in the development of
the MH phenotype, which is resistant to the metabolic risk factors of obesity,
have been discussed in recent years and it is emphasized that lifestyle factors
may be a distinctive factor. Identifying the possible effects of lifestyle
factors such as healthy nutrition and active life on the development of the
obese phenotype of MH will be useful in the treatment of obesity

Anahtar Kelimeler

Obesity, metabolic health, dietary quality, sedentary time

Kaynakça

• Achilike I, Hazuda HP, Fowler SP, Aung K, Lorenzo C. (2005). Predicting Development of the Metabolically Healthy Obese Phenotype. International journal of obesity 2015;39:228.
• Baysal A, Aksoy M, Bozkurt N, Merdol T, Pekcan G, Keçecioğlu S, et al. (2002) Diyet el kitabı (8. Baskı). Hatiboğlu yayınları: Ankara
• Baysal A. (1999) Beslenme. (8. Baskı). Hatiboğlu yayınları: Ankara
• Bazzano LA, Li TY, Joshipura KJ, Hu FB. (2008). Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes care. 31(7):1311-7.
• Bell JA, Kivimaki M, Batty GD, Hamer M. (2014). Metabolically healthy obesity: What is the role of sedentary behaviour? Preventive medicine. 62:35-7.
• Bell LK, Edwards S, Grieger JA. (2015). The relationship between dietary patterns and metabolic health in a representative sample of adult Australians. Nutrients. 7(8):6491-505.
• Camhi SM, Crouter SE, Hayman LL, Must A, Lichtenstein AH. (2015) Lifestyle behaviors in metabolically healthy and unhealthy overweight and obese women: A preliminary study. PloS one. 10(9):e0138548.
• Camhi SM, Evans EW, Hayman LL, Lichtenstein AH, Must A. (2015). Healthy eating index and metabolically healthy obesity in US adolescents and adults. Preventive medicine. 77:23-7.
• Camhi SM, Waring ME, Sisson SB, Hayman LL, Must A. (2013). Physical activity and screen time in metabolically healthy obese phenotypes in adolescents and adults. Journal of obesity. 2013.
• Duvivier BM, Schaper NC, Bremers MA, van Crombrugge G, Menheere PP, Kars M, et al. (2013) Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PLoS One. 8(2):e55542
• Guenther PM, Reedy J, Krebs-Smith SM. (2008). Development of the healthy eating index-2005. Journal of the American Dietetic Association. 108(11):1896-901.
• Hamer M, Stamatakis E, Steptoe A. (2014). Effects of substituting sedentary time with physical activity on metabolic risk. Med Sci Sports Exerc.
• Hankinson AL, Daviglus ML, Horn LV, Chan Q, Brown I, Holmes E, et al. (2013). Diet composition and activity level of at risk and metabolically healthy obese American adults. Obesity. 21(3):637-43.
• Healy GN, Dunstan DW, Salmon J, Cerin E, Shaw JE, Zimmet PZ, et al. (2007). Objectively measured lightintensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care. 30(6):1384–9
• Jennings CL, Lambert EV, Collins M, Joffe Y, Levitt NS, Goedecke JH. (2008) Determinants of insulin‐resistant phenotypes in normal‐weight and obese Black African women. Obesity.
• Kimokoti RW, Judd SE, Shikany JM, Newby P. (2014). Food intake does not differ between obese women who are metabolically healthy or abnormal. The Journal of nutrition. 144(12):2018-26.
• Matthews DR. Hosker JP. Rudenski AS. Naylor BA. Treacher DF. Turner RC. (1985). Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 28:412–419. McKeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. (2002). Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. The American journal of clinical nutrition. 76(2):390-8.
• Merdol T. (2003). Standart Yemek Tarifeleri (3. baskı). Ankara: Hatipoğlu Yayınevi.
• Müller MJ, Bosy-Westphal A, Heller M. (2009). ‘Functional’body composition: differentiating between benign and non-benign obesity. F1000 biology reports.1.
• NCD Risk Factor Collaboration. (2016). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19• 2 million participants. The Lancet, 387(10026), 1377-1396.
• Organization WH. (2011). Waist circumference and waist-hip ratio: Report of a WHO expert consultation, Geneva, 8-11 December 2008.
• Phillips CM, Dillon C, Harrington JM, McCarthy VJ, Kearney PM, Fitzgerald AP, et al. (2013). Defining metabolically healthy obesity: role of dietary and lifestyle factors. PloS one. 8(10):e76188.
• Phillips CM. (2017). Metabolically healthy obesity across the life course: epidemiology, determinants, and implications. Annals of the New York Academy of Sciences. 1391(1):85-100.
• Primeau V, Coderre L, Karelis A, Brochu M, Lavoie M, Messier V, et al. Characterizing the profile of obese patients who are metabolically healthy. International journal of obesity. 2011;35(7):971.
• Rakıcıoğlu N, Acar Tek N, Ayaz A, Pekcan G. (2012). Yemek ve besin fotoğraf kataloğu. (3. Baskı). Hatiboğlu Yayınevi. 1.
• Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. (2010). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and motor skills. 111(1):278-84.
• Schwingshackl, L., & Hoffmann, G. (2015). Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. Journal of the Academy of Nutrition and Dietetics. 115(5), 780-800.
• Slagter, S. N., Corpeleijn, E., Van Der Klauw, M. M., Sijtsma, A., Swart-Busscher, L. G., Perenboom, C. W., ... & van Vliet-Ostaptchouk, J. V. (2018). Dietary patterns and physical activity in the metabolically (un) healthy obese: the Dutch lifelines cohort study. Nutrition journal, 17(1), 18.
• Türkiye Beslenme ve Sağlık Araştırması (TBSA) 2010 Saha Uygulaması El Kitabı. (2010). Ankara: T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü
• Velho S, Paccaud F, Waeber G, Vollenweider P, Marques-Vidal P. (2010). Metabolically healthy obesity: different prevalences using different criteria. European Journal of Clinical Nutrition. 64(10):1043.
• Wildman R.P., Muntner P., Reynolds K., McGinn A.P., Rajpathak S., Wylie-Rosett J., et al. (2008). The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med
• Yu R, Yau F, Ho SC, Woo J. (2013). Associations of cardiorespiratory fitness, physical activity, and obesity with metabolic syndrome in Hong Kong Chinese midlife women. BMC public health. 13(1):614.