Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi

Yıl 2019, Cilt: 3 Sayı: 1, 1 - 13, 29.04.2019

Merve Kayalı Sebiha Özge Duman Yıldız Tütüncü Nevin Dinççağ

Öz

Amaç: Ülkemizde farklı ekmek çeşitlerinin ve tam buğday unlu gıdaların üretimi son yıllarda artmış olsa da hâlâ çok yüksek oranda beyaz ekmek tüketilmektedir. Çalışmada farklı ekmek çeşitleri tüketiminin obez ve kilolu bireylerde glukoz, insülin ve GLP-1 yanıtları üzerine etkilerinin araştırılması amaçlandı. 

Gereç ve Yöntemler: Çalışmamıza yaşları 28-50 yıl ve Beden Kütle İndeksi (BKİ) 25-35 kg/m2 aralığında; 75 gram glukozlu Oral Glukoz Tolerans Testi (OGTT) ile karbonhidrat metabolizmasının normal olduğu saptanmış 21 gönüllü [10 kilolu (BKİ: 25-30 kg/m2 ve 11 obez (BKİ: 30-35 kg/m2)] birey dahil edildi. Gönüllülere sabah kahvaltıda yalnızca 250 ml su ile 50 gram karbonhidrat (KH) içeren test ekmekleri; 102 gramlık beyaz ekmek ve 114 gramlık tam buğday ekmeği; birer hafta ara ile yedirildi. Testin başlangıcında ve ekmek tüketiminin başlangıcından itibaren 60, 120 ve 180. dakikalarda glukoz, insülin ve Glukagon benzeri Peptid-1 (GLP-1) düzeylerini belirlemek üzere venöz kan örnekleri alındı. Test ekmeklerinin glukoz, insülin ve GLP-1 düzeylerini yükseltme hızları; eğri altında kalan alanları (AUC) hesaplanarak belirlendi.

Bulgular: Tüm bireylerde beyaz ekmeğin, daha hızlı emilime yol açarak postprandiyal glukoz değerlerini yükselttiği, insulin ve GLP-1 düzeylerini artırdığı görüldü (p<0,05). Kilolu bireylerde beyaz ekmekle yapılan uygulamada 1. st (postabsorptif) ve 2. st (postprandiyal) fazlarda glukoz, insulin cevaplarında anlamlı olmayan, GLP-1 düzeyinde 120. dakikada anlamlı düzeyde (p<0,05) artış saptandı. Obez bireylerin her iki test ekmeği uygulamasında da glukozun tüm tokluk fazlarında, insülinin ise 60. dakika toklukta hızlı yükseldiği (p<0,01) saptandı; GLP-1 düzeyinde anlamlı değişiklik görülmedi.

Sonuç: Çalışmamız, beyaz ekmeğin karbonhidrat metabolizmasındaki olumsuz etkilerini işaret etmektedir. Toplumdaki tüm bireylere, özellikle obezlere, gelecekte maruz kalacakları metabolik hastalıkları önlemek için beyaz ekmek yerine tam tahıl ekmeği önerilmeli ve tam tahıl ekmek tüketimi yaygınlaştırılmalıdır. 

Anahtar Kelimeler

GLP-1, Ekmek Tüketimi, İnkretin, karbonhidrat

The Effect of Different Bread Varieties on Non-Carbonhydrate Intolerance with Owerweight and Obes Volunteers

Öz

Aim: Although the consumption of different bread types and whole wheat flour foods has recently increased in our country, the consumption of white bread is still very high. In our study we aimed to investigate the effects of consumption of different bread types on glucose, insulin and GLP-1 responses in obese and overweight individuals.

Material and Methods: A total of 21 volunteers with Body Mass Index (BMI) 25-35 kg /m2 (10 overweight and 11 obese) and aged 28-50 years, and have carbohydrate tolerance after normal 75 grams glucose Oral Glucose Tolerance Test (OGTT), were allocated for this study. The volunteers were given two test breads in one week intervals, as white bread or whole wheat bread after consumption of the test breads, At the beginning and after consumption of breads at 60nd, 120th and 180nd minutes, blood samples were taken to to investigate glucose, insulin and glucagon-like peptide-1 (GLP-1) levels. The rate of increase of glucose, insulin and GLP-1 levels during test were calculated using the areas under the curve (AUC).

Results: It was we observed that postprandial glucose and insulin levels were increased after consumption of white bread in individuals (p<0.05).In overweight individuals, while both glucose levels and insulin response showed no significant increase to the white bread test in the post-absorptive and postprandial phase, the GLP-1 levels showed a significant increase in the 120th minute (p<0.05). In obese individuals, while glucose levels showed a significant response in all postprandial phases to both test breads and insulin showed a fast increase in the 60nd postprandial mark (p<0.01), there was no significant change in the GLP-1 levels.

Conclusion: Our study shows that white bread has a negative effect on carbohydrate metabolism. In order to prevent metabolic diseases in a society, whole wheat bread consumption should be increased and preferred over white bread, particularly in obese individuals.

Anahtar Kelimeler

GLP-1, Bread consumption, Incretin, Carbohydrate

Kaynakça

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