ÇOCUK VE ADÖLESANLARDA KAHVALTI GLİSEMİK İNDEKSİNİN METABOLİZMA VE DOYGUNLUK ÜZERİNE ETKİLERİ

Kahvaltı gün boyunca tüketilen ilk öğündür ve günlük önerilen toplam enerji, makro ve mikro besin ögelerinin alımına katkıda bulunmaktadır. Çocuklar ve adölesanlarda kahvaltı tüketimi birçok sağlık problemini önleyebilecek bir beslenme davranışı olarak tanımlanmaktadır. Ancak, çocukluk döneminden adölesan döneme geçtikçe kahvaltı tüketimi sıklığı azalmaktadır. Düzenli kahvaltı tüketimi gençlerde ağırlık kazanımı, besin ögesi yetersizlikleri ve kronik hastalık risk faktörlerini azaltabilen beslenme ve yaşam tarzı ile ilgili sağlık sonuçları ile ilişkilidir. Kahvaltı tüketimi ile sağlık arasında gözlenen ilişkilerin sadece tüketime bağlı olmadığı, hatta tüketimden ziyade kahvaltının kalitesiyle ilişkili olabileceği son dönemde üzerinde durulan bir konu haline gelmiştir. Bu nedenle, düşük glisemik indekse (Gİ) sahip karbonhidratları içeren tam tahıllı, posadan zengin ve düşük enerji yoğunluğu olan kahvaltılara kayda değer bir ilgi oluşmuştur. Gençlerle yapılan çalışmalarda, yüksek Gİ’li kahvaltı yerine düşük Gİ’li kahvaltının tercih edilmesinin postprandiyal glisemi ve insülinemiyi azaltarak artmış glisemik kontrol sağladığı, yağ oksidasyonunu iyileştirebildiği ve kısa dönem iştahı baskılayarak, sonraki öğünde besin alımını azaltabildiği gösterilmiştir. Düşük Gİ’li kahvaltı tüketimi, bu olumlu etkileri sayesinde özellikle fazla kilolu veya obez çocuk ve adölesanlar için yararlı olabilir. Bu derlemede, çocuk ve adölesanlarda kahvaltı Gİ’sindeki manipülasyonların glikoz, insülin, doygunluk ve yağ oksidasyonu üzerine etkilerinin incelenmesi amaçlanmıştır.

Anahtar Kelimeler:

adölesan, çocuk, doygunluk, glisemik indeks, metabolizma

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1. Tolfrey K, Zakrzewski JK. Breakfast, glycaemic index and health in young people. Journal of Sport and Health Science 2012; 1:149-59.
2. Rampersaud GC, Pereira MA, Girard BL, et al. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. Journal of the American Dietetic Association 2005; 105(5):743-60; quiz 61-2.
3. Szajewska H, Ruszczynski M. Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Critical Reviews in Food Science and Nutrition 2010; 50(2):113-9.
4. Hallstrom L, Vereecken CA, Labayen I, et al. Breakfast habits among European adolescents and their association with sociodemographic factors: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutrition 2012; 15(10):1879-89.
5. Lyerly JE, Huber LR, Warren-Findlow J, et al. Is breakfast skipping associated with physical activity among U.S. adolescents? A cross-sectional study of adolescents aged 12-19 years, National Health and Nutrition Examination Survey (NHANES). Public Health Nutrition 2014; 17(4):896-905.
6. Pekcan G, Karaağaoğlu N, Samur G. Türkiye’de okul çağı çocuklarında (6-10 yaş grubu) büyümenin izlenmesi (TOÇBİ) projesi araştırma raporu, Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü, Ankara, 2011.
7. Özcebe H, Bosı TB, Yardım N, ve ark. Türkiye çocukluk çağı (ilkokul 2. sınıf öğrencilerde) şişmanlık araştırması COSI-TUR 2016, Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Milli Eğitim Bakanlığı, Dünya Sağlık Örgütü Avrupa Bölge Ofisi, Yayın No: 1080, Ankara, 2017.
8. Timlin MT, Pereira MA, Story M, et al. Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens). Pediatrics 2008; 121(3):e638-45.
9. Chiarelli F, Marcovecchio ML. Insulin resistance and obesity in childhood. European Journal of Endocrinology 2008; 159 Suppl 1:S67-74.
10. Kesztyus D, Traub M, Lauer R, et al. Skipping breakfast is detrimental for primary school children: cross-sectional analysis of determinants for targeted prevention. BMC Public Health 2017; 17(1):258.
11. Silva F, Padez C, Sartorelli DS, et al. Cross-sectional study showed that breakfast consumption was associated with demographic, clinical and biochemical factors in children and adolescents. Acta Pediatrica 2018.
12. Lazarou C, Matalas AL. Breakfast intake is associated with nutritional status, Mediterranean diet adherence, serum iron and fasting glucose: the CYFamilies study. Public Health Nutrition 2015; 18(7):1308-16.
13. Barlow SE, Expert C. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007; 120 Suppl 4:S164-92.
14. Blondin SA, Anzman-Frasca S, Djang HC, et al. Breakfast consumption and adiposity among children and adolescents: an updated review of the literature. Pediatric Obesity 2016; 11(5):333-48.
15. Coulthard JD, Palla L, Pot GK. Breakfast consumption and nutrient intakes in 4-18-year-olds: UK National Diet and Nutrition Survey Rolling Programme (2008-2012). The British Journal of Nutrition 2017; 118(4):280-90.
16. Frieden TR, Dietz W, Collins J. Reducing childhood obesity through policy change: acting now to prevent obesity. Health Affairs 2010; 29(3):357-63.
17. Deshmukh-Taskar PR, Nicklas TA, O'Neil CE, et al. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999-2006. Journal of the American Dietetic Association 2010; 110(6):869-78.
18. Kosti RI, Panagiotakos DB, Zampelas A. Ready-to-eat cereals and the burden of obesity in the context of their nutritional contribution: are all ready-to-eat cereals equally healthy? A systematic review. Nutrition Research Reviews 2010; 23(2):314-22.
19. O'Neil CE, Byrd-Bredbenner C, Hayes D, et al. The role of breakfast in health: definition and criteria for a quality breakfast. Journal of the Academy of Nutrition and Dietetics 2014; 114(12 Suppl):S8-S26.
20. Atkinson FS, Foster-Powell K, Brand-Miller JC. International tables of glycemic index and glycemic load values: 2008. Diabetes Care 2008; 31(12):2281-3.
21. Zakrzewski JK, Stevenson EJ, Tolfrey K. Effect of breakfast glycemic index on metabolic responses during rest and exercise in overweight and non-overweight adolescent girls. European Journal of Clinical Nutrition 2012; 66(4):436-42.
22. Ludwig DS, Majzoub JA, Al-Zahrani A, et al. High glycemic index foods, overeating, and obesity. Pediatrics 1999; 103(3):E26.
23. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. Jama 2002; 287(18):2414-23.
24. Ball SD, Keller KR, Moyer-Mileur LJ, et al. Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescents. Pediatrics 2003; 111(3):488-94.
25. Song YJ, Sawamura M, Ikeda K, et al. Soluble dietary fibre improves insulin sensitivity by increasing muscle GLUT-4 content in stroke-prone spontaneously hypertensive rats. Clinical and Experimental Pharmacology & Physiology 2000; 27(1-2):41-5.
26. Cooper SB, Dring KJ, Morris JG, et al. Sex differences in adolescents glycaemic and insulinaemic responses to high and low glycaemic index breakfasts: a randomised control trial. The British Journal of Nutrition 2017; 117(4):541-7.
27. Kobayashi F, Ogata H, Omi N, et al. Effect of breakfast skipping on diurnal variation of energy metabolism and blood glucose. Obesity Research & Clinical Practice 2014; 8(3):e201-98.
28. Maki KC, Phillips-Eakley AK, Smith KN. The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. Advances in Nutrition 2016; 7(3):613S-21S.
29. Bauer LB, Reynolds LJ, Douglas SM, et al. A pilot study examining the effects of consuming a high-protein vs normal-protein breakfast on free-living glycemic control in overweight/obese 'breakfast skipping' adolescents. International Journal of Obesity 2015; 39(9):1421-4.
30. Rouhani MH, Kelishadi R, Hashemipour M, et al. The Impact of a Low Glycemic Index Diet on Inflammatory Markers and Serum Adiponectin Concentration in Adolescent Overweight and Obese Girls: A Randomized Clinical Trial. Hormone and Metabolic 2016; 48(4):251-6.
31. Clayton DJ, James LJ. The effect of breakfast on appetite regulation, energy balance and exercise performance. The Proceedings of the Nutrition Society 2016; 75(3):319-27.
32. Pereira MA, Erickson E, McKee P, et al. Breakfast frequency and quality may affect glycemia and appetite in adults and children. The Journal of Nutrition 2011; 141(1):163-8.
33. Warren JM, Henry CJ, Simonite V. Low glycemic index breakfasts and reduced food intake in preadolescent children. Pediatrics 2003; 112(5):e414.
34. Anderson GH, Woodend D. Effect of glycemic carbohydrates on short-term satiety and food intake. Nutrition Reviews 2003; 61(5 Pt 2):S17-26.
35. Ludwig DS. The glycemic index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002; 287:2414-23.
36. Fajcsak Z, Gabor A, Kovacs V, et al. The effects of 6-week low glycemic load diet based on low glycemic index foods in overweight/obese children--pilot study. Journal of the American College of Nutrition 2008; 27(1):12-21.
37. Brindal E, Baird D, Danthiir V, et al. Ingesting breakfast meals of different glycaemic load does not alter cognition and satiety in children. European Journal of Clinical Nutrition 2012; 66(10):1166-71.
38. LaCombe A, Ganji V. Influence of two breakfast meals differing in glycemic load on satiety, hunger, and energy intake in preschool children. Nutrition Journal 2010; 9:53.
39. Holloway GP, Bonen A, Spriet LL. Regulation of skeletal muscle mitochondrial fatty acid metabolism in lean and obese individuals. The American Journal of Clinical Nutrition 2009; 89(1):455S-62S.
40. Rogge MM. The role of impaired mitochondrial lipid oxidation in obesity. Biological Research for Nursing 2009; 10(4):356-73.
41. Gao R, Chilibeck PD. Glycemic Index Meal Feeding and Lipid Profiling. In: Patel V (eds), The Molecular Nutrition of Fats. Academic Press, London, United Kingtom 2019; pp 135-49.
42. Scazzina F, Del Rio D, Benini L, et al. The effect of breakfasts varying in glycemic index and glycemic load on dietary induced thermogenesis and respiratory quotient. Nutrition, Metabolism and Cardiovascular Diseases 2011; 21(2):121-5.
43. Baum JI, Gray M, Binns A. Breakfasts Higher in Protein Increase Postprandial Energy Expenditure, Increase Fat Oxidation, and Reduce Hunger in Overweight Children from 8 to 12 Years of Age. The Journal of Nutrition 2015; 145(10):2229-35.