درشت مغذی‌ها و پاسخ‌های التهابی پس از جذب غذا در سندرم متابولیک: مروری بر شواهد موجود

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی کارشناسی ارشد، کمیته‌ی تحقیقات دانشجویی، گروه تغذیه‌ی جامعه، دانشکده‌ی تغذیه و علوم غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، مرکز تحقیقات امنیت غذایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: افزایش سطح بیومارکرهای التهابی پس از جذب غذا، محرکی در جهت شروع و پیشروی فرایندهای التهابی سیستمیک در بیماری‌های مزمن می‌باشد. به نظر می‌رسد فرایندهای التهابی مستقل از سطح لیپیدهای خونی موجب افزایش خطر بیماری‌های قلبی‌ عروقی و سندرم متابولیک می‌گردند. ترکیب درشت مغذی‌های رژیم غذایی به عنوان یکی از مهم‌ترین عوامل تعیین کننده‌ی موفقیت در کنترل فرایندهای التهابی در سندرم متابولیک مطرح شده است. هدف از بررسی حاضر، مروری بر پژوهش‌های انجام شده در زمینه‌ی درشت مغذی‌ها و پاسخ‌های التهابی پس از جذب غذا در سندرم متابولیک بود.روش‌ها: برای این منظور از جستجو در PubMed/Medline بین سال‌های 1970 تا 2011 با کلید واژه‌های Macronutrient، High/low-carbohydrate، Fat، Protein meal، postprandial/acute Inflammation، Endothelial function، Metabolic syndrome و هر یک از بیومارکرهای التهابی استفاده شد. مطالعات حیوانی و انسانی که به صورت مقطعی، آینده‌نگر و کارآزمایی‌های بالینی انجام شده بودند، در این مطالعه وارد شدند.یافته‌ها: دریافت درشت مغذی‌ها به ویژه دریافت کربوهیدرات در وعده‌ی غذایی منجر به افزایش سطح شاخص‌های التهابی پس از جذب غذا در افراد سالم و بیماران می‌گردد. در این میان به نظر می‌رسد بیشترین شدت و پایداری اثر بر فرایندهای استرس اکسیداتیو و پاسخ التهابی پس از جذب در میان درشت مغذی‌ها به کربوهیدرات رژیم غذایی اختصاص داشته باشد. پس از کربوهیدرات‌ها، چربی‌ها نیز بیش از پروتئین منجر به القای پاسخ التهابی پس از جذب غذا می‌شوند. در بین انواع چربی‌ها، مصرف ω3 در دوز بالا و MUFA (Monounsaturated fatty acid) با کاهش سطح سرمی‌ بیومارکرهای التهابی و آدیپوسیتوکین‌های پس از مصرف غذا همراه بود.نتیجه‌گیری: به نظر می‌رسد از میان درشت مغذی‌های رژیم غذایی، کربوهیدرات بیشترین نقش را در پیشروی عوامل خطر سنتی سندرم متابولیک و فرایندهای التهابی پس از غذا ایفا می‌نماید. با این وجود انجام تحقیقات بیشتر و نیز تعدیل نقایص طراحی مطالعات موجود، مؤید نتایج نهایی خواهد بود.

کلیدواژه‌ها

عنوان مقاله [English]

Macronutrients and Postprandial Inflammation in the Metabolic Syndrome: Review of Current Evidence

نویسندگان [English]

  • Somayeh Rajaie 1
  • Ahmad Esmaillzadeh 2
1 MSc Student, Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Elevated postprandial inflammation accelerates the process of systemic inflammation involved in chronic diseases. It seems that inflammation promotes the risk of cardiovascular disease and metabolic syndrome (MetS) independent from the effect of blood lipids. Dietary macronutrient composition has been suggested as one of the most important determinants of inflammation in the MetS. This study aimed to review the current evidence on the effect of dietary macronutrients on postprandial inflammation in the MetS.Methods: We searched PubMed/Medline from 1970 until 2011 with macronutrient, high/low-carbohydrate,-fat,-protein meal, postprandial/acute inflammation, endothelial function, metabolic syndrome and individual inflammatory biomarkers as keywords. The cross-sectional and prospective studies as well as clinical trials were included in this investigation.Findings: Consumption of all dietary macronutrients, particularly dietary carbohydrates, was associated with elevated levels of postprandial inflammation in both healthy and unhealthy subjects. Carbohydrates have been consistently shown to induce postprandial inflammatory response as well as oxidative stress. Consumption of dietary fats has also been reported to result in increased levels of postprandial inflammation. However, the effects of dietary fats have been less than carbohydrates and more than dietary proteins. Of individual fatty acids, dietary intakes of MUFA (monounsaturated fatty acid) and high doses of ω3 fatty acids have been associated with reduced postprandial inflammation.Conclusion: Dietary intakes of carbohydrates, followed by dietary fats, are associated with elevated levels of postprandial inflammation. Further investigations are needed to confirm these conclusions. 

کلیدواژه‌ها [English]

  • Macronutrient
  • Carbohydrate
  • Fat
  • Protein
  • Inflammation
  • Metabolic Syndrome

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مجله دانشکده پزشکی اصفهان
دوره 29، شماره 164 - شماره پیاپی 164
آذر و دی 1390
صفحه 2142-2157

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  • تاریخ دریافت: 01 تیر 1390
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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