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Zum Inhaltsverzeichnis 06/2007
Naturheilpraxis 06/2007
Von Nicolai Worm
Mit dem Anstieg der Prävalenz von Übergewicht und Fettsucht in den industrialisierten Ländern steigt auch die Prävalenz des metabolischen Syndroms (MetS). Als zentrale Komponenten hierfür gelten die viszerale (zentrale) Adipositas, die gestörte Glukosetoleranz, atherogene Dyslipidämie (Hypertriglyzeridämie), erniedrigtes HDL-Cholesterin, kleine dichte LDL-Partikel (bei “normal” hoher LDL-Cholesterinkonzentration) und erhöhter Blutdruck. Diese Symptome bzw. Krankheiten treten deutlich häufiger gemeinsam auf, als es der Zufallserwartung entspricht. Das gilt für alle Altersklassen und für beide Geschlechter (1).
Als wesentliche zugrunde liegende Störung gilt die Insulinresistenz (2). Das relative Risiko für tödliche und nicht-kardiovaskuläre Ereignisse ist beim MetS auch ohne Diabetesmanifestation schon um etwa das zweifache erhöht (3). Nach den 2005 definierten Kriterien der International Diabetes Federation (IDF) kann man davon ausgehen, dass gegenwärtig etwa 30-40% der Westeuropäer davon betroffen sind (1).
Mit dem MetS sind neben den erwähnten Herzkreislauferkrankungen und als direkte Folge Typ 2-Diabetes mellitus (T2DM) noch eine Reihe weiterer Krankheiten, wie die nicht-alkoholische Fettleber, das Polyzystische Ovarsyndrom und verschiedene Krebsformen assoziiert (2). Vor diesem Hintergrund wird deutlich, welch große gesundheitliche und gesellschaftliche Bedeutung der Prävention und Therapie dieser Störungen zukommt.
Entsprechend ist das Ziel des präventiven und therapeutischen Handelns eine Änderung des Lebensstils. Hierzu wurden von Fachgremien konkrete Empfehlungen zur Lebensstil-Änderung abgegeben, die primär auf eine dauerhafte Erhöhung der Bewegungsaktivität und auf die dauerhafte Beseitigung des Übergewichts zielen. Darüber hinaus stellt man die Behandlung der assoziierten Risikofaktoren, vor allem der Hyperglykämie, der Dyslipoproteinämie und der Hypertonie ins Zentrum therapeutischen Handelns (4).
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1 http://www.joslin.org/Files/Nutrition_ClinGuide.pdf
Anschrift des Verfassers:
Dr. Nicolai Worm
Geibelstr. 9
D-81679 München
E-Mail: nicolai.worm@t-online.de
Zum Inhaltsverzeichnis 06/2007
Naturheilpraxis 06/2007