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

Abstract

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.

Keywords

• Obezite,Metabolik sağlık,Diyet kalitesi,Sedanter süre

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

Abstract

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

Keywords

• Obesity,metabolic health,dietary quality,sedentary time

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