Çocukluk Çağı Obezitesinin Beslenme Tedavisinde Yeni Bir Kavram: Besin İnsülin İndeksi

Yıl 2018, Cilt: 16 Sayı: 2, 205 - 218, 01.08.2018

Zeynep Caferoğlu Nihal Hatipoğlu Hülya Gökmen Özel

Öz

Çocukluk çağı obezitesinin tedavisinde ilk adımı, sağlıklı beslenme alışkanlıklarının kazandırılması ve fiziksel aktivite düzeyinin artırılmasını kapsayan sağlıklı yaşam tarzı değişiklikleri oluşturmaktadır. Bununla birlikte, geleneksel yaklaşımlar ile istenilen başarının elde edilememesi klinisyenleri yeni tedavi arayışlarına yöneltmiştir. Bunlar arasında en çok ilgi çeken yaklaşımlardan birisi, postprandiyal kan glukoz ve insülin düzeylerinin düzenlenmesine yönelik beslenme yaklaşımları olmuştur. Bu yaklaşımlar ile karbonhidrat içeren besinlerin glisemik yanıtlarını değerlendirmek için kullanılan glisemik indeks (Gİ) kavramı gündeme gelmiştir. Yapılan çalışmalarda, diyetin Gİ’i ile obezite arasındaki ilişkinin gösterilmesi ve düşük Gİ’li öğünler ile postprandiyal kan glukoz ve insülin düzeylerinin yanısıra açlık hissi ve besin alımının azaltılabileceğine ilişkin sonuçlar elde edilmesi obezite tedavisinde düşük Gİ’li diyetlerin yardımcı olabileceğini düşündürmüştür. Diğer taraftan, postprandiyal insülin salınımında sadece karbonhidratların değil aynı zamanda protein ve yağların da rolü olduğunun bilinmesi akılları karıştırmaktadır. Bu nedenle, postprandiyal glisemik ve insülinemik yanıtın kontrol altına alınması için Gİ’in göz önünde bulundurulması yetersiz kalmakta ve karbonhidratlar ile birlikte protein ve yağların etkisini de değerlendiren bir yönteme ihtiyaç duyulmaktadır. Bu gereksinimi karşılamak amacıyla besin insülin indeksi (Bİİ) kavramı geliştirilmiştir. Oldukça yeni bir kavram olan Bİİ ile ilgili yapılan çalışma sayısı sınırlı olmakla birlikte, postprandiyal insülin yanıt ve iştah üzerine elde edilen olumlu sonuçlar umut vaat edicidir. Sonuç olarak, çocukluk çağı obezitesinin tedavisinde düşük Gİ’li ve Bİİ’li diyetlerin kullanımı yararlı olabilir. Ancak, kesin önerilerde bulunabilmek için iyi planlanmış daha fazla kısa ve uzun dönem çalışmaya gereksinme vardır.

Anahtar Kelimeler

çocuk, adölesan, obezite, glisemik indeks, besin insülin indeksi

A New Concept in the Nutrition Therapy of Childhood Obesity: Food Insulin Index

Öz

Kaynakça

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