ÖZET
Amaç:
Yağlı tohumlar ve üzümden elde edilen ürünlerin lipid profili üzerine olumlu etki gösterdiği epidemiyolojik ve klinik araştırmalarla kanıtlanmıştır. Bununla beraber kuru üzümün lipid profili üzerine etkisini araştıran çalışmalar sınırlıdır. Bu araştırmada hiperlipidemili obez kadınlarda fındık, kuru üzüm veya fındık ile birlikte kuru üzüm içeren kardiyoprotektif diyetlerin tüketilmesi ile kardiyoprotektif kontrol diyeti tüketilmesinin lipid profili ve antropometrik ölçümler açısından karşılaştırılması amaçlanmıştır.
Yöntemler:
Paralel kontrollü randomize klinik araştırmaya 37 hiperlipidemili obez kadın katılmıştır. Katılımcılar randomizasyonla dört gruba ayrılmıştır. Altı hafta boyunca kontrol grubu kardiyoprotektif diyet, diğer gruplardaki katılımcılar bulundukları gruba göre 50 g/gün fındık, 50 g/gün kuru üzüm ve 50 g/gün fındık+ kuru üzüm içeren kardiyoprotektif diyetleri tüketmişlerdir. Araştırmanın başında ve sonunda katılımcıların kan lipidleri, kan glikozu düzeyleri ve kan basıncı ölçümleri yapılmış, antropometrik ölçümleri alınmıştır.
Bulgular:
Gruplar arasında lipid profilleri, kan glikozu, kan basıncı ve antropometrik ölçümler bakımından anlamlı fark bulunmamıştır (tüm p>0,05). Başlangıç ölçümleri ile karşılaştırıldığında, araştırmanın sonunda tüm gruplarda toplam kolesterol, düşük yoğunluklu lipoprotein kolesterol ve beden kütle indeksi düzeyleri istatistiksel olarak anlamlı düzeyde azalmıştır (tüm p<0,05).
Sonuç:
Araştırmanın sonunda dört grubun lipid profilleri ve antropometrik ölçümlerinde meydana gelen olumlu değişiklikler nedeniyle hiperlipidemili bireylere uygun bir diyet programına ek olarak fındık, kuru üzüm ve fındıkla beraber kuru üzüm tüketiminin önerilebileceği sonucuna varılmıştır.
References
1
World Health Organization. Global status report on noncommunicable diseases 2014. WHO Library Cataloguing-in-Publication Data, WHO. 2014 [cited 2016/8/12]; Available from: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf.
2
World Health Organization. Cardiovascular diseases (CVDs). WHO Media Centre, WHO.[cited 2016/11/8]; Available from: http://www.who.int/mediacentre/factsheets/fs317/en/.
3
National Institutes of Health. National cholesterol education program. Detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III) final report. NIH Publication. 2002 [cited 2013/2/10]; Available from: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf.
4
Martinez-Gonzalez MA, Bes-Rastrolloa M. Dietary patterns, Mediterranean diet, and cardiovascular disease. Curr Opin Lipidol 2014;25:20-6.
5
Fischer S, Glei M. Potential health benefits of nuts. Ernaehrungs Umschau International 2013;60:206-15.
6
Ros E. Nuts and novel biomarkers of cardiovascular disease. Am J Clin Nutr 2009;89:1649-56.
7
Sabate J, Oda K, Ros E. Nut consumption and blood lipid levels. A pooled analysis of 25 intervention trial. Arch Intern Med 2010;170:821-7.
8
Alasalvar C, Shahidi F, Ohshima T, Wanasundara U, Yurttaş HC. Liyanapathirana CM, et al. Turkish tombul hazelnut (CorylusavellanaL.). 2. lipid characteristics and oxidative stability. J Agric Food Chem 2003;51:3797-805.
9
Mercanlıgil SM, Arslan P, Alasalvar C, Okut E, Akgül E, Pinar A, et al. Effects of hazelnut-enriched diet on plasma cholesterol and lipoprotein profiles in hypercholesterolemic adult men. Eur J Clin Nutr 2007;61:212-20.
10
Eagappan K, Sasikumar S. Therapeutic effects of nuts in various diseases. Int J Recent Sci Res 2014;5:190-7.
11
Griel AE, Kris-Etherton PM. Tree nuts and the lipid profile: a review of clinical studies. Br J Nutr 2006;96:68-78.
12
Balaban Yücesan F, Örem A, Vanizor Kural B, Örem C, Turan İ. Hazelnut consumption decreases the susceptibility of LDL to oxidation, plasma oxidized LDL level and increases the ratio of large/small LDL in normolipidemic healthy subjects. Anadolu Kardiyol Derg 2010;10:28-35.
13
Tey SL, Brown R, Chisholm AW, Delahunty C, Gray AR, Williams SM. Effects of different forms of hazelnuts on blood lipids and α-tocopherol concentrations in mildly hypercholesterolemic individuals. Eur J Clin Nutr 2011;65:117-24.
14
Örem A, Balaban Yücesan F, Örem C, Akcan B, VanizorKural B, Alasalvar C, et al. Hazelnut-enriched diet improves cardiovascular risk biomarkers beyond a lipid-lowering effect in hypercholesterolemic subjects. J Clin Lipidol 2013;7:123-31.
15
Anderson JW, Waters AR. Raisin consumption by humans: effects on glycemia and insulinemia and cardiovascular risk factors. J Food Sci 2013;78:11-7.
16
Perez-Jimenez J, Saura-Calixto F. Grape products and cardiovascular disease risk factors. Nutr Res Rev 2008;21:158-73.
17
Vislocky LM, Fernandez ML. Biomedical effects of grape products. Nutr Rev 2010;68:656-70.
18
Frederiksen H, Mortensen A, Schroder M, Frandsen H, Bysted A, Knuthsen P, et al. Effects of red grape skin and seed extract supplementation on atherosclerosis in Watanabe heritable hyperlipidemic rabbits. Mol Nutr Food Res 2007;51:564-71.
19
Zern TL, Wood RJ, Greene C, West KL, Liu Y, Aggarwal D, et al. Grape polyphenols exert a cardioprotective effect in pre- and postmenopausal women by lowering plasma lipids and reducingoxidative stress. J Nutr 2005;135:1911-7.
20
Perez-Jimenez J, Serrano J, Tabernero M, Arranz S, Diaz-Rubio ME, Garcia-Diz L, et al. Effects of grape antioxidant dietary fiber in cardiovascular disease risk factors. Nutrition 2008;24:646-53.
21
ZibaeeNezhad MJ, Mohammadi E, BabaieBeigi MA, Mirzamohammadi F, Salehi O. The effects of unripe grape juice on lipid profile improvement. Cholesterol 2012;2012:1-3.
22
Feringa HH, Laskey DA, Dickson JE, Coleman CI. The effect of grape seed extract on cardiovascular risk markers: a meta-analysis of randomized controlled trials. J Am Diet Assoc 2011;111:1173-81.
23
Tome-Carneiro J, Gonzálvez M, Larrosa M, Francisco J, García-Almagro FJ, Avilés-Plaza F, et al. Consumption of a grape extract supplement containing resveratrol decreases oxidized LDL and ApoB in patients undergoing primary prevention of cardiovascular disease: a triple-blind, 6-month follow-up, placebo-controlled, randomized trial. Mol Nutr Food Res 2012;56:810-21.
24
Queipo-Ortuno MI, Boto-Ordonez M, Murri M, Gomez-Zumaquero JM, Clemente-Postigo M, Estruch R, et al. Influence of red wine polyphenols and ethanol on the gut microbiota ecology and biochemical biomarkers. Am J Clin Nutr 2012;95:1323-34.
25
Carughi A. Health benefits of sun-dried raisins. California: Health Research and Studies Center; 2008.
26
Onat A. Türk Halkında Lipid, Lipoprotein ve Apolipoproteinler. TEKHARF Çalışması, Türk Kardiyoloji Derneği. 2009: [cited 2013/4/11]; Available from: http://tekharf.org/2009.html.
27
Desu MM, Raghavarao D. Sample Size Methodology. New York: Academic Press; 1990.
28
Fleiss JL. The Design and Analysis of Clinical Experiments. New York: John Wiley &Sons; 1986.
29
Sabate J, Haddad E, Tanzman JS, Jambazian P, Rajaram S. Serum lipid response to the graduated enrichment of a Step I diet with almonds: a randomized feding trial. Am J Clin Nutr 2003;77:1379-84.
30
Mukuddem-Petersen J, Oosthuizen W, JerlingJC. A Systematic Review of the Effects of Nuts on Blood Lipid Profiles in Humans. J Nutr 2005;135:2082-9.
31
American Heart Association Nutrition Committee, Lichtenstein AH, Apel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee. Circulation 2006;114:82-96.
32
Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women- 2011 Update: A Guideline From the American Heart Association. Circulation 2011;123:1243-62.
33
Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012;33:1635-701.
34
Otten JJ, Hellwig JP, Meyers LD (eds). Dietary Reference Intakes The Essential Guide to Nutrient Requirements.Washington: The National Academies Press; 2006.
35
Parikh P, Mochari H, Mosca L. Clinical utility of a fingerstick technology to identify individuals with abnormal blood lipids and high-sensitivity c-reactive protein levels. Am J Health Promot 2009;23:279-82.
36
Ros E, Mataix J. Fatty acid composition of nuts – implications for cardiovascular health. Br J Nutr 2006;96:29-35.
37
Bruckert E, Rosenbaum D. Lowering LDL-cholesterol through diet: potential role in the statin era. Curr Opin Lipidol 2011;22:43-8.
38
Tey SL, Brown R, Gray A, Chisholm AW, Delahunty C. Nuts Improve Diet Quality Compared to Other Energy-Dense Snacks While Maintaining Body Weight. J Nutr Metab 2011;2011:1-11.
39
Qin Y, Xia M, Ma J, Hao Y, Liu J, Mou H, et al. Anthocyanin supplementation improves serum LDL- and HDL-cholesterol concentrations associated with the inhibition of cholesteryl ester transfer protein in dyslipidemic subjects. Am J Clin Nutr 2009;90:485-92.
40
Puglisi MJ, Vaishnav U, Shrestha S, Torres-Gonzalez M, Wood RJ, Volek JS, et al. Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines. Lipids in Health Dis 2008;7:1-9.
41
Rajesh V, Perumal P, Aruna P. Hypolipidemic and antioxidant activity of grape skin extract and resveratrol on rats fed with high-fat diet. Orient Pharm Exp Med 2013;13:11-20.
42
Jiang R, Manson JE, Stamfer MJ, Liu S, Willett WC, Hu FD. Nut and peanut butter consumption and risk of type 2 diabetes in women. JAMA 2002;288:2554-60.
43
Kim Y, Hertzler SR, Byrne HK, Mattern CO. Raisins are a low to moderate glycemic index food with a correspondingly low insulin index. Nutr Res 2008;28:304-8.
44
Anderson JW, Weiter KM, Christian AL, Ritchey MB, Bays HE. Raisins compared with other snack effects on glycemia and blood pressure: a randomized, controlled trial. Postgrad Med 2014;126:37-43.
45
Tey SL, Gray A, Chisholm AW, Delahunty C, Brown R. The Dose of hazelnuts influences acceptance and diet quality but not inflammatory markers and body composition in overweight and obese individuals. J Nutr 2013;143:1254-62.
46
Martinez-Gonzalez MA, Bes-Rastrollo M. Nut consumption, weight gain and obesity: Epidemiological evidence. Nutr Metab Cardiovasc Dis 2011;21:40-5.
47
Sheridan MJ, Cooper JN, Erario M, Cheifetz CE. Pistachio nut consumption and serum lipid levels. J Am Coll Nutr 2007;26:14-48.
48
McKiernan F, Lokko P, Kuevi A, Sales, RL, Costa NMB, Bressan J, et al. Effects of peanut processing on body weight and fasting plasma lipids. Br J Nutr 2010;104:418-26.
