31.05.2013 Views

Dieta, regole igieniche e salute - PikiWiki

Dieta, regole igieniche e salute - PikiWiki

Dieta, regole igieniche e salute - PikiWiki

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

73<br />

Una malattia attribuita all’iperinsulinemia, che si va diffondendo a macchia d’olio nei Paesi<br />

Occidentali,è la c.d. Sindrome Metabolica.(4, )<br />

Quando si può parlare di Sindrome Metabolica? Esistono definizioni diverse secondo il National<br />

Cholesterol Program o l’Organizzazione mondiale della Sanità ), che sono indicate nella Tabella<br />

che segue (5,6,7,8)<br />

Tab. 30. Definizioni di Sindrome Metabolica<br />

sec. Nation. Cholesterol Program(5) sec. Organizz: Mondiale Sanità (6,7)<br />

*Obesità centrale<br />

Circonferenza vita uomini > 102 cm. Rapp.vita/fianchi > 0,90<br />

Donne > 88 cm. > 0,85<br />

* Indice Massa Corp. > 30 kg/m2<br />

• Colesterolo HDL uomini < 40 mg/dl < 35 mg/dl<br />

• Donne < 50 “ < 39 mg/dl<br />

• Trigliceridi >= 150 “ >= 150 mg/dl<br />

• Pressione Arteriosa >= 130/80 mmHg >= 140/90 mmHg<br />

• Glicemia a digiuno >= 110 mg/dl<br />

• Microalbuminuria Tasso giornaliero escrezione urinaria albumina > 20 microg/m<br />

Rapporto albumina-creatinina >=30 mg/g<br />

Il trattamento e la prevenzione dell’iperinsulinemia si basa su 2 elementi: una dieta povera di<br />

calorie, di carboidrati raffinati cioè ad alto indice glicemico (zucchero, dolci, ecc., vedi Cap IV)<br />

) e la loro sostituzione con cereali integrali, verdura, frutta.<br />

Occorre inoltre incrementare l’attività fisica giornaliera, che aumenta la sensibilità all’insulina<br />

migliorando l’insulinoresistenza, dovuta forse nell’obeso, oltre che al meccanismo sopra descritto,<br />

ad una anomalia biochimica primaria della cellule stesse nelle forme più gravi ed avanzate.(9,10).<br />

Bibliografia.<br />

1) DeFronzo RA et al. Insuline resistance. A multifaceted syndrome responsible for NIDDM,<br />

obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care<br />

1991; 14: 173.<br />

2) Groop L et al. The dysmetabolic syndrome. J Intern Med 2001; 250: 105.<br />

3) Ford ES. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the<br />

metabolic syndrome: a summary of the evidence. Diabetes Care 2005; 28 (7): 1769-78<br />

4) Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. Diabetes, 1988;<br />

37 (12); 1595-607.<br />

5) Executive summary of the third report of the National Cholesterol Education Program. Expert<br />

panel of detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment<br />

Panel III. JAMA 2001; 285 (19): 2486-97<br />

6) Grundy SM et al. Diagnosis and management of the metabolic syndrome:an American Heart<br />

Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation 2005; 112:<br />

2735.<br />

7) Alberti KG et al. Definition, diagnosis and classification of diabetes mellitus and its<br />

complications. Part 1: diagnosis and classification of diabetes diabetes mellitus provisional report<br />

of a WHO consultation. Diabet Med 1998; 15: 539.<br />

8) Alberti KG et al. Metabolic syndrome- a new world-wide definition: A Consensus Statement<br />

from the International Diabet Med 2006; 23: 469.<br />

9) Katzmarzyk PT et al. Cardiorespiratory fitness attenuates the effects of the metabolic sindrome<br />

on all-cause and cardiovascular disease mortalità in men. Arch. Intern. Med. 2004;164 (10): 1092.<br />

10) Ekelund U. et al. Physical activity energy expenditure predicts progression toward the<br />

metabolic sindrome indipendently of aerobic fitness in middle-aged healthy Caucasians: The<br />

Medical Research Council Ely Study. Diabetes Care 2005; 28 (5): 1195.

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!