Fette oder Kohlenhydrate in der Adipositastherapie?

Zusammenfassung

Die Adipositas ist ein wachsendes Problem der Industrieländer. Neben der Vererbung sind von Seiten der Umwelt der Überfluss an verarbeiteten Lebensmitteln und der Mangel an körperlicher Bewegung die wichtigsten kausalen Faktoren. Die Bedeutung des Fett- und Kohlenhydratverzehrs für die Therapie der Adipositas wird heftig diskutiert. Bei isoenergetischer Ernährung werden Fett und Kohlenhydrate mit gleicher Effizienz zur Deckung des Energiebedarfs verwendet. Bei Ad-libitum-Verzehr wird mit fettreicher Nahrung passiv mehr Energie aufgenommen, weil die Menschen dazu neigen, unabhängig von der Zusammensetzung der Nahrung immer die gleiche Menge aufzunehmen. Die Atkins-Diät nimmt für sich in Anspruch, wirksam Gewicht abzubauen, obwohl dabei fettreiche Nahrung unbeschränkt aufgenommen werden darf. Selbst wenn fettreiche Diäten in Studien über drei bis sechs Monate zu einem höheren Gewichtsverlust führen, zeigen doch Studien über 12 Monate, dass die fettreichen Diäten nicht überlegen sind. Im Gegensatz zu fettreichen haben fettmoderate Diäten gezeigt, dass sie über mehr als ein Jahr moderate Gewichtsverluste bewirken und das Risiko für Diabetes und wahrscheinlich auch für Herzinfarkt und bestimmte Krebsarten reduzieren.

Abstract

Obesity is an increasing problem in the industrialized countries. Besides genetic predisposition from the environment increasing abundance of refined food and insufficient physical activity are the most important causal factors. There is much debate on the importance of fat and carbohydrate intake in the therapy of obesity. Presuming isoenergetic diets carbohydrates and fat calories are used with the same efficiency to cover the energy needs. With high fat, energy dense ad libitum diets more calories are passively ingested then with high carbohydrate diets since people tend to consume a similar bulk of food regardless of its composition.The Atkins diet claims to be effective at producing weight loss despite ad libitum consumption of high fat food. Even if high fat diets produce higher weight losses over three to six months, the 12 months studies indicate that the high fat diets may be no better in the longer term. By contrast, moderate-fat diets have been shown to promote moderate weight loss over more than one year and to reduce the risk of diabetes and propably also of coronary heart disease and certain cancers.

Schlüsselwörter

Adipositastherapie - fettreiche Diäten - kohlenhydratreiche Diäten - Compliance - langfristige Ergebnisse

Key words

Obesity therapy - high fat diets - high carbohydrate diets - compliance - long-term results

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