科研之友
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摘要
Obesity affects approximately 20 % of the German population. It is closely associated with type 2 diabetes mellitus, which represents more than 90 % of diabetes cases in the Western world and which affects about one-third of overweight individuals. Genetic, nutritional, and other lifestyle factors are discussed as causal variables. The purpose of this article is to discuss which nutritional concepts are meaningful and the relevance of multimodal programs for the therapy of obesity and type 2 diabetes. The work is based on selective literature search in PubMed and other databases as well as on existing guidelines. The dietetic concepts recommended in obesity and type 2 diabetes are not really different: in both cases, the primary goal is normalization or at least reduction of body weight. Energy intake is adapted only by regulation of nutrition, which requires modification of behavior via validated multimodal programs and which becomes more effective by using initial supporting actions (e.g., low caloric formula diet or gastric balloon, gastric banding, or gastric bypass techniques). In addition, diet habits like high sugar intake and fiber-poor diets should be avoided, because they favor the development of glucose intolerance, insulin resistance, and finally diabetes. In addition to weight reduction therapy, dietetic concepts are needed for prevention and weight maintenance, which aim to prevent weight (re-)gain and the development of obesity-associated diseases. This can be achieved by a low sugar, high fiber diet with mono-unsaturated fatty acids, such as the Mediterranean diet. By using the evidence-based dietetic regimen, in particular if embedded in multimodal programs and initial usage of formula diet, obesity and type 2 diabetes can be effectively treated. Sustained weight maintenance requires other dietetic concepts than those required for weight reduction.
- 出版日期2015-9
