Besin Alımı ve Enerji Dengesi

Enerji alımının düzenlenmesinde, hipotalamus, gastrointestinal sistem, beyaz ve kahverengi yağ dokusu ile kaslar rol oynamaktadır. Enerji dengesinin sürdürülmesi karşılıklı olarak etkileşen karmaşık ve dinamik bir süreç ile sağlanmaktadır. Bazı genetik ve hormonal etmenler de insanın yeme davranışında etkilidir. Son yıllarda, sindirim sisteminden salgılanan peptid türündeki kolesistokinin (CCK), peptid YY (PYY), glukagon benzeri peptid- 1 (GLP-1) ve ghrelin gibi hormonların doygunluk sinyalleri oluşturduğu ve dolayısı ile bunların etkisi ile besin alımının denetlendiği bildirilmiştir. Bu nedenle potansiyel olarak obezitede görülen postprandiyal iştah hormon değişimlerinin, iştahı veya yeme davranışını değiştirdiği ile ilgili veriler net olmamakla birlikte şuana kadar peptidlerin vücut ağırlığı kaybında ve ağırlığın korunmasında etkili olup olmadığı bilinmemektedir.

Food Intake and Energy Regulation

In the regulation of energy intake, hypothalamus, gastrointestinal tract, white and brown adipose tissue and muscle play a role. Sustaining energy balance is provided by a complex and dynamic process. Some genetic and hormonal factors are effective in human eating behavior. In recent years, it has been reported that gastrointestinal (GI) peptide species, such as peptide YY (PYY), ghrelin, glucagon like peptide-1 (GLP-1) and cholecystokinin (CCK) occurs signals of satiety and these lead the control of food intake. Therefore, the data of that these hormones potential fluctuation have an effect on changes of eating behaviour or appetite is not clear in obesity. Besides, whether these peptides are effective in the protection and loss of body weight is still unknown.

PDF

___

1.Gosman GG, Katcher HI, Legro RS. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update 2006;12(5):585-601.
2.Baysal A. Beden ağırlığının denetimi. (Eds: Baysal A, Aksoy M, Besler HT, Bozkurt N, Keçecioğlu S, Kutluay Merdol T ve ark.). Diyet El Kitabı. 5. Baskı. Ankara: Hatipoğlu Basın ve Yayım San.Tic.Ltd. Şti, Ankara, 2011, s. 39-65.
3.Baysal A. Besin alımını etkileyen hormonal ve genetik faktörler:şişmanlık ilintisi. Beslenme ve Diyet Dergisi 2005.
4.Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest 2007;117(1):13-23.
5.Ünal F. İştahsız Çocuklara Klinik Yaklaşım. Güncel Pediatri 2011;9:79-84.
6.Arusoglu G KG. İştah kontrolüne genel bakış: iştah kontrolüne ilişkin teoriler. Türkiye Klinikleri J Pediatr Sci 2014;10(3):1-4.
7.Arusoglu G KG, Cinar N, Tapan S, Aksoy DY, Yıldız BO. Basal and meal-stimulated ghrelin, PYY, CCK levels and satiety in lean women with polycystic ovary syndrome: effect of low-dose oral contraceptive. J Clin Endocrinol and Metabolism Nov 2013;98(11):4475- 4482.
8.Gültekin H, Şahin, S., Budak, N. Beslenme Davranışı: Farmakolojik Hedef Moleküller. Erciyes Üniversitesi Sağlık Bilimleri Dergisi 2004 2008;13(1):77-87.
9.Degen L, Matzinger D, Drewe J, Beglinger C. The effect of cholecystokinin in controlling appetite and food intake in humans. Peptides 2001;22(8):1265-1269.
10.Kissileff HR, Carretta JC, Geliebter A, Pi-Sunyer FX. Cholecystokinin and stomach distension combine to reduce food intake in humans. Am J Physiol Regul Integr Comp Physiol 2003;285(5):R992-998.
11.Chaput J, Tremblay A. The glucostatic theory of appetite control and the risk of obesity and diabetes. Int J Obesity 2008;33(1):46-53.
12.Bray GA. Static theories in a dynamic world: a glucodynamic theory of food intake. Obes Res 1996;4(5):489-492.
13.Lopez M, Tovar S, Vazquez MJ, Williams LM, Dieguez C. Peripheral tissue-brain interactions in the regulation of food intake. Proc Nutr Soc 2007;66(1):131-155.
14.Levitsky DA. The control of food intake and the regulation of body weight in humans. Appetite and Food Intake: Behavioral and Physiological Considerations 2008:21-42.
15.Wren A, Bloom S. Gut hormones and appetite control. Gastroenterology 2007;132(6):2116-2130.
16.Woods SC. Gastrointestinal satiety signals I. An overview of gastrointestinal signals that influence food intake. Am J Physiol Gastrointest Liver Physiol 2004;286(1):G7-13.
17.Baskin DG, Figlewicz Lattemann D, Seeley RJ, Woods SC, Porte Jr D, Schwartz MW. Insulin and leptin: dual adiposity signals to the brain for the regulation of food intake and body weight. Brain Research 1999;848(1- 2):114-123.
18.Klein S CS, Alpers D. Alimentary Tract in Nutrition. 10th ed. Philadelphia, USA: LWW; 2006.
19.Schwartz GJ. Biology of eating behavior in obesity. Obes Res 2004;12 Suppl 2:102S-106S.
20.Orhan Y, Bozbora A. Obezite. Vol 1. İstanbul: İstanbul Medikal Yayıncılık Ltd.Şti.; 2008.
21.Huda M, Wilding J, Pinkney J. Gut peptides and the regulation of appetite. Obes Rev 2006;7(2):163-182.
22.Ballinger A, McLoughlin L, Medbak S, Clark M. Cholecystokinin is a satiety hormone in humans at physiological post-prandial plasma concentrations. Clin Sci (Lond) 1995;89(4):375-381.
23.Gibbs J, Young RC, Smith GP. Cholecystokinin decreases food intake in rats. J Comp Physiol Psychol 1973;84(3):488-495.
24.West DB, Greenwood MR, Sullivan AC, Prescod L, Marzullo LR, Triscari J. Infusion of cholecystokinin between meals into free-feeding rats fails to prolong the intermeal interval. Physiol Behav 1987;39(1):111-115.
25.Batterham RL, Heffron H, Kapoor S, Chivers JE, Chandarana K, Herzog H, et al. Critical role for peptide YY in protein-mediated satiation and body-weight regulation. Cell Metab 2006;4(3):223-233.
26.Adrian TE, Ferri GL, Bacarese-Hamilton AJ, Fuessl HS, Polak JM, Bloom SR. Human distribution and release of a putative new gut hormone, peptide YY. Gastroenterology 1985;89(5):1070-1077.
27.Imamura M. Effects of surgical manipulation of the intestine on peptide YY and its physiology. Peptides 2002;23(2):403-407.
28.Stanley S, Wynne K, McGowan B, Bloom S. Hormonal regulation of food intake. Physiol Rev 2005;85(4):1131- 1158.
29.Kojima M. HH. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 1999;402:656- 660.
30.Dabak ÖD KT. Ghrelin ve Metabolik Etkileri. Doğu Anadolu Bölgesi Araştırmaları. 2008.
31.Sachs G, Zeng N, Prinz C. Physiology of isolated gastric endocrine cells. Annu Rev Physiol 1997;59:234-256.
32.Muccioli G, Tschöp M, Papotti M, Deghenghi R, Heiman M, Ghigo E. Neuroendocrine and peripheral activities of ghrelin: implications in metabolism and obesity. Eur J Pharmacol 2002;440(2-3):235-254.
33.Burton-Freeman B, Davis PA, Schneeman BO. Plasma cholecystokinin is associated with subjective measures of satiety in women. Am J Clin Nutr 2002;76(3):659- 667.
34.Gaytan F, Barreiro ML, Chopin LK, Herington AC, Morales C, Pinilla L, et al. Immunolocalization of ghrelin and its functional receptor, the type 1a growth hormone secretagogue receptor, in the cyclic human ovary. J Clin Endocrinol and Metabolism 2003;88(2):879.
35.Nakazato M1, Murakami N, Date Y, Kojima M, Matsuo H, Kangawa K, Matsukura S. A role for ghrelin in the central regulation of feeding. Nature 2001;409(6817):194-198.
36.Harmancı A, Yıldız BO. Polikistik Over Sendromu: Patogenez ve Metabolik Değişiklikler. Türkiye Klinikleri J Endocrin Special Topics 2011;4(1):24-34.
37.Purnell J, Cummings D, Weigle D. Changes in 24-h area-under-the-curve ghrelin values following diet- induced weight loss are associated with loss of fat-free mass, but not with changes in fat mass, insulin levels or insulin sensitivity. Int J of Obes 2006;31(2):385-389.
38.Leidy H, Williams N. Meal energy content is related to features of meal-related ghrelin profiles across a typical day of eating in non-obese premenopausal women. Horm Metab Res 2006;38(5):317-322.