El efecto de la alimentación intuitiva y consciente sobre el control glucémico en personas con diabetes tipo 2: un estudio transversal

Autores/as

  • Meltem Mermer Toros University, Department of Nutrition and Dietetics, Mersin, Türkiye
  • Özlem Özpak Akkuş Toros University, Department of Nutrition and Dietetics, Mersin, Türkiye https://orcid.org/0000-0002-1471-8000

DOI:

https://doi.org/10.14306/renhyd.27.4.1940

Palabras clave:

Diabetes Mellitus Tipo 2, Hemoglobina Glucada, Obesidad, Alimentación Intuitiva

Resumen

Introducción. Los modelos de comportamiento alimentario como la alimentación intuitiva (IE) y la alimentación consciente (ME) han cobrado importancia recientemente por su papel en el control glucémico. En este estudio, nuestro objetivo fue evaluar el efecto de la alimentación intuitiva y la alimentación consciente en el tratamiento dietético de la diabetes mellitus tipo 2 (DM2) e investigar su relación con el control glucémico y la obesidad.

Metodología. Se incluyeron un total de 153 pacientes diagnosticados de DM2 en al menos un año y con edades comprendidas entre 19 y 64 años. Las características descriptivas de los pacientes fueron obtenidas mediante entrevistas cara a cara y medidas antropométricas. Se utilizó la Escala de alimentación intuitiva 2 (IES-2) para evaluar los comportamientos alimentarios intuitivos y el Cuestionario de alimentación consciente (MEQ) para evaluar los comportamientos alimentarios conscientes.

Resultados. La puntuación total del IES-2 fue mayor en pacientes con DM2 que tenían un control glucémico inadecuado (p<0.05), y un aumento de un punto en el IES-2 aumentó la probabilidad de que el nivel de HbA1c estuviera por encima del 7 % en un 25.2 % (p <0.05). Hubo una correlación negativa moderada entre la puntuación total del MEQ y el peso corporal, el IMC, la circunferencia de la cintura y la relación cintura-talla en los pacientes con control glucémico adecuado (r=-0.526, r=-0.537, r=-0.506, r=-0.510, respectivamente; p<0.05). Hubo una débil correlación negativa entre la puntuación total del IES-2 y el IMC y entre la puntuación total del MEQ y el índice cintura-talla, triglicéridos y colesterol unido a lipoproteínas de muy baja densidad en los pacientes con control glucémico inadecuado (r=-0.225, r=-0.224, r=-0.114, r=-0.178, respectivamente; p<0.05).

Conclusión. Los resultados de este estudio sugieren que la alimentación intuitiva afecta negativamente el control glucémico en pacientes con DM2 y la alimentación consciente se asocia positivamente con el control del peso corporal, aunque no tiene un efecto directo sobre el control glucémico.

Citas

World Health Organization. Diabetes. [Internet]. 2023. [accessed 13 February 2023]. Disponible en: https://www.who.int/health-topics/diabetes#tab=tab_1

Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2013;36(11):3821-42, https://doi.org/10.2337/dc13-2854.

Tribole E, Resch E. Intuitive eating: A revolutionary program that works . New York: St. 2012, Martin's Press.

Tylka TL. Development and psychometric evaluation of a measure of intuitive eating. J Couns Psychol. 2006;53(2):226–240, https://doi.org/10.1037/0022-0167.53.2.226.

Tylka TL, Kroon Van Diest AM. The Intuitive Eating Scale–2: Item refinement and psychometric evaluation with college women and men. J Couns Psychol. 2013;60(1):137, https://doi.org/10.1037/a0030893.

Van Dyke N, Drinkwater EJ. Review article relationships between intuitive eating and health indicators: literature review. Public Health Nutrition. 2014;17(8);1757-1766, https://doi.org/10.1017/S1368980013002139.

Soares FLP, Ramos MH, Gramelisch M, de Paula Pego Silva R, da Silva Batista J, Cattafesta M, Salaroli LB. Intuitive eating is associated with glycemic control in type 2 diabetes. Eat Weight Disorders. 2021;26(2):599-608, https://doi:10.1007/s40519-020-00894-8.

Tylka TL, Calogero RM, Daníelsdóttir S. Intuitive eating is connected to self-reported weight stability in community women and men. Eating Disorders. 2019:1-9, https://doi:10.1080/10640266.2019.1580126.

Koçak Ö, Yıldırım Y, Şarer Yürekli B. Tip 2 diabetes mellitus hastalarında sezgisel yemenin yeme tutumu ve glisemik kontrol ile ilişkisi. Ege Tıp Dergisi. 2022;61(3):360-370, https://doi.org/10.19161/etd.1167421.

Higgs S, Spetter MS, Thomas JM, Rotshtein P, Lee M, Hallschmid M, et al. Interactions between metabolic, reward and cognitive processes in appetite control: Implications for novel weight management therapies. Journal of Psychopharmacology. 2017;31(11):1460-1474, https://doi.org/10.1177/0269881117736917.

Nelson JB. Mindful eating: the art of presence while you eat. Diabetes Spectrum. 2017; 30(3): 171-174, https://doi.org/10.2337/ds17-0015.

Herpertz S, Albus C, Lichtblau K, Köhle K, Mann K, Senf, W. Relationship of weight and eating disorders in type 2 diabetic patients: a multicenter study. International Journal of Eating Disorders. 2000; 28(1): 68-77, https://doi.org/10.1002/(SICI)1098-108X(200007)28:1<68::AID-EAT8>3.0.CO;2-R

Kes D, Can Cicek S. Mindful eating, obesity, and risk of type 2 diabetes in university students: A cross-sectional study. Nursing Forum. 2021; 56(3): 483-489, https://doi.org/10.1111/nuf.12561.

Bas M, Karaca KE, Saglam D, Arıtıcı G, Cengiz E, Köksal S, et al. Turkish version of the Intuitive Eating Scale-2: Validity and reliability among university students. Appetite. 2017; 114: 391-397, https://doi.org/10.1016/j.appet.2017.04.017.

Köse G, Tayfur M, Birincioğlu İ, Dönmez A. Adaptation study of the mindful eating questiıonnare (MEQ) into Turkish. JCBPR. 2018;5(3):125-125, http://dx.doi.org/10.5455/JCBPR.250644 .

Lohman T, Roche AF, Martorell R. Anthropometric standardization reference manual. 1st ed. Human kinetics; 1988.

Consultatıon, WHO. Obesity: preventing and managing the global epidemic. World Health Organization technical report series. 2000;894:1-253.

World Health Organization‎. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. [Internet] 2008. [accessed 13 February 2022]. Disponible en: https://www.who.int/publications/i/item/9789241501491.

Ashwell M, Gibson S. Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’based on BMI and waist circumference. BMJ Open. 2016;6(3):e010159, http://dx.doi.org/10.1136/bmjopen-2015-010159.

Framson C, Kristal AR, Schenk JM, Littman AJ, Zeliadt S, Benitez D. Development and validation of the mindful eating questionnaire. J Am Diet Assoc. 2009;109(8):1439-1444, https://doi.org/10.1016/j.jada.2009.05.006.

Mathieu J. What should you know about mindful and intuitive eating? J Am Diet Assoc. 2009; 109(12): 1982-7, https://doi.org/10.1016/j.jada.2009.10.023.

Quansah DY, Gross J, Gilbert L, Helbling C, Horsch A, Puder JJ. Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study. Eat Behav. 2019; 34: 101304, https://doi.org/10.1016/j.eatbeh.2019.101304.

Wheeler BJ, Lawrence J, Chae M, Paterson H, Gray AR, Healey D, Reith DM, Taylor BJ. Intuitive eating is associated with glycaemic control in adolescents with type I diabetes mellitus. Appetite. 2016; 96: 160-165, https://doi.org/10.1016/j.appet.2015.09.016.

Willig AL, Richardson BS, Agne A, Cherrington A. Intuitive eating practices among African-American women living with type 2 diabetes: a qualitative study. J Acad Nutr Diet. 2014; 114(6): 889-896, https://doi.org/10.1016/j.jand.2014.02.004.

Chechlacz M, Rotshtein P, Klamer S, Porubská K, Higgs S, Booth D, Fritsche A, Preissl H, Abele H, Birbaumer N, Nouwen A. Diabetes dietary management alters responses to food pictures in brain regions associated with motivation and emotion: a functional magnetic resonance imaging study. Diabetologia. 2009;52(3):524-33, https://doi.org/10.1007/s00125-008-1253-z.

Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological inquiry. 2007;18(4):211-237, https://doi.org/10.1080/10478400701598298.

Dalen J, Smith BW, Shelley BM, Sloan AL, Leahigh L, Begay D. Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Complement Ther Med. 2010;18(6):260-4, https://doi.org/10.1016/j.ctim.2010.09.008.

Miller CK. Mindful Eating With Diabetes. Diabetes Spectr. 2017;30(2):89-94, https://doi.org/10.2337/ds16-0039.

Grider HS, Douglas SM, Raynor HA. The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review. J Acad Nutr Diet. 2021;121(4):709-727, https://doi.org/10.1016/j.jand.2020.10.019.

Miller CK, Kristeller JL, Headings A, Nagaraja H, Miser WF. Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. J Acad Nutr Diet. 2012;112(11):1835-42, https://doi.org/10.1016/j.jand.2012.07.036.

Rosenzweig S, Reibel DK, Greeson JM, Edman JS, Jasser SA, McMearty KD, Goldstein BJ. Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Altern Ther Health Med. 2007;13(5):36-8.

Tovote KA, Fleer J, Snippe E, Peeters AC, Emmelkamp PM, Sanderman R, Links TP, Schroevers MJ. Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care. 2014; 37(9): 2427-34, https://doi.org/10.2337/dc13-2918.

van Son J, Nyklícek I, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, Toorians AW, Pouwer F. The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA(1c) in outpatients with diabetes (DiaMind): a randomized controlled trial. Diabetes Care. 2013;36(4):823-30, https://doi.org/10.2337/dc12-1477.

Freemantle N, Holmes J, Hockey A, Kumar S. How strong is the association between abdominal obesity and the incidence of type 2 diabetes? Int J Clin Pract. 2008;62(9):1391-6, https://doi.org/10.1111/j.1742-1241.2008.01805.x.

Oumer A, Ale A, Tariku Z, Hamza A, Abera L, Seifu A. Waist-to-hip circumference and waist-to-height ratio could strongly predict glycemic control than body mass index among adult patients with diabetes in Ethiopia: ROC analysis. PLoS One. 2022;17(11):e0273786, https://doi.org/10.1371/journal.pone.0273786.

Caixàs A, Villaró M, Arraiza C, Montalvá JC, Lecube A, Fernández-García JM, et al. SEEDO-SEMERGEN consensus document on continuous care of obesity between Primary Care and Specialist Hospital Units 2019. Med Clin (Barc). 2020; 155(6): 267.e1-267.e11, https://doi.org/10.1016/j.medcle.2019.10.010.

Hassapidou M, Vlassopoulos A, Kalliostra M, Govers E, Mulrooney H, Ells L, et al. European Association for the Study of Obesity Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Adults Developed in Collaboration with the European Federation of the Associations of Dietitians. Obes Facts. 2023;16(1):11-28, https://doi.org/10.1159/000528083.

García-Galbis MR, Gallardo DI, Martínez-Espinosa RM, Soto-Méndez MJ. Personalized Diet in Obesity: A Quasi-Experimental Study on Fat Mass and Fat-Free Mass Changes. Healthcare (Basel). 2021;9(9):1101, https://doi.org/10.3390/healthcare9091101.

Flint A, Gregersen NT, Gluud LL, Møller BK, Raben A, Tetens I, et al. Associations between postprandial insulin and blood glucose responses, appetite sensations and energy intake in normal weight and overweight individuals: a meta-analysis of test meal studies. Br J Nutr. 2007;98(1):17-25, https://doi.org/10.1017/S000711450768297X.

Publicado

2023-12-04

Cómo citar

Mermer, M., & Özpak Akkuş, Özlem. (2023). El efecto de la alimentación intuitiva y consciente sobre el control glucémico en personas con diabetes tipo 2: un estudio transversal. Revista Española De Nutrición Humana Y Dietética, 27(4), 294–304. https://doi.org/10.14306/renhyd.27.4.1940