nach oben

Erschienen in:

11.04.2016 | Ernährung | FORTBILDUNG_SCHWERPUNKT

Paradigmenwechsel bei den Ernährungsempfehlungen

So steuern Sie das Essverhalten Ihrer Patienten in die richtige Richtung

verfasst von: Dr. med. Katharina Lechner, Prof. Dr. med. Klaus G. Parhofer

Erschienen in: MMW - Fortschritte der Medizin | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Seit einigen Jahren zeichnet sich ein Paradigmenwechsel in Bezug auf die Ernährungsempfehlungen bei Typ-2-Diabetes ab. Diese betreffen primär ein Aufheben der Cholesterin- und Fettbegrenzung zugunsten einer Fokussierung auf die Fettqualität sowie Veränderungen der empfohlenen Makronährstoff-Zusammensetzung.

Deutscher Gesundheitsbericht Diabetes 2015,8.

Global status report on noncommunicable diseases 2014. Geneva, World Health Organization, 2012.

Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Research and Clinical Practice.103(2):150–60.

Update of mortality attributable to diabetes for the IDF Diabetes Atlas: Estimates for the year 2011. Diabetes Research and Clinical Practice.100(2):277-9.

Domingueti CP, Dusse LM, Carvalho MD, de Sousa LP, Gomes KB, Fernandes AP. Diabetes mellitus: The linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. Journal of diabetes and its complications. 2015 Dec 18.

http://www.who.int/features/factfiles/diabetes/facts/en/index5.html.

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006 Nov;3(11):e442.CrossRefPubMedPubMedCentral

Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Research and Clinical Practice.87(3):293–301.

Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition (Burbank, Los Angeles County, Calif). 2015 Jan;31(1):1–13.CrossRef

10.

DiNicolantonio JJ. The cardiometabolic consequences of replacing saturated fats with carbohydrates or Omega-6 polyunsaturated fats: Do the dietary guidelines have it wrong? Open heart. 2014;1(1):e000032.CrossRefPubMedPubMedCentral

11.

Walker TB, Parker MJ. Lessons from the war on dietary fat. Journal of the American College of Nutrition. 2014;33(4):347–51.CrossRefPubMed

12.

Bischoff SC. Adipositas im Erwachsenenalter. Aktuel Ernahrungsmed. 2015 // 13.05.2015;40(03):147–78.CrossRef

13.

Harcombe Z, Baker JS, Cooper SM, Davies B, Sculthorpe N, DiNicolantonio JJ, et al. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open heart. 2015;2(1):e000196.CrossRefPubMedPubMedCentral

14.

Taubes G. Nutrition. The soft science of dietary fat. Science (New York, NY). 2001 Mar 30;291(5513):2536–45.

15.

Mozaffarian D. Saturated fatty acids and type 2 diabetes: more evidence to re-invent dietary guidelines. The lancet Diabetes & endocrinology. 2014 Oct;2(10):770–2.CrossRef

16.

Hamdy O. Nutrition revolution the end of the high carbohydrates era for diabetes prevention and management. Diabetes Manag 2014;10:103–104

17.

Scholl J, Schneider M. Gesundheitspolitik: Gesundheitsförderung und Prävention weiterdenken. Dtsch Arztebl International. 2015 October 30, 2015;112(44):1830.

18.

Hu T, Bazzano LA. The low-carbohydrate diet and cardiovascular risk factors: evidence from epidemiologic studies. Nutrition, metabolism, and cardiovascular diseases: NMCD. 2014 Apr;24(4):337–43.PubMedPubMedCentral

19.

Twig G, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Gerstein HC, et al. Diabetes risk among overweight and obese metabolically healthy young adults. Diabetes care. 2014 Nov;37(11):2989–95.CrossRefPubMed

20.

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama. 2003 Jan 1;289(1):76–9.CrossRefPubMed

21.

Lustig RH, Schmidt LA, Brindis CD. Public health: The toxic truth about sugar. Nature. 2012 Feb 2;482(7383):27–9.CrossRefPubMed

22.

Taubes G. The science of obesity: what do we really know about what makes us fat? An essay by Gary Taubes. BMJ (Clinical research ed). 2013;346:f1050.

23.

Livesey G, Taylor R, Livesey H, Liu S. Is there a dose-response relation of dietary glycemic load to risk of type 2 diabetes? Meta-analysis of prospective cohort studies. The American journal of clinical nutrition. 2013 Mar;97(3):584–96.CrossRefPubMed

24.

DiNicolantonio JJ, Lucan SC, O’Keefe JH. The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease. Progress in cardiovascular diseases. 2015 Nov 14.

25.

Mozaffarian D. Diverging global trends in heart disease and type 2 diabetes: the role of carbohydrates and saturated fats. The lancet Diabetes & endocrinology. 2015 Aug;3(8):586–8.CrossRef

26.

Lustig RH, Mulligan K, Noworolski SM, Tai VW, Wen MJ, Erkin-Cakmak A, et al. Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity (Silver Spring, Md). 2016 Feb;24(2):453–60.CrossRef

27.

Elliott SS, Keim NL, Stern JS, Teff K, Havel PJ. Fructose, weight gain, and the insulin resistance syndrome. The American journal of clinical nutrition. 2002 Nov;76(5):911–22.PubMed

28.

Malik VS, Hu FB. Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us. Journal of the American College of Cardiology. 2015 Oct 6;66(14):1615–24.CrossRefPubMed

29.

Stanhope KL, Medici V, Bremer AA, Lee V, Lam HD, Nunez MV, et al. A dose-response study of consuming high-fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. The American journal of clinical nutrition. 2015 Jun;101(6):1144–54.CrossRefPubMed

30.

Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet (London, England). 2014 Jun 7;383(9933):1999–2007.CrossRef

31.

Cox CL, Stanhope KL, Schwarz JM, Graham JL, Hatcher B, Griffen SC, et al. Consumption of fructose-sweetened beverages for 10 weeks reduces net fat oxidation and energy expenditure in overweight/obese men and women. European journal of clinical nutrition. 2012 Feb;66(2):201–8.CrossRefPubMedPubMedCentral

32.

Cox CL, Stanhope KL, Schwarz JM, Graham JL, Hatcher B, Griffen SC, et al. Consumption of fructose- but not glucose-sweetened beverages for 10 weeks increases circulating concentrations of uric acid, retinol binding protein-4, and gamma-glutamyl transferase activity in overweight/obese humans. Nutrition & metabolism. 2012;9(1):68.CrossRef

33.

Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. The Journal of clinical investigation. 2009 May;119(5):1322–34.CrossRefPubMedPubMedCentral

34.

Basaranoglu M, Basaranoglu G, Bugianesi E. Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction. Hepatobiliary surgery and nutrition. 2015 Apr;4(2):109–16.

35.

Huang PL. A comprehensive definition for metabolic syndrome. Disease models & mechanisms. 2009 May-Jun;2(5-6):231–7.CrossRef

36.

Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutrition & metabolism. 2005;2:31.CrossRef

37.

Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & metabolism. 2008;5:9.CrossRef

38.

Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. The New England journal of medicine. 2010 Nov 25;363(22):2102–13.CrossRefPubMedPubMedCentral

39.

Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. Jama. 2007 Mar 7;297(9):969–77.CrossRefPubMed

40.

Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, et al. Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women. New England Journal of Medicine. 2006;355(19):1991–2002.CrossRefPubMed

41.

eWestman EC, Vernon MC. Has carbohydrate-restriction been forgotten as a treatment for diabetes mellitus? A perspective on the ACCORD study design. Nutrition & metabolism. 2008;5:10.CrossRef

42.

https://www.joslin.org/about/elliot_p_joslin_md.html

43.

Feinman R. Carbohydrates for people with diabetes is not cautious. Nutrition (Burbank, Los Angeles County, Calif). 2016 1//;32(1):153–4.CrossRef

44.

Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. Jama. 2006 Feb 8;295(6):655–66.CrossRefPubMed

45.

Noakes TD. The Women’s Health Initiative Randomized Controlled Dietary Modification Trial: an inconvenient finding and the diet-heart hypothesis. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 2013 Nov;103(11):824–5.

46.

Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Annals of internal medicine. 2014 Mar 18;160(6):398–406.CrossRefPubMed

47.

de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed). 2015;351:h3978.

48.

Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American journal of clinical nutrition. 2010 Mar;91(3):535–46.CrossRefPubMedPubMedCentral

49.

http://health.gov/dietaryguidelines/2015.

50.

Berger S, Raman G, Vishwanathan R, Jacques PF, Johnson EJ. Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. The American journal of clinical nutrition. 2015 Aug;102(2):276–94.CrossRefPubMed

51.

Mozaffarian D, Ludwig DS. The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat. Jama. 2015 Jun 23-30;313(24):2421–2.CrossRefPubMed

52.

Fuller NR, Caterson ID, Sainsbury A, Denyer G, Fong M, Gerofi J, et al. The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study-a 3-mo randomized controlled trial. The American journal of clinical nutrition. 2015 Apr;101(4):705–13.CrossRefPubMed

53.

Evidenzbasierte Leitlinie: „Fettzufuhr und Prävention ausgewählter ernährungsmitbedingter Krankheiten“, 2. Version (2015).

54.

Fernando WM, Martins IJ, Goozee KG, Brennan CS, Jayasena V, Martins RN. The role of dietary coconut for the prevention and treatment of Alzheimer’s disease: potential mechanisms of action. The British journal of nutrition. 2015 Jul 14;114(1):1–14.CrossRefPubMed

55.

Wang L, Bordi PL, Fleming JA, Hill AM, Kris-Etherton PM. Effect of a moderate fat diet with and without avocados on lipoprotein particle number, size and subclasses in overweight and obese adults: a randomized, controlled trial. Journal of the American Heart Association. 2015 Jan;4(1):e001355.CrossRefPubMedPubMedCentral

56.

Wu L, Piotrowski K, Rau T, Waldmann E, Broedl UC, Demmelmair H, et al. Walnut-enriched diet reduces fasting non-HDL-cholesterol and apolipoprotein B in healthy Caucasian subjects: a randomized controlled cross-over clinical trial. Metabolism: clinical and experimental. 2014 Mar;63(3):382–91.CrossRef

57.

Kris-Etherton PM, Yu-Poth S, Sabate J, Ratcliffe HE, Zhao G, Etherton TD. Nuts and their bioactive constituents: effects on serum lipids and other factors that affect disease risk. The American journal of clinical nutrition. 1999 Sep;70(3 Suppl):504s–11s.PubMed

58.

Bao Y, Han J, Hu FB, Giovannucci EL, Stampfer MJ, Willett WC, et al. Association of nut consumption with total and cause-specific mortality. The New England journal of medicine. 2013 Nov 21;369(21):2001–11.CrossRefPubMedPubMedCentral

59.

Erickson N, Wawer A. Prinzipien der mediterranen Ernährung: Definition, Hintergrund, Eigenschaften und klinische Bedeutung. Aktuel Ernahrungsmed. 2015 // 17.12.2015;40(06):355–9.

60.

Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. The New England journal of medicine. 2013 Apr 4;368(14):1279–90.CrossRefPubMed

61.

Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ (Clinical research ed). 2014;349:g4490.

62.

Endo J, Arita M. Cardioprotective mechanism of omega-3 polyunsaturated fatty acids. Journal of cardiology. 2016 Jan;67(1):22–7.CrossRefPubMed

Titel: Paradigmenwechsel bei den Ernährungsempfehlungen
So steuern Sie das Essverhalten Ihrer Patienten in die richtige Richtung
verfasst von: Dr. med. Katharina Lechner
Prof. Dr. med. Klaus G. Parhofer
Publikationsdatum: 11.04.2016
Verlag: Springer Medizin
Schlagwörter: Ernährung
Typ-2-Diabetes
Erschienen in: MMW - Fortschritte der Medizin / Ausgabe 7/2016
Print ISSN: 1438-3276
Elektronische ISSN: 1613-3560
DOI: https://doi.org/10.1007/s15006-016-8060-0

Passend zum Thema

Fatal verkannt: Vitamin-B12-Mangel frühzeitig behandeln!

Ernährung

Müdigkeit und Erschöpfung sind meist die ersten Symptome eines Vitamin-B12-Mangels. Wird das Defizit nicht rechtzeitig behandelt, drohen mitunter schwerwiegende Folgen. Lesen Sie hier, was bei der Therapie zu beachten ist.

Vitamin-B12-Mangel durch Arzneimittel

Ernährung

Einige häufig verordnete Medikamente wie das orale Antidiabetikum Metformin oder Protonenpumpeninhibitoren (PPI) können einen Mangel an Vitamin B12 verursachen. Bei einer Langzeitmedikation mit diesen Wirkstoffen sollte daher an ein mögliches Defizit gedacht werden. Erfahren Sie hier, worauf dabei zu achten ist.

Vitamin-B12-Mangel – Aktuelles Basiswissen für die Praxis.

Content Hub

Ein Mangel an Vitamin B12 tritt in bestimmten Risikogruppen häufig auf. Diese Patienten sind auch regelmäßig in Ihrer Praxis. Wird der Mangel nicht rechtzeitig behandelt, drohen mitunter schwerwiegende Folgen. Erhalten Sie hier einen Überblick über aktuelles Basiswissen für den Praxisalltag.

Praxisempfehlungen der Deutschen Diabetes Gesellschaft

Kurz, prägnant und aktuell: Die Praxisempfehlungen der Deutschen Diabetes Gesellschaft.

Zu den Praxisempfehlungen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2016

Hochdosiertes GLP-1-Analogon jetzt verfügbar

Post an die Kasse nach EBM abrechnen, Patientenbrief höchstens nach GOÄ

Neue Fixkombination gegen Typ-2-Diabetes

Einfache, effektive und sichere Antikoagulation

Stadtluft wird sauberer, Kinder atmen auf

Moderne Endoskope eröffnen neue Perspektiven

Passend zum Thema

Fatal verkannt: Vitamin-B12-Mangel frühzeitig behandeln!

Vitamin-B12-Mangel durch Arzneimittel

Vitamin-B12-Mangel – Aktuelles Basiswissen für die Praxis.

Praxisempfehlungen der Deutschen Diabetes Gesellschaft