What is the Circadian Rhythm?

Biological rhythms are defined as the biochemical, physiological and behavioral responses of living things to physical effects in the outside world. One of these biological rhythms is called the circadian rhythm.

The circadian rhythm is a biological cycle that takes about 24 hours and includes changes in sleep and wakefulness. In general, a healthy adult person completes 24 hours with 16 hours of wakefulness and 8 hours of sleep. In addition, the circadian rhythm is responsible for the performance of the heart, growth hormone, neurotransmitter secretion, and secretion of various hormones such as cortisol.

Disruption of circadian rhythm, which affects many hormones and therefore the system, can trigger diseases such as obesity, diabetes, heart diseases and hypertension.

Circadian Rhythm and Nutrition:

Circadian rhythm and nutrition affect each other. Especially for individuals working in shifts, both sleep and feeding times can disrupt the circadian rhythm. Disruption of the rhythm leads to changes in the appetite mechanism together with the decrease in the amount of sleep. As a result, an increase in body fat mass can be observed in these individuals with the wrong energy taken at the wrong time. According to a study, how poor quality and insufficient sleep affects nutrition is summarized as follows:

• • Increased consumption of food and snacks
• • Less consumption of vegetables and fruits
• • Irregular meal times
• • Skipping breakfast

Suggestions for Maintaining the Circadian Rhythm:

• • It is necessary to have a sufficient and balanced diet, to arrange the meal times and contents.

• • Light emitted from electronic items affects the circadian rhythm. Therefore, make sure that there are no electronic items in the room.
• • Stress should be avoided in daily life.
• • Foods with high energy content such as chocolate should not be consumed in the evening.
• • Individuals experiencing jet-lag should be fed according to the hours of the region they are in and should pay attention to the consumption of plenty of fluids to prevent dehydration. In addition, beverages containing caffeine and alcohol should be avoided during the trip.
• • Digestive system problems can be seen in shift workers. For this reason, it is recommended to consume fibrous food, fresh fruit and vegetables, whole wheat instead of white bread, bulgur instead of rice.

Factors Affecting Circadian Rhythm:

Light: The light emitted from electronic equipment disrupts the circadian rhythm.

Melatonin: The release of melatonin, known as the sleep hormone, begins at 21:00-22:00 and reaches its peak at 02:00-03:00 at night, and it is necessary to be asleep during this time.

Temperature: As the organism is adversely affected by high temperature, the circadian rhythm is disrupted.

Jetlag: Time difference affects metabolism negatively.

Shift working hours: The person is awake when he should be asleep, and this leads to disruption of the rhythm.

The most important difference of the swallowable gastric balloon is that it can be inserted without endoscopy and anesthesia. The balloon is in the shape of a pill attached to a thin tube. The position of the swallowed balloon with the help of water is controlled by the doctor with the help of X-rays. After making sure that it is well placed, the balloon is filled with a special liquid with the help of a catheter, and the catheter is slowly withdrawn. The entire procedure takes 15 minutes. The balloon remains in the stomach for 4 to 6 months and then is eliminated from the body by itself. Thanks to the swallowable gastric balloon, there is less feeling of fullness because less food is eaten, and so weight is lost.

For whom can the swallowable gastric balloon be used?

• Body mass index over 27
• between the ages of 18 and 65
• who have been on a diet before but were not successful are not pregnant
• No excessive alcohol consumption

What should be the diet after the application of a swallowable gastric balloon?

After the administration of the swallowable gastric balloon, only liquid should be consumed for 3 days. After that, a slow transition to semi-solid food should be made. After an average of 2 weeks, a complete transition to solid food is possible.

• The food portions should be reduced.
• Food should be consumed in the form of small bites.
• Liquid intake should be done between meals.
• Fatty foods should not be consumed.

DIABETES (DIABETES MELLITUS)

DEFINITION:

Diabetes mellitus is a disease characterized by carbohydrate, protein and fat metabolism disorders that occur as a result of insufficiency or deficiency of insulin hormone secreted from the pancreas. It is chronic and progressive. It is a disease that requires lifelong medical treatment and medical nutrition therapy for the individual. Treatment is as important as diagnosis.

CLASSIFICATION:

• Type 1 DM: It arises with insulin deficiency as a result of damage to pancreatic cells and is an insulin-dependent progressive type.
• Type 2 DM: It is a non-insulin dependent type characterized by insulin resistance.
• Gestational Diabetes: It is the type of diabetes that occurs during pregnancy. Diagnosis can be made at 24 to 28 weeks.
• Other Specific Types: Includes certain genetic syndromes, exocrine pancreatic diseases, endocrinopathies, drug- or chemical-associated diabetes.

CLINICAL FINDINGS:

• GLYCOSURIA (excretion of glucose in the urine as a result of hyperglycemia)
• POLYURIA (increased water output with urine)
• POLYDIPSY (constant desire to drink water as a result of water loss)
• POLYPHAGIA (increased feeling of hunger)
• TIREDNESS
• LATE HEALING OF SKIN WOUNDS
• Frequent Infection
• BLURRED VISION

COMPLICATIONS:

When the necessary treatment principles are not applied in diabetic patients, blood sugar remains high and may cause complications. For this reason, individuals with diabetes should not neglect their controls.

Diabetic ketoacidosis: Due to insulin deficiency, carbohydrates cannot be used enough and the body starts to provide energy from fats. As a result, ketones appear in the blood and urine. Infection, insufficient insulin therapy, excessive carbohydrate intake, eating disorders are among the causes of diabetic ketoacidosis.

Diabetic Nonketotic Hyperosmolar Coma: Diabetes is characterized by hyperglycemia (plasma glucose>500 mg/dL), dehydration without ketoacidosis.

Hypoglycemia: It is characterized by plasma glucose being 50 mg/dL and below. Tremors, palpitations, weakness, sleepiness, and speech difficulties are among the symptoms. Hypoglycemia may be caused by skipping meals, failure to administer medical treatment or dose errors, and heavy exercise.

Nephropathy, Retinopathy, Neuropathy, Gastroparesis, Constipation, Atherosclerosis, Diabetic foot

DIAGNOSTIC CRITERIA:

Diabetes diagnosis criteria for the American Diagnostic Society (ADA) and the World Health Organization (WHO) are as follows:

– Fasting blood glucose level ≥126 mg/dL, or

– 2nd hour blood glucose level ≥200 mg/dL in the oral blood glucose tolerance test (OGTT), or

– Random blood glucose level ≥200 mg/dL and the presence of classic symptoms of diabetes (polyuria, polydipsia, nocturia, enuresis, weight loss, polyphagia), or

-HbA1c> 6.5%

TREATMENT:

Insulin therapy, nutrition and exercise are a combination for diabetes treatment. Treatment should aim to reduce chronic complications by providing optimal glycemic control. Studies show that correct and adequate administration of insulin therapy reduces the risk of cardiovascular complications.

To reduce the risk of complications arising from diabetes, smoking should be avoided and blood pressure and cholesterol levels should be kept within appropriate ranges.

Nutrition programs of diabetic patients should be specially planned by the dietitian. The person’s height, weight, blood parameters, drugs used are important data for the program prepared.

SUGGESTIONS:

• Complex carbohydrates, which take longer to digest, should be preferred instead of simple carbohydrates.
• Nutrition program should be sustainable for life and should be made into a lifestyle.
• It should be known that the consumption of legumes, vegetables, fruits, whole grain bread is important.
• Saturated fat consumption should be avoided and healthy fats such as olive oil and butter should be consumed.
• Pastry, fried food, packaged foods should not be preferred.
• Water consumption should not be neglected during the day, care should be taken to consume an average of 2-2.5 liters of water per day.
• Exercise is as important as nutrition and medication.
• Nutrition program should include the number of meals as the patient needs, and if there is no opposite, it should be aimed at maintaining the ideal weight.
• Fiber slows down the absorption of carbohydrates, so foods high in fiber are important to keep sugar levels under control.
• Avoid foods with high glycemic index.
• Consumed foods should be grilled, baked or boiled.
• Omg-3 intake is important, so fish consumption is recommended 2 days a week.
• Fat, sugar and salt should be consumed as little as possible.
• Insomnia and stress make it difficult to comply with the diet and can lead to weight gain.