Sürdürülebilir Beslenme ve Beslenme Örüntüsü: Bitkisel Kaynaklı Beslenme

Sürdürülebilir beslenme yeni bir kavram olmamasına karşın, dünya nüfusunda artış projeksiyonları ve iklim değişikliği konularına artan ilgi sonucunda günümüzde daha fazla dikkat çeker duruma gelmiştir. Gıda Tarım Örgütü (FAO) ve Dünya Sağlık Örgütü (WHO) sürdürülebilir sağlıklı diyeti “Sürdürülebilir diyetler çevresel etkisi düşük olan, besin ve beslenme güvencesini ve günümüz ve gelecek nesiller için sağlıklı yaşamı destekleyen diyetlerdir” diye tanımlamaktadır. Sürdürülebilir diyetler insan ve doğal kaynakları optimize ederken; biyoçeşitliliğe ve ekosisteme saygılı ve koruyucu, kültürel olarak kabul gören, erişilebilir, ekonomik olarak uygun ve karşılanabilir, beslenme açısından yeterli, güvenilir ve sağlıklı diyetlerdir. Besin üretimi ve tüketimi çevresel bozulmanın temel etmenleri arasındadır. Günümüzde küresel besin sisteminin sürdürülebilir olmadığı dikkati çekmektedir. Küresel olarak üretilen besinlerin üçte biri israf edilmekte veya kayba uğramaktadır. Optimal ve sürdürülebilir sağlık yaşam döngüsü sürecinde sürdürülebilir beslenme örüntüsü ile olasıdır. Bunun da bitkisel kaynaklı beslenme ile olasılığı rapor edilmektedir. Diyetisyenlerin mesleki eğitim ve öğretim programında sürdürülebilir beslenme, sürdürülebilir sağlık ve sürdürülebilir çevre yaklaşımları yer almalı, diyetisyenler varlıklarını görünür kılmalı, becerilerini pekiştirmeli ve sürdürülebilirlik okuryazarı ve savunucusu olmalıdır.

Sustainable Diets and Dietary Pattern: Plant-Based Nutrition

The concept of sustainable diets, although not new, is gaining increased attention across the globe, especially in relation to projected population growth and growing concerns about climate change. As defined by the FAO “Sustainable diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations”. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy, while optimizing natural and human resources. Food production and consumption are among the main drivers of environmental degradation. Globally, a third of the food produced is lost or wasted. Optimal (healthy) nutrition is possible with a sustainable dietary pattern. It is reported that it could only be sustained by plant-based diets. In the professional educational curricula of the dietitian, sustainable nutrition, sustainable health and sustainable environment approaches should include and dietitians need to amplify their visibility, consolidate their skills and become more sustainability literate and advocates.

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1. FAO/WHO. Sustainable healthy diets – Guiding principles. Rome, 2019.
2. United Nations World Commission on Environment and Development, ed. Report of the World Commission on Environment and Development: Our Common Future. Oxford: Oxford University Press, 1987.
3. Dernini S, Berry EM, Serra-Majem L, La Vecchia C, Capone R, Medina FX, et al., on behalf of the Scientific Committee of the International Foundation of Mediterranean Diet. Med Diet 4.0: The sustainable Mediterranean diet with four benefits. PHN. 2017;20:7:1322-30.
4. Burlingame B, Dernini S. Sustainable diets and biodiversity. FAO, 2012.
5. Alexandratos N, Bruinsma J. World Agriculture Towards 2030/2050: The 2012 Revision. ESA Working Paper no. 12-03. Rome: FAO, 2012.
6. Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, et al. Food in the Anthropocene: the EAT– Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393:447-92.
7. Vermeulen SJ, Campbell BM, Ingram JSI. Climate change and food systems. Annu Rev Environ Resour. 2012; 37:195-222.
8. Foley JA1, Defries R, Asner GP, Barford C, Bonan G, Carpenter SR, et al. Global consequences of land use. Science. 2005;309:570-74.
9. Food and Agriculture Organization of the UN, International Fund for Agricultural Development, UNICEF, World Food Programme, WHO. The state of food security and nutrition in the world. Rome: Food and Agriculture Organization of the UN, 2018.
10. UN. Sustainable Development Goals. Available at: https://sustainable development.un.org/?menu=1300 Accessed September 13, 2017.
11. UNICEF, WHO, World Bank. Levels and trends in child malnutrition: joint child malnutrition estimates. Washington, DC: World Health Organization, 2018.
12. WHO. Global report on diabetes. Geneva: World Health Organization, 2016.
13. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513-30.
14. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393:1958-72.
15. Renzella J, Townsend N, Jewell J, Breda J, Roberts N, Rayner M, et al. What national and subnational interventions and policies based on Mediterranean and Nordic diets are recommended or implemented in the WHO European Region, and is there evidence of effectiveness in reducing noncommunicable diseases? Copenhagen: WHO Regional Office for Europe; 2018. Health Evidence Network (HEN) Synthesis Report No.:58
16. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al.; Mediterranean Diet Foundation Expert Group. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14(12A):2274-84.
17. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and metaanalysis. Am J Clin Nutr. 2010;92(5):1189-96.
18. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337:a1344.
19. Schwingshackl L, Hoffmann G. Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies. Cancer Med. 2015;4(12):1933–47.
20. Gonzalez CA, Riboli E. Diet and cancer prevention: contributions from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Eur J Cancer. 2010;46(14):2555–62.
21. Singh B, Parsaik AK, Mielke MM, Erwin PJ, Knopman DS, Petersen RC, et al. Association of Mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014;39(2):271-82.
22. Alcalay RN, Gu Y, Mejia-Santana H, Cote L, Marder KS, Scarmeas N. The association between Mediterranean diet adherence and Parkinson’s disease. Mov Disord. 2012;27(6):771-4.
23. Grosso G, Mistretta A, Frigiola A, Gruttadauria S, Biondi A, Basile F, et al. Mediterranean diet and cardiovascular risk factors: a systematic review. Crit Rev Food Sci Nutr. 2014;54(5):593-610.
24. Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.
25. Tong TYN, Wareham NJ, Khaw KT, Imamura F, Forouhi NG. Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC–Norfolk study. BMC Med. 2016;14(1):135.
26. Salas-Salvadó J, Bulló M, Babio N, Martínez-González MÁ, Ibarrola-Jurado N, Basora J, et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet. Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011;34(1):14-9.
27. García-Fernández E, Rico-Cabanas L, Rosgaard N, Estruch R, Bach-Faig A. Mediterranean diet and cardiodiabesity: a review. Nutrients. 2014;6(9):3474.
28. Esposito K, Maiorino MI, Ceriello A, Giugliano D. Prevention and control of type 2 diabetes by Mediterranean diet: a systematic review. Diabetes Res Clin Pract. 2010;89(2):97-102.
29. Esposito K, Maiorino MI, Ciotola M, Di Palo C, Scognamiglio P, Gicchino M. et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann Intern Med. 2009;151(5):306-14.
30. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229-41.
31. Mithril C, Dragsted LO, Meyer C, Blauert E, Holt MK, Astrup A. Guidelines for the New Nordic Diet. Public Health Nutr. 2012;15(10):1941-7.
32. Kanerva N, Kaartinen NE, Rissanen H, Knekt P, Eriksson JG, Saaksjarvi K, et al. Associations of the Baltic Sea diet with cardiometabolic risk factors: a meta-analysis of three Finnish studies. Br J Nutr. 2014;112(4):616-26.
33. Kanerva N, Kaartinen NE, Schwab U, Lahti-Koski M, Männistö S. The Baltic Sea Diet Score: a tool for assessing healthy eating in Nordic countries. Public Health Nutr. 2014;17(8):1697-705.
34. Kanerva N, Rissanen H, Knekt P, Havulinna AS, Eriksson JG, Männistö S. The healthy Nordic diet and incidence of type 2 diabetes: 10-year follow-up. Diabetes Res Clin Pract. 2014;106(2):e34-7.
35. Uusitupa M, Hermansen K, Savolainen MJ, Schwab U, Kolehmainen M, Brader L, et al. Effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile and inflammation markers in metabolic syndrome: a randomized study (SYSDIET). J Intern Med. 2013;274(1):52-66.
36. Brader L, Uusitupa M, Dragsted LO, Hermansen K. Effects of an isocaloric healthy Nordic diet on ambulatory blood pressure in metabolic syndrome: a randomized SYSDIET substudy. Eur J Clin Nutr. 2014;68(1):57-63.
37. Adamsson V, Reumark A, Fredriksson IB, Hammarström E, Vessby B, JohanssonG, et al. Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET). J Intern Med. 2011;269(2):150-9.
38. Lacoppidan SA, Kyrø C, Loft S, Helnæs A, Christensen J, Hansen CP, et al. Adherence to a healthy Nordic food index is associated with a lower risk of type-2 diabetes: the Danish Diet, Cancer and Health Cohort Study. Nutrients. 2015;7(10):8633-44.
39. Poulsen SK, Due A, Jordy AB, Kiens B, Stark KD, Stender S, et al. Health effect of the New Nordic Diet in adults with increased waist circumference: a 6-mo randomized controlled trial. Am J Clin Nutr. 2014;99(1):35-45.
40. Rockström J, Gaffney O, Rogelj J, Meinshausen M, Nakicenovic N, Schellnhuber HJ. A roadmap for rapid decarbonization. Science. 2017;355:1269-71.
41. Katz DL, Meller S. Can we say what diet is best for health? Annu. Rev. Public Health 2014;35:83-103.
42. Hirvonen K, Bai Y, Headey D, Masters WA. Affordability of the EAT–Lancet reference diet: a global analysis. Lancet Glob Health. 2019; 1-8.
43. Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K,et al. Food groups and risk of allcause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2017;105:1462-73.
44. Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, et al. Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2019;59:7:1071-90.
45. Schwingshackl L, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Schwedhelm C, et al. Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol. 2017;32:363-75.
46. Schwingshackl L, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, Andriolo V, et al. Food groups and risk of hypertension: A systematic review and dose-response meta-analysis of prospective studies. Adv Nutr. 2017;8:793–803.
47. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359-E86.
48. Schwingshackl L, Schwedhelm C, Hoffmann G, Kn€uppel S, Preterre AL, Iqbal K, et al. Food groups and risk of colorectal cancer. Int J Cancer. 2018;142:1748-58.
49. EFAD (The European Federation of the Associations of Dietitians). Sustainable Health Through the Life Span. 2019.
50. Pettinger C. Sustainable eating: Opportunities for nutrition professionals. Nutr Bull. 2018;43:226-37.