Kuzey Kıbrıs Türk Cumhuriyeti’ndeki Çocuk ve Adolesanlarda Akdeniz Diyetine Uyum ile Obezitenin Belirlenmesi

Öz

Giriş ve Amaç: Akdeniz diyeti, kardiyovasküler hastalıklar, kanser, diyabet, obezite ve oksidatif stresle ilişkili diğer hastalıklardan koruyucu etkileri olan ve sağlıklı beslenme alışkanlıklarından oluşan bir beslenme şeklidir. Bu çalışma, KKTC’de yaşayan çocuk ve adolesanlarda Akdeniz diyetine uyum ile obezite arasındaki ilişkinin belirlenmesi amacıyla yürütülmüştür.Gereç ve Yöntemler: Aşırı kilolu ve obez çocukların belirlenebilmesi için vücut ağırlığı, boy uzunluğu, bel çevresi, kalça çevresi, üst orta kol çevresi ölçümleri alınmış ve vücut kütle indeksi (VKİ) değeri hesaplanmıştır. Çocuk ve adolesanlarda Akdeniz diyetine uyum Akdeniz Diyeti Kalite İndeksi (KIDMED indeksi) ile değerlendirilmiştir.Bulgular: Çalışma kapsamına alınan katılımcıların % 22.7’sinin iyi, % 18.3’ünün ise düşük KIDMED indeksine sahip olduğu saptanmıştır. Yaşa göre VKİ persentil değerlerine göre çocuk ve adolesanların % 65.8’i 15-85. persentiller arasında, % 18.5’sı 85-95. persentiller arasında, % 16.2’si 95. persentilin üzerindedir. Ayrıca, KIDMED indeksi ile VKİ arasında negatif yönde zayıf ilişki belirlenmiştir (p<0,05).Sonuç: Sonuç olarak, KKTC’de çocuk ve adolesanların Akdeniz diyetine uyumunun artırılması, obezite ve obezite ile ilintili hastalık riskinin en aza indirilmesi için ulusal plan ve politikalar geliştirilmesi gereklidir.

Anahtar Kelimeler

• Akdeniz diyeti, Antropometrik ölçüm, Çocuklar, Obezite

Determination of the Mediterranean Diet and the Obesity Status of Children and Adolescents in Turkish Republic of Northern Cyprus

Öz

Objective: The Mediterranean diet is reported as a healthy eating pattern with protective effects on cardiovascular diseases, cancer, type 2 diabetes, obesity and oxidative stress related disorders. The aim of this study was to assess the relationship between Mediterranean diet and obesity status in Turkish Cypriot children and adolescents.Material and Methods: Body weight, height and waist, hip and mid upper arm circumferences were performed and body mass index (BMI) was calculated for determining the overweight and obese children and adolescents. To evaluate the children’s and adolescents’ nutrition status by the degree of adherence to the Mediterranean diet was assessed by the Mediterranean Diet Quality Index (KIDMED index).Results: It was found that 22,7% of the sample was classified as high adherers of Mediterranean diet, whereas 18.3% had a poor KIDMED index. According to percentiles of BMI for age, 65.8% were between 15-85th percentiles, 18.6% were between 85-95th percentiles, and 16.2% were above 95th percentile. Also, this study has shown that there is a negative weak correlation between mean KIDMED index and BMI (p<0,05).conclusion: In conclusion, there is a need for national plans and politicals to encourage children’s and adolescents’ adherence to the Meditarrenean diet, also reducing the risk of obesity and obesity related disorders in North Cyprus

Anahtar Kelimeler

• Mediterranean diet, Anthropometric measurement, Children, Obesity

Kaynakça

1. Biesalski HK, Grimm P. Pocket Atlas of Nutrition. Translation of 3rd German ed. Germany: Georg Thieme Verlag; 2005:6-7.
2. Keys A. Mediterranean diet and public health: Personal reflections. Am J Clin Nutr 1995; 61:1321-3.
3. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, et al. Mediterranean diet pyramid: A cultural model for healthy eating. Am J Clin Nutr 1995; 61:1402-6.
4. The Local Food-Nutraceuticals Consortium. Understanding local Mediterranean diets: A multidisciplinary pharmacological and ethnobotanical approach. Pharmacol Res 2005; 52:353-66.
5. Fidanza F, Alberti A, Lanti M, Menotti A. Mediterranean Adequacy Index: Correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metabol Cardiovasc Dis 2004;14:254-8.
6. Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 2009;119: 1093-100.
7. Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menorri A, et al. Mediterranean diet, lifestyle factors, and 10- year mortality in elderly European men and women: The HALE project. JAMA 2004;292:1433-9.
8. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003;348:2599-608.

9. Martınez-Gonzalez MA, Garcıa-Lopez M, Bes-Rastrollo M, Toledo E, Martinez-Lapiscina EH, Delgado-Rodriguez M, et al. Mediterranean diet and the incidence of cardiovascular disease: A Spanish cohort. Nutr Metabol Cardiovasc Dis 2011;21:237-44.
10. Carter SJ, Roberts MB, Salter J, Eaton CB. Relationship between Mediterranean Diet Score and atherothrombotic risk: Findings from the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Atherosclerosis 2010;210:630-6.
11. Kastorini CM, Milionis HJ, Goudevenos JA, Panagiotakos DB. Mediterranean diet and coronary heart disease: Is obesity a link? A systematic review. Nutr Metabol Cardiovasc Dis 2010;20: 536-51.
12. Esposito K, Maiorino MI, Ceriello A, Giugliano D. Prevention and control of type 2 diabetes by Mediterranean diet: A systematic review. Diabetes Res Clin Pract 2010; 89:97-102.
13. Pérez-López FR, Chedraui P, Haya J, Cuadros JL. Effects of the Mediterranean diet on longevity and age-related morbid conditions. Maturitas 2009;64:67-79.
14. Sahingoz SA, Sanlier N. Compliance with Mediterranean Diet Quality Index (KIDMED) and nutrition knowledge levels in adolescents. A case study from Turkey. Appetite 2011; 57:272–7.
15. Mariscal-Arcas M, Rivas A, Velasco J, Ortega M, Caballero AM, Olea-Serrano F. Evaluation of the Mediterranean Diet Quality Index (KIDMED) in children and adolescents in Southern Spain. Public Health Nutr 2009;12:1408-12.
16. Serra-Majem L, Trichopoulou A, Ngo de la Cruz J, Cervera P, Garcia Alvarez A, La Vecchia C, et al. Does the definition of the Mediterranean Diet need to be updated? Public Health Nutr 2004;7:927-9.
17. Trichopoulos D, Lagiou P. Mediterranean Diet and overall mortality differences in the European Union. Public Health Nutr 2004;7: 949-51.
18. Trichopoulou A, Lagiou P, Kuper H, Trichopoulos D. Cancer and Mediterranean Dietary traditions. Cancer Epidemiol Biomarkers Prev 2000;9:869-73.
19. Gorin AA, Crane MM. The obesogenic environment. In: Jelalian E, Steele RG, eds. Handbook of Childhood and Adolescent Obesity. New York: Springer Science, Business Media LLC. 2008:145-63.
20. Story M, Neumark-Sztainer D, French S. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 2002;102:40-51.
21. Lobstein T, Baur L, Uauy R; IASO International Obesity TaskForce. Obesity in children and young people: A crisis in public health. Obes Rev 2004;5 Suppl 1:4-85.
22. Apovian CM. Overweight in older children and adolescents: Treatment or prevention?. Arch Dis Child 2010;95:1-2.
23. Wang LY, Chyen D, Lee S, Lowry R. The association between body mass index in adolescence and obesity in adulthood. J Adoles Health 2008;42:512-8.
24. Lazarou C, Panagiotakos DB, Matalas AL. Physical activity mediates the protective effect of the Mediterranean diet on children’s obesity status: The CYKIDS study. Nutrition 2010;26:61-7.
25. Samur G, Şahin TC, Dönmez N, Besler T. 10-12 yaş grubu çocuklarda Diyet Kalite İndeksi (KIDMED) ile belirlenen beslenme alışkanlıkları ile beden kütle indeksi ve vücut bileşimi arasındaki ilişkinin araştırılması. VI. Uluslar arası Beslenme ve Diyetetik Kongresi, Nisan, 2-6, Antalya-Türkiye, 2008:274.
26. Panagiotakos DB, Chrysohoou C, Pitsavos C, Stefanadis C. Association between the prevalence of obesity and adherence to the Mediterranean Diet: The ATTICA study. Nutrition 2006;22: 449-56.
27. Lydakis C, Stefanaki E, Stefanaki S, Thalassinos E, Kavousanaki M, Lydaki D. Correlation of blood pressure, obesity, and adherence to the Mediterranean diet with indices of arterial stiffness in children. Eur J Pediatr 2012;171:1373-82.
28. Buckland G, Bach A, Serra-Majem L. Obesity and the Mediterranean Diet: A systematic review of observational and intervention studies. Obes Rev 2008;9:582-93.
29. Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. Adherence to the traditional mediterranean diet is inversely associated with body mass index and obesity in a spanish population. J Nutr 2004;134:3355-61.
30. Due A, Larsen TM, Hermansen K, Stender S, Holst JJ, Toubro S, et al. Comparison of the effects on insulin resistance and glucose tolerance of 6-mo high-monounsaturated-fat, low-fat, and control diets. Am J Clin Nutr 2008;87:855-62.
31. Kontogianni MD, Farmaki AE, Vidra N, Sofrona S, Maqkanari F, Yannakoulia M. Associations between lifestyle patterns and body mass index in a sample of Greek children and adolescents. J Am Diet Assoc 2010;110:215-21.
32. Deshmukh-Taskar PR, Nicklas TA, O’Neil CE, Keast DR, Radcliffe JD, Cho S. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: The national health and nutrition examination survey 1999-2006. J Am Diet Assoc 2010;110: 869-78.
33. Stockman NK, Schenkel TC, Brown JN, Duncan AM. Comparison of energy and nutrient intakes among meals and snacks of adolescent males. Prev Med 2005;41:203-10.
34. Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics 2007;120:229-53.
35. Lean M, Lara J, Hill JO. ABC of obesity. Strategies for preventing obesity. BMJ 2006; 333:959-62.
36. Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2009;1:2-80.