Adipositas - Ursachen, Folgeerkrankungen, Therapie 2019; 13(03): 145-148
DOI: 10.1055/a-0962-3295
Review
© Georg Thieme Verlag KG Stuttgart · New York

Prävention und Therapie von Adipositas durch Personalisierung der Ernährung

Personalized nutrition in prevention and treatment of obesity
Torsten Schröder
Institut für Ernährungsmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
,
Christian Sina
Institut für Ernährungsmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck
› Author Affiliations
Further Information

Publication History

Publication Date:
04 September 2019 (online)

Zusammenfassung

Übergewicht und Adipositas zeigen eine deutlich steigende Prävalenz auf und begünstigen Folgekomplikationen wie Typ 2 Diabetes mellitus und kardiovaskuläre Endpunkte. Die bisherige Ernährungstherapie konnte dieser Entwicklung nicht ausreichend effektiv entgegentreten. Personalisierungsstrategien unter Zuhilfenahme von modernen Analyseverfahren objektivierbarer Messgrößen stellen eine innovative und effektive Strategie dar, um Übergewicht und Adipositas sowohl zu verhindern als auch zu therapieren. Die hohe Individualität des Darm-Mikrobioms und der postprandialen Blutzuckerregulation steht im Zentrum dieser Ansätze.

Abstract

The prevalence of overweight and obesity is increasing tremendously. In addition, overweight and obesity promote co-morbidities and complications such as type 2 diabetes and fatal cardiovascular outcomes. Recent strategies of nutritional therapies were not effective in preventing this development. Strategies to tailor nutritional recommendations to the individual’s metabolism by using modern analytical methods constitute innovative and effective prospects to treat and prevent overweight and obesity. The high variability of the intestinal microbiome and postprandial glycemic reactions between the individuals are central for these measures.

 
  • Referenzen

  • 1 WHO. Body mass index – BMI. Im Internet: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi Stand: 03.08.2019
  • 2 Kinlen D, Cody D, O’Shea D. Complications of obesity. QJM 2018; 111: 437-443
  • 3 Jørgensen TSH, Osler M, Ängquist LH. et al. The U-shaped association of body mass index with mortality: Influence of the traits height, intelligence and education. Obesity 2016; 24: 2240-7
  • 4 Qin W, Liu F, Wan C. A U-shaped association of body mass index and all-cause mortality in heart failure patients: A dose-response meta-analysis of prospective cohort studies. Cardiovasc Ther 2017; 35: e12232 doi: 10.1111/1755–5922.12232
  • 5 Kuo JF, Hsieh YT, Mao IC. et al. The Association Between Body Mass Index and All-Cause Mortality in Patients With Type 2 Diabetes Mellitus: A 5.5-Year Prospective Analysis. Medicine (Baltimore) 2015; 94: e1398
  • 6 Aune D, Schlesinger S, Norat T. et al. Body mass index, abdominal fatness, and the risk of sudden cardiac death: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol 2018; 33: 711-722
  • 7 Wing RR, Lang W, Wadden TA. et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011; 34: 1481-6
  • 8 Héroux M, Watt M, McGuire KA. et al. A personalized, multi-platform nutrition, exercise, and lifestyle coaching program: A pilot in women. Internet Interv 2017; 7: 16-22
  • 9 Fildes A, Charlton J, Rudisill C. et al. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health 2015; 105: e54-9
  • 10 (NCD-RisC) NRFC. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390: 2627-2642
  • 11 Radulian G, Rusu E, Dragomir A. et al. Metabolic effects of low glycaemic index diets. Nutr J 2009; 8: 5
  • 12 Ebbeling CB, Leidig MM, Feldman HA. et al. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA 2007; 297: 2092-102
  • 13 Pfeiffer AFH, Keyhani-Nejad F. High Glycemic Index Metabolic Damage – a Pivotal Role of GIP and GLP-1. Trends Endocrinol Metab 2018; 29: 289-299
  • 14 Blaak EE, Antoine JM, Benton D. et al. Impact of postprandial glycaemia on health and prevention of disease. Obes Rev 2012; 13: 923-84
  • 15 Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes 2015; 6: 296-303
  • 16 Nathan DM, Davidson MB, DeFronzo RA. et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007; 30: 753-9
  • 17 Cavalot F, Pagliarino A, Valle M. et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care 2011; 34: 2237-43
  • 18 Lamkin DM, Spitz DR, Shahzad MMK. et al. Glucose as a prognostic factor in ovarian carcinoma. Cancer 2009; 115: 1021-7
  • 19 Ma Y, Yang Y, Wang F. et al. Obesity and risk of colorectal cancer: a systematic review of prospective studies. PLoS One 2013; 8: e53916
  • 20 Neuhouser ML, Aragaki AK, Prentice RL. et al. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Oncol 2015; 1: 611-21
  • 21 Millsop JW, Bhatia BK, Debbaneh M. et al. Diet and psoriasis, part III: role of nutritional supplements. J Am Acad Dermatol 2014; 71: 561-9
  • 22 DAG, DDG, DGEM, DGE. Interdisziplinäre Leitlinie der Qualität S3 zur „Prävention und Therapie der Adipositas“. Im Internet: https://www.adipositas-gesellschaft.de/fileadmin/PDF/Leitlinien/S3_Adipositas_Praevention_Therapie_2014.pdf Stand: 03.08.2019
  • 23 Bhoraskar A. Nutrition in prediabetes. J Indian Med Assoc 2005; 103: 596-598 –9
  • 24 Martínez-González MÁ, Ruiz-Canela M, Hruby A. et al. Intervention Trials with the Mediterranean Diet in Cardiovascular Prevention: Understanding Potential Mechanisms through Metabolomic Profiling. J Nutr 2016; 146: 913S-919S doi: 10.3945/jn.115.219147
  • 25 Gibson AA, Sainsbury A. Strategies to Improve Adherence to Dietary Weight Loss Interventions in Research and Real-World Settings. Behav Sci 2017; 7: 44 doi: 10.3390/bs7030044
  • 26 Wolever TM, Jenkins DJ, Jenkins AL. et al. The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991; 54: 846-54
  • 27 Wolever TM, Jenkins DJ, Vuksan V. et al. Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care 1992; 15: 562-4
  • 28 Greenwood DC, Threapleton DE, Evans CEL. et al. Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Diabetes Care 2013; 36: 4166-71
  • 29 Kristo AS, Matthan NR, Lichtenstein AH. Effect of diets differing in glycemic index and glycemic load on cardiovascular risk factors: review of randomized controlled-feeding trials. Nutrients 2013; 5: 1071-80
  • 30 Hjorth MF, Zohar Y, Hill JO. et al. Personalized Dietary Management of Overweight and Obesity Based on Measures of Insulin and Glucose. Annu Rev Nutr 2018; 38: 245-272
  • 31 Zeevi D, Korem T, Zmora N. et al. Personalized Nutrition by Prediction of Glycemic Responses. Cell 2015; 163: 1079-1094
  • 32 Korem T, Zeevi D, Zmora N. et al. Bread Affects Clinical Parameters and Induces Gut Microbiome-Associated Personal Glycemic Responses. Cell Metab 2017; 25: 1243-1253.e5
  • 33 Mendes-Soares H, Raveh-Sadka T, Azulay S. et al. Assessment of a Personalized Approach to Predicting Postprandial Glycemic Responses to Food Among Individuals Without Diabetes. JAMA Netw open 2019; 2: e188102
  • 34 Chambers ES, Viardot A, Psichas A. et al. Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults. Gut 2015; 64: 1744-54
  • 35 Rahat-Rozenbloom S, Fernandes J, Cheng J. et al. The acute effects of inulin and resistant starch on postprandial serum short-chain fatty acids and second-meal glycemic response in lean and overweight humans. Eur J Clin Nutr 2017; 71: 227-233
  • 36 Cani PD. Human gut microbiome: hopes, threats and promises. Gut 2018; 67: 1716-1725
  • 37 Ley RE, Bäckhed F, Turnbaugh P. et al. Obesity alters gut microbial ecology. Proc Natl Acad Sci USA 2005; 102: 11070-5
  • 38 Turnbaugh PJ, Ley RE, Mahowald MA. et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006; 444: 1027-31
  • 39 Ahima RS. Digging deeper into obesity. J Clin Invest 2011; 121: 2076-9
  • 40 Ley RE. Obesity and the human microbiome. Curr Opin Gastroenterol 2010; 26: 5-11
  • 41 Lozupone CA, Stombaugh JI, Gordon JI. et al. Diversity, stability and resilience of the human gut microbiota. Nature 2012; 489: 220-30
  • 42 Segata N. Gut Microbiome: Westernization and the Disappearance of Intestinal Diversity. Curr Biol 2015; 25: R611-3
  • 43 Vangay P, Johnson AJ, Ward TL. et al. US Immigration Westernizes the Human Gut Microbiome. Cell 2018; 175: 962-972.e10