Obezitenin önlenmesi ve tedavisinde diyet fitokimyasallarının olası rolleri

Obezite, aşırı ve anormal yağ birikimi ile karakterize olan ve sağlığı olumsuz etkileyen kronik metabolik bir bozukluk olarak tanımlanmaktadır. Son yıllarda tüm dünyada artış gösteren obezite, tip 2 diyabet, kalp hastalıkları, hipertansiyon ve çeşitli kanser türleri gibi metabolik ve kronik hastalıklarla ilişkilendirildiğinden sağlık hizmetleri için büyük bir yük oluşturmaktadır. Diyet ve fiziksel aktivite başta olmak üzere yaşam tarzı ve davranış değişikliği müdahaleleri, obezitenin önlenmesi ve tedavisi için hala önemli köşe taşlarıdır. Bunların yanında, bitkisel ürünlerin obezite tedavisini destekleyici potansiyelleri de son yıllarda büyük ilgi görmektedir. Fitokimyasallar, doğal olarak meyveler, sebzeler, tahıllar ve diğer bitkisel ürünlerde bulunan ve genellikle bitkilerin renk, tat ve koku gibi organoleptik özelliklerinden sorumlu olan biyoaktif bileşenlerdir. Diyetle alınan bu biyoaktif besin bileşenlerinin, antioksidan, hipolipidemik, hipotansif, antiaterojenik, antidiyabetik, hepatoprotektif, nöroprotektif, antikanser ve anti-inflamatuar özellikler göstererek sağlığı geliştirici etkilere sahip oldukları bilinmektedir. Obezite ve ilişkili komplikasyonların önlenmesi ve tedavisinde potansiyel faydaları en çok dikkat çeken ve sıklıkla çalışılan diyet fitokimyasalları arasında polifenoller, terpenoidler, organosülfürler ve fitosteroller yer almaktadır. Son dönemde yapılan çalışmalar antioksidan ve anti-inflamatuar aktivite gösteren biyoaktif bileşenlerin termogenez ve total enerji harcamasını arttırarak, oksidatif stres ve inflamasyonu azaltarak ağırlık kaybını destekleyebildiğini göstermektedir. Buna ek olarak, fitokimyasalların, adipogenez üzerindeki rolleri dahil olmak üzere obezite ile ilgili fizyolojik ve moleküler yolakları düzenleyebildiği de bildirilmektedir. Bu derlemede in vitro, in vivo ve epidemiyolojik çalışmalardan elde edilen kanıtlar çerçevesinde, diyet fitokimyasallarının adipoz doku gelişimi ve preadipozit farklılaşmasını baskılayabilme, mevcut adipozitlerin apoptozunu indükleyebilme, lipolizi uyarabilme ve böylece yağ dokusunu azaltabilme; iştahı baskılayarak ve enerji alımını azaltarak ağırlık yönetimini destekleyebilme potansiyelleri tartışılmıştır.

The potential roles of dietary phytochemicals in the prevention and treatment of obesity

Obesity is defined as a chronic metabolic disorder in which excessive and abnormal fat accumulation that negatively affects health. Obesity is one of major burdens to health services due to its increasing worldwide prevalence in the recent years and associations with metabolic and chronic diseases such as type 2 diabetes, heart diseases, hypertension and various types of cancer. Lifestyle and behavior modification interventions, especially the modification of diet and physical activity level, are still important cornerstones for the prevention and treatment of obesity. In addition to lifestyle modifications, the potential of plant based products in obesity management has gained great attention in recent years. Phytochemicals are bioactive components naturally found in fruits, vegetables, cereals, and other plant based products, and generally responsible for the organoleptic properties of plants, such as color, taste and smell. It is known that dietary bioactive components have antioxidant, hypolipidemic, hypotensive, antiatherogenic, antidiabetic, hepatoprotective, neuroprotective, anticancer and anti-inflammatory properties that promote health. Dietary phytochemicals with potential benefits in the prevention and treatment of obesity and related complications include polyphenols, terpenoids, organosulfurs, and phytosterols. Recent studies show that bioactive components with antioxidant and antiinflammatory activity can support weight loss by increasing thermogenesis and total energy expenditure and reducing oxidative stress and inflammation. In addition, it is reported that phytochemicals can regulate physiological and molecular pathways involved in obesity, including their role in adipogenesis. In this review, the potential roles of dietary phytochemicals in the suppression of adipose tissue development and preadipocyte differentiation, induction of apoptosis of present adipocytes and stimulation of lipolysis, thereby, reduction of body fat mass; and also in suppression of appetite and reduction of dietary energy intake, and hence management of body weight were discussed within the framework of the evidence obtained from in vitro, in vivo and epidemiological studies.

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