Healthy Nutrition Dr Mustafa Sahin Ankara Universitesi Tp

Healthy Nutrition Dr. Mustafa Sahin Ankara Universitesi Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı

Nasıl prezente olur ? • • • Çoğu asemptomatik Karında gaz Sağ üst kadranda hassasiyet Yorgunluk Obez, Tip 2 diyabet, HT Alkol çok az ya da yok

Diabetes Type 2 is preventable!

What is diabesity? Because obesity and diabetes often go hand in hand, a new term has been coined to describe America's current healthcare crisis: "the diabesity epidemic.

The number of cans of soda the average male teenager drinks each year

The bottom line is…… • There are many factors influencing obesity and diabetes rates. Sedentary lifestyles, ubiquitous junk food, the supersizing of meal portions, and "emotional eating" are just a few! • Too much sugar, too many trans fats, & too many calories consumed!

Recommendations to reduce your risk Fruits & veggies Whole-grain, high fiber Oily fish Lean meats Fat-free, skim, low fat, 1% dairy Reduce added sugars Little or no salt If alcohol, moderation 8

Metabolik Sendrom Obezite Dislipidemi NAFLD Diyabet Hipertansiyon

Metabolik Sendrom (Sendrom-X) ATP III criteria : Aşağıdakilerden ≥ 3 • Abdominal obezite : Etnik farklılık • (Bel çevresi > 102 cm ♂, > 88 cm ♀) • Trigliserid > 150 mg/dl • HDL < 40 mg/dl ♂, < 50 mg/dl ♀ • KB ≥ 130/85 mm. Hg • AKŞ ≥ 110 mg/dl ? ? 100 mg/dl

Recommendations to reduce your risk 1/2 Limit your intake of added sugars to no more than ½ of your daily discretionary calories Limit saturated fat to less than 7 % and trans fat to less than 1 % of daily calorie intake <300 mg <7% Limit cholesterol intake to less than 300 mg per day. Limit sodium intake to 1, 500 mg per day (this is about 1 teaspoon of salt). 1 tsp 12

So what should we eat and consume? • • • Basics of nutrition Nutrition for teens, adults, pregnant women, and athletes Prevention of illness and disease Improve brain function and vitality Enhance skin, hair, and nails Repair, restore, and revitalize

Poor Diets and Asthma Teens with the lowest intake of fruit, vitamins C and E, and omega-3 fatty acids had lower lung function and higher reports of respiratory symptoms such as cough and wheeze. Teens who consumed less than 25 percent of one serving of fruit each day were more likely to have less efficient lung function than their peers.

Never skip meals All of my morbidly obese clients have one thing in common – skipping meals. The moment you allow your blood sugar to drop (when you feel hunger pangs) you become a fat storing machine. You must eat small meals or snacks every few hours.

Serving Size

Nutrition interacts with genotype to influence health and ageing British Mathers JCCopyright (2002) Br. J. Nutr. 88, (Suppl. 3), S 273 -S 279 Nutrition

www. hsph. harvard. edu

Food Sources of Saturated Fat in the US Based on NHANES 2005 -06. From USDA Dietary Guidelines 2010

Food Sources: Meats & CHD Unprocessed Red Meat (100 g/d) RR = 1. 00 (0. 81, 1. 23) Processed Meat (50 g/d) RR = 1. 42 (1. 07, 1. 89) Micha et al. , Circulation 2010

Dietary Fats & CHD Events Chowdury et al, Annals Intern Med 2014

Food Sources: Meats & CVD Mortality Total Red Meat RR = 1. 09 (0. 93, 1. 27) Processed Meat RR = 1. 17 (1. 02, 1. 33) O’Sullivan et al. , Am J Public Health 2013

Dairy Foods & Diabetes Among 340, 234 Europeans from 8 countries, with 12, 403 cases of incident diabetes P-trend=0. 50 RR of Diabetes P-trend=0. 06 P-trend=0. 01 Quintiles of Consumption Adjusted for age, sex, center, education, smoking, physical activity, alcohol intake, and consumption of fruits, vegetables, red meat, processed meat, sugar sweetened beverages, coffee, cereals, and cerearl products. Sluijis et al. , AJCN 2012

Healthy Diet Patterns & CVD Events Randomized controlled trial among 7447 Spanish adults at higher risk No change in saturated fat. HR = 0. 70 (0. 55, 0. 89) Estruch et al. NEJM 2013

Global Disease Burdens Due to Major Risk Factors in 2010 Diet high in SFA & low in PUFA 0. 47 Lim et al, Lancet 2012

Essential Dietary Habits for Health EAT: LIMIT: • Seafood • Fruits • Starches, refined grains, sugars • Nuts • Processed Meats • Vegetables • Sweetened Drinks • Vegetable Oils • Industrial Trans Fat * • Whole grains • Salt * • Yogurt Mozaffarian, Appel, & Van Horn. Circulation 2011 Also: Don’t smoke, turn off the TV, get enough sleep, and be physically active.

Energy Density 28

Dietary Reference Intakes

Estimated Average Requirements & Recommended Dietary Allowances compared

Energy Recommendations • Estimated Energy Requirement – the average dietary energy intake that maintains energy balance in a healthy person of a given age, gender, weight, height, and activity level • Acceptable Macronutrient Distribution Ranges – Carbohydrate: 45% - 65% – Fat: 20% - 35% – Protein: 10% - 35%

Food Guide Pyramid

Metabolik Sendrom Obezite Dislipidemi NAFLD Diyabet Hipertansiyon

Metabolik Sendrom (Sendrom-X) ATP III criteria : Aşağıdakilerden ≥ 3 • Abdominal obezite : Etnik farklılık • (Bel çevresi > 102 cm ♂, > 88 cm ♀) • Trigliserid > 150 mg/dl • HDL < 40 mg/dl ♂, < 50 mg/dl ♀ • KB ≥ 130/85 mm. Hg • AKŞ ≥ 110 mg/dl ? ? 100 mg/dl

Old Food See board for Pyramid updates!

Food Pyramid My Plate (6/11)

Obezite ve İnsulin Direnci Thrombofili Makrovasküler hastalık Santral obezite İnsulin Direnci Hyperglisemi Hipertansiyon Hiperurisemi Dislipidemi NAFLD

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