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Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi

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

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. 

Kaynakça

  • 1. Juntunen KS, Niskanen LK, Liukkonen KH, Poutanen KS, Holst JJ, Mykkanen HM. Postprandial glucose, insulin, and inkretin responses to grain producuts in healthy subjects. Am J Clin Nutr 2002;75:254-262.
  • 2. Türkiye Beslenme ve Sağlik Araştirması (TBSA) 2010. Erişim tarihi: 29.09.2014. http://ekutuphane.sagem.gov.tr/.
  • 3. Newby PK, Maras J, Bakun P, Muller D, Ferruci L, and Tucker LK. Intake of whole grains, refined grains, and cereal fiber measured with 7-d diet records and associations with risk factors for chronic disease. Am J Clin Nutr 2007;86:1745-1753.
  • 4. Pereira MA, Jacobs DR, Pins JJ, et al. Effect of whole grains on insulin sensivity in overweight hyperinsulinemich adults. Am J Clin Nutr 2002;75:848-855.
  • 5. Jensen KM, Koh-Banerjee P, Franz M, Sampson L, Grønbak M, Rimm BE. Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation. Am J Clin Nutr 2006;83:275-283.
  • 6. Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: A review of the literature. Eur J Clin Nutr 2006;60:1145-1159.
  • 7. Sciacqua A, Perticone M, Falbo T, Grillo N, Tassone EJ, Sinopoli F, Lo Russo C, Succurro E, Andreozzi F, Sesti G, Perticone F. Dietary patterns and 1-h post-load glucose in essential hypertension. Nutr Metab Cardiovasc Dis 2013;13:4739-4753.
  • 8. Pericleous M, Mandair D, Caplin EM. Diet and supplements and their impact on colorectal cancer. J Gastrointest Oncol 2013;4:409-423.
  • 9. Yao B, Fang H, Xu W, Yan Y, Xu H, Liu Y, Mo M, Zhang H, Zhao Y. Dietary fiber intake and risk of type 2 diabetes: A dose-response analysis of prospective studies. Eur J Epidemiol 2014;10:10654-10013.
  • 10. Ramage S, Farmer A, Eccles KA and McCargar L. Healthy strategies for successful weight loss and weight maintenance: A systematic review. Appl Physiol Nutr Metab 2014;39:1-20.
  • 11. Kamp, Van Der JW. Dietary fibre: New frontiers for food and health. Wageningen Academic Publishers, 2010:586.
  • 12. Bonora E, Muggeo M. Postprandial blood glucose as a risk factor for cardiovascular disease in Type II diabetes: The epidemiological evidence. Diabetologia 2001;44:2107-2114.
  • 13. Burcelin R. The incretins: A link between nutrients and well-being. Br J Nutr 2005;93:147-156.
  • 14. Cernea S, Dobreanu M. Diabetes and beta cell function: From mechanisms to evaluation and clinical implications. Biochem Med 2013;23:266-280.
  • 15. Vilsbøll T. The effects of glucagon-like peptide-1 on the beta cell. Diabetes Obes Metab 2009;11 Suppl 3:11-18.
  • 16. Holst J. The Physiology of glucagon-like peptide 1. Physiol Rev 2007;87:1409-1439.
  • 17. Nauck MA. Unraveling the science of incretin biology. Eur J Intern Med 2009;20:303-308.
  • 18. Geelhoed-Duijvestijn PM. Incretins: New treatment potion for type 2 diabetes. Neth J Med 2007;65:60-64.
  • 19. Girard J. The incretins: From the concept to their use in the treatment of type 2 diabetes. Diabetes Metab 2008;34:550-559.
  • 20. Axelsen M, Arvidsson LR, Lonnroth P, Smith U. Breakfast glycaemic response in patients with type 2 diabetes: Effects of bedtime dietary carbonhyrates. Eur J Clin Nutr 1999;53:706-710.
  • 21. Mofidi A, Ferraro ZM, Stewart KA, Tulk HMF, Robinson LE, Duncan AM, Graham TE. The Acute impact of ingestion of sourdough and whole-grain breads on blood glucose, insulin and incretins in overweight and obese men. J Nutr Metab 2012;2012:184710.
  • 22. Penaforte FRO, Japur CC, Diez-Garcia RW, Chiarello PG. Effects of a high-fat meal on postprandial incretin responses, appetite scores and ad libitum energy intake in women with obesity. Nutr Hosp 2017;34(2):376-382.
  • 23. Ranganath LR. The entero-insular axis: Implications for human metabolism. Clin Chem Lab Med 2008;46(1):43-56.
  • 24. Drucker D. The role of gut hormones in glukoce homeostasis. J Clin Invest 2007;117(1):24-32.
  • 25. Brubaker PL. Minireview: Update on incretin biology: Focus on glucagon like peptide-1. Endocrinology 2010;151:1984-1989.
  • 26. Brubaker PL, Gil-Lozano M. Glucagon-like peptide-1: The missing link in the metabolic clock? J Diabetes Investig 2016; 1:70-75.
  • 27. Eelderink C, Noort MW, Sozer N, Koehorst M, Holst JJ, Deacon CF, Rehfeld JF, et al. Difference in postprandial GLP-1 response despite similar glucose kinetics after consumption of wheat breads with different particle size in healthy men. Eur J Nutr 2017;56:1063-1076.
  • 28. Najjar MA, Parsons PM, Duncan MA, Robinson EL, Yada YR, Graham TE. The acute impact of ingestion of breads of varying composition on blood glucose, insulin and incretins following first and second meals. Br J Nutr 2009;101:391-398.
  • 29. Zammit, VA, Waterman, IJ, Topping D, McKay, G. Insulin stimulation of hepatic triacylglycerol secretion and the etiology of insulin resistance. J Nutr 2001;131(8):2074-2077.
  • 30. Mesci B, Kılıç D, Oguz A. Dietary breads and impact on postprandial parameters. Flour and Breads and their Fortification in Health and Disease Prevention 2011; 429-435.
  • 31. Tucker AJ, Vandermey JS, Robinson LE, Graham TE, Bakovic M, Duncan AM. Effects of breads of varying carbohydrate quality on postprandial glycaemic, incretin and lipidaemic response after first and second meals in adults with diet-controlled type 2 diabetes. Journal of Functional Foods 2014; 6: 116-125.
  • 32. Bo S, Seletto M, Choc A, Ponzo V, Lezo A, Demagistris A, Evangelista A, Ciccone G, Bertolino M, et al. The acute impact of the intake of four types of bread on satiety and blood concentrations of glucose, insulin, free fatty acids, triglyceride and acylated ghrelin. A randomized controlled cross-over trial. Food Res Int 2017; 92: 40-47.
  • 33. Nounmusig J, Kongkachuichai R, Sirichakwal PP, Yamborisut U, Charoensiri R, Vanavichit A. The effect of low and high glycemic index based rice varieties in test meals on postprandial blood glucose, insulin and incretin hormones response in prediabetic subjects. International Food Research Journal 2018;25: 835-841.
  • 34. Liljeberg H, Bjorck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur J Clin Nutr 1998;52:368-371.
  • 35. Liljeberg HG, Lonner CH, Bjorck IM. Sourdough fermentation or addition of organic acids or corresponding salts to bread improves nutritional properties of starch in healthy humans. J Nutr 1995;125:1503-1511.
  • 36. Liljeberg HG, Bjorck IM. Delayed gastric emptying rate as a potential mechanism for lowered glycemia after eating sourdough bread: Studies in humans and rats using test products with added organic acids or an organic salt. Am J Clin Nutr 1996;64:886-893.
  • 37. Ostman EM, Liljeberg Elmstahl HG, Bjorck, IM. Barley bread containing lactic acid improves glucose tolerance at a subsequent meal in healthy men and women. J Nutr 2002;132:1173-1175.
  • 38. Vilsbøll T, Krarupa T, Madsbadc S, Holst J. Both GLP-1 and GIP are insulinotropic at basal and postprandial glucose levels and contribute nearly equally to the incretin effect of a meal in healthy subjects. Regul Pept 2003;114:115-121.
  • 39. Adam TC, Jocken J, Westerterp-Plantenga MS. Decreased glucagon-like peptide 1 release after weight loss in overweight/ obese subjects. Obes Res 2005;13:710-716.

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

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

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.


Kaynakça

  • 1. Juntunen KS, Niskanen LK, Liukkonen KH, Poutanen KS, Holst JJ, Mykkanen HM. Postprandial glucose, insulin, and inkretin responses to grain producuts in healthy subjects. Am J Clin Nutr 2002;75:254-262.
  • 2. Türkiye Beslenme ve Sağlik Araştirması (TBSA) 2010. Erişim tarihi: 29.09.2014. http://ekutuphane.sagem.gov.tr/.
  • 3. Newby PK, Maras J, Bakun P, Muller D, Ferruci L, and Tucker LK. Intake of whole grains, refined grains, and cereal fiber measured with 7-d diet records and associations with risk factors for chronic disease. Am J Clin Nutr 2007;86:1745-1753.
  • 4. Pereira MA, Jacobs DR, Pins JJ, et al. Effect of whole grains on insulin sensivity in overweight hyperinsulinemich adults. Am J Clin Nutr 2002;75:848-855.
  • 5. Jensen KM, Koh-Banerjee P, Franz M, Sampson L, Grønbak M, Rimm BE. Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation. Am J Clin Nutr 2006;83:275-283.
  • 6. Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: A review of the literature. Eur J Clin Nutr 2006;60:1145-1159.
  • 7. Sciacqua A, Perticone M, Falbo T, Grillo N, Tassone EJ, Sinopoli F, Lo Russo C, Succurro E, Andreozzi F, Sesti G, Perticone F. Dietary patterns and 1-h post-load glucose in essential hypertension. Nutr Metab Cardiovasc Dis 2013;13:4739-4753.
  • 8. Pericleous M, Mandair D, Caplin EM. Diet and supplements and their impact on colorectal cancer. J Gastrointest Oncol 2013;4:409-423.
  • 9. Yao B, Fang H, Xu W, Yan Y, Xu H, Liu Y, Mo M, Zhang H, Zhao Y. Dietary fiber intake and risk of type 2 diabetes: A dose-response analysis of prospective studies. Eur J Epidemiol 2014;10:10654-10013.
  • 10. Ramage S, Farmer A, Eccles KA and McCargar L. Healthy strategies for successful weight loss and weight maintenance: A systematic review. Appl Physiol Nutr Metab 2014;39:1-20.
  • 11. Kamp, Van Der JW. Dietary fibre: New frontiers for food and health. Wageningen Academic Publishers, 2010:586.
  • 12. Bonora E, Muggeo M. Postprandial blood glucose as a risk factor for cardiovascular disease in Type II diabetes: The epidemiological evidence. Diabetologia 2001;44:2107-2114.
  • 13. Burcelin R. The incretins: A link between nutrients and well-being. Br J Nutr 2005;93:147-156.
  • 14. Cernea S, Dobreanu M. Diabetes and beta cell function: From mechanisms to evaluation and clinical implications. Biochem Med 2013;23:266-280.
  • 15. Vilsbøll T. The effects of glucagon-like peptide-1 on the beta cell. Diabetes Obes Metab 2009;11 Suppl 3:11-18.
  • 16. Holst J. The Physiology of glucagon-like peptide 1. Physiol Rev 2007;87:1409-1439.
  • 17. Nauck MA. Unraveling the science of incretin biology. Eur J Intern Med 2009;20:303-308.
  • 18. Geelhoed-Duijvestijn PM. Incretins: New treatment potion for type 2 diabetes. Neth J Med 2007;65:60-64.
  • 19. Girard J. The incretins: From the concept to their use in the treatment of type 2 diabetes. Diabetes Metab 2008;34:550-559.
  • 20. Axelsen M, Arvidsson LR, Lonnroth P, Smith U. Breakfast glycaemic response in patients with type 2 diabetes: Effects of bedtime dietary carbonhyrates. Eur J Clin Nutr 1999;53:706-710.
  • 21. Mofidi A, Ferraro ZM, Stewart KA, Tulk HMF, Robinson LE, Duncan AM, Graham TE. The Acute impact of ingestion of sourdough and whole-grain breads on blood glucose, insulin and incretins in overweight and obese men. J Nutr Metab 2012;2012:184710.
  • 22. Penaforte FRO, Japur CC, Diez-Garcia RW, Chiarello PG. Effects of a high-fat meal on postprandial incretin responses, appetite scores and ad libitum energy intake in women with obesity. Nutr Hosp 2017;34(2):376-382.
  • 23. Ranganath LR. The entero-insular axis: Implications for human metabolism. Clin Chem Lab Med 2008;46(1):43-56.
  • 24. Drucker D. The role of gut hormones in glukoce homeostasis. J Clin Invest 2007;117(1):24-32.
  • 25. Brubaker PL. Minireview: Update on incretin biology: Focus on glucagon like peptide-1. Endocrinology 2010;151:1984-1989.
  • 26. Brubaker PL, Gil-Lozano M. Glucagon-like peptide-1: The missing link in the metabolic clock? J Diabetes Investig 2016; 1:70-75.
  • 27. Eelderink C, Noort MW, Sozer N, Koehorst M, Holst JJ, Deacon CF, Rehfeld JF, et al. Difference in postprandial GLP-1 response despite similar glucose kinetics after consumption of wheat breads with different particle size in healthy men. Eur J Nutr 2017;56:1063-1076.
  • 28. Najjar MA, Parsons PM, Duncan MA, Robinson EL, Yada YR, Graham TE. The acute impact of ingestion of breads of varying composition on blood glucose, insulin and incretins following first and second meals. Br J Nutr 2009;101:391-398.
  • 29. Zammit, VA, Waterman, IJ, Topping D, McKay, G. Insulin stimulation of hepatic triacylglycerol secretion and the etiology of insulin resistance. J Nutr 2001;131(8):2074-2077.
  • 30. Mesci B, Kılıç D, Oguz A. Dietary breads and impact on postprandial parameters. Flour and Breads and their Fortification in Health and Disease Prevention 2011; 429-435.
  • 31. Tucker AJ, Vandermey JS, Robinson LE, Graham TE, Bakovic M, Duncan AM. Effects of breads of varying carbohydrate quality on postprandial glycaemic, incretin and lipidaemic response after first and second meals in adults with diet-controlled type 2 diabetes. Journal of Functional Foods 2014; 6: 116-125.
  • 32. Bo S, Seletto M, Choc A, Ponzo V, Lezo A, Demagistris A, Evangelista A, Ciccone G, Bertolino M, et al. The acute impact of the intake of four types of bread on satiety and blood concentrations of glucose, insulin, free fatty acids, triglyceride and acylated ghrelin. A randomized controlled cross-over trial. Food Res Int 2017; 92: 40-47.
  • 33. Nounmusig J, Kongkachuichai R, Sirichakwal PP, Yamborisut U, Charoensiri R, Vanavichit A. The effect of low and high glycemic index based rice varieties in test meals on postprandial blood glucose, insulin and incretin hormones response in prediabetic subjects. International Food Research Journal 2018;25: 835-841.
  • 34. Liljeberg H, Bjorck I. Delayed gastric emptying rate may explain improved glycaemia in healthy subjects to a starchy meal with added vinegar. Eur J Clin Nutr 1998;52:368-371.
  • 35. Liljeberg HG, Lonner CH, Bjorck IM. Sourdough fermentation or addition of organic acids or corresponding salts to bread improves nutritional properties of starch in healthy humans. J Nutr 1995;125:1503-1511.
  • 36. Liljeberg HG, Bjorck IM. Delayed gastric emptying rate as a potential mechanism for lowered glycemia after eating sourdough bread: Studies in humans and rats using test products with added organic acids or an organic salt. Am J Clin Nutr 1996;64:886-893.
  • 37. Ostman EM, Liljeberg Elmstahl HG, Bjorck, IM. Barley bread containing lactic acid improves glucose tolerance at a subsequent meal in healthy men and women. J Nutr 2002;132:1173-1175.
  • 38. Vilsbøll T, Krarupa T, Madsbadc S, Holst J. Both GLP-1 and GIP are insulinotropic at basal and postprandial glucose levels and contribute nearly equally to the incretin effect of a meal in healthy subjects. Regul Pept 2003;114:115-121.
  • 39. Adam TC, Jocken J, Westerterp-Plantenga MS. Decreased glucagon-like peptide 1 release after weight loss in overweight/ obese subjects. Obes Res 2005;13:710-716.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Merve Kayalı 0000-0001-8795-5130

Sebiha Özge Duman Bu kişi benim 0000-0003-3986-4546

Yıldız Tütüncü Bu kişi benim 0000-0001-6764-1994

Nevin Dinççağ Bu kişi benim 0000-0002-3905-6429

Yayımlanma Tarihi 29 Nisan 2019
Kabul Tarihi 6 Nisan 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 1

Kaynak Göster

APA Kayalı, M., Duman, S. Ö., Tütüncü, Y., Dinççağ, N. (2019). Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi. Turkish Journal of Diabetes and Obesity, 3(1), 1-13.
AMA Kayalı M, Duman SÖ, Tütüncü Y, Dinççağ N. Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi. Turk J Diab Obes. Nisan 2019;3(1):1-13.
Chicago Kayalı, Merve, Sebiha Özge Duman, Yıldız Tütüncü, ve Nevin Dinççağ. “Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu Ve Obez Gönüllülerde Etkisi”. Turkish Journal of Diabetes and Obesity 3, sy. 1 (Nisan 2019): 1-13.
EndNote Kayalı M, Duman SÖ, Tütüncü Y, Dinççağ N (01 Nisan 2019) Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi. Turkish Journal of Diabetes and Obesity 3 1 1–13.
IEEE M. Kayalı, S. Ö. Duman, Y. Tütüncü, ve N. Dinççağ, “Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi”, Turk J Diab Obes, c. 3, sy. 1, ss. 1–13, 2019.
ISNAD Kayalı, Merve vd. “Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu Ve Obez Gönüllülerde Etkisi”. Turkish Journal of Diabetes and Obesity 3/1 (Nisan 2019), 1-13.
JAMA Kayalı M, Duman SÖ, Tütüncü Y, Dinççağ N. Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi. Turk J Diab Obes. 2019;3:1–13.
MLA Kayalı, Merve vd. “Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu Ve Obez Gönüllülerde Etkisi”. Turkish Journal of Diabetes and Obesity, c. 3, sy. 1, 2019, ss. 1-13.
Vancouver Kayalı M, Duman SÖ, Tütüncü Y, Dinççağ N. Farklı Ekmek Çeşitlerinin Karbonhidrat İntoleransı Olmayan Kilolu ve Obez Gönüllülerde Etkisi. Turk J Diab Obes. 2019;3(1):1-13.

Zonguldak Bülent Ecevit Üniversitesi Obezite ve Diyabet Uygulama ve Araştırma Merkezi’nin bilimsel yayım organıdır.

Web: https://obdm.beun.edu.tr/  Twitter: https://twitter.com/obezite_diyabet     Instagram: https://www.instagram.com/zbeuobezitediyabet/