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Identifier 000377739
Title Σύγκριση της αποτελεσματικότητας της μεσογειακής δίαιτας και της κοινής δίαιτα; στην έκβαση του αποφρακτικού τύπου συνδρόμου απνοιών υποπνοιών κατά τον ύπνο (ΣΑΑΥΥ). Παρεμβατική μελέτη
Alternative Title Comparison of the effectiveness of the mediterranean diet and a prudent diet on obstructive sleep apnea-hypnoea syndrome. An intervention study
Author Παπανδρέου, Χριστόφορος
Thesis advisor Τζανάκης, Νικόλαος Ε.
Reviewer Σχίζα, Σοφία Ε.
Κογεβίνας, Εμμανουήλ
Κουρούμαλης, Ηλίας
Σιαφάκας, Νικόλαος
Βγόντζας, Αλέξανδρος
Μοσχανδρέα, Ιωάννα
Abstract Background Obstructive sleep apnoea-hypopnoea syndrome (OSAHS) constitutes a disease that is associated with increased mortality and morbidity. The most important risk factor is obesity. In severe cases of OSAHS the weight loss strategy is essential and must accompany continuous positive airway pressure (CPAP) treatment. Mild treatment of obesity includes the adoption of strategy for weight loss induced by diet and exercise. Aim The aim of this doctorate was to investigate a) the obesity problem in Mediterranean region, b) the effect of the Mediterranean diet on weight loss and c) on lipid peroxidation, estimated using the thiobarbituric acid reacting substances (TBARS) method, in obese patients with OSAHS, for a 6-month period. d) Also, in these patients possible correlations between the long-term intake of n-3 and n-6 polyunsaturated fatty acids from diet and depressive symptoms were examined. Subjects and methods A series of consecutive patients, who were diagnosed with OSAHS by overnight attended polysomnography in the Sleep Disorders Unit, Medical School, University of Crete, during November 2008-October 2009 and met the inclusion criteria, participated in this study. In the initial phase of the doctorate we investigated the obesity problem in the Mediterranean region during the period 1997-2007, using the method of systematic review in combination with a meta-analysis. Then, gluteal adipose tissue biopsies were performed in 63subjects for investigation of possible correlations between the long-term intake of n-3 and n-6 polyunsaturated fatty acids from diet and depressive symptoms as assessed by the Zung self-rating depression scale. The effectiveness of the Mediterranean diet in 20 patients was compared with that of a prudent diet in other 20 for OSAHS outcome and in 11 and 10 respectively for lipid peroxidation measured by TBARS. All patients underwent CPAP treatment and were counselled to increase their physical activity. Results The meta-analysis highlighted obesity problem in Mediterranean region during 1997-2007 and particularly in adults. The percentage of females burdened from obesity was found to be 25.3% and of males 20.0%. Mediterranean adults in the European region were found to be at higher risk of obesity. No link between symptoms of depression and individual n-6 and/or n-3 PUFAs of gluteal adipose tissue was detected. However, multiple linear regression analysis showed a positive correlation between depressive symptoms and 20:3n-6/18:3n-6. Regarding TBARS, there was a substantial reduction in both intervention groups without statistical significant difference between them. Participants consuming the Mediterranean diet in combination with the higher increase in physical activity compared to the prudent diet group demonstrated a greater decrease in waist circumference, waist to height ratio, and waist to hip ratio, without better improvement in overall OSAHS severity. However, the Mediterranean diet group reduced more the apnoea-hypopnoea index during rapid eye movement sleep compared to the prudent diet group. Conclusion Awareness programmes addressing the importance of adopting healthy dietary habits combined with physical activity should target the whole community in general and European adults in particular. Long term dietary n-6 and n-3 polyunsaturated fatty acids intake as assessed in gluteal adipose tissue is probably not useful when evaluating depressive symptoms among obese OSAHS patients. The effectiveness of the Mediterranean diet combined with an increase in physical activity did not show significant difference in lipid peroxidation estimated by TBARS and in overall OSAHS severity compared to prudent diet, except in the apnoea-hypopnoea index to rapid eye movement ratio due to the notable reduction in abdominal fat, and therefore an improvement in the mechanical load associated with OSAHS.
Language English, Greek
Subject Apnoea-hypnoea index during rapid eye movement sleep
Body Weight
Mediterranean diet
Obesity
Physical activity
Sleep Apnea, Obstructive
TBARS
Αποφρακτικού τύπου σύνδρομο απνοιών-υποπνοιών στον ύπνο
Δείκτης απνοιών-υποπνοιών κατά το REM στάδιο ύπνου
Μεσογειακή δίαιτα
Παχυσαρκία
Σωματική δραστηριότητα
Issue date 2011-11-16
Collection   Faculty/Department--School of Medicine--Department of Medicine--Doctoral theses
  Type of Work--Doctoral theses
Permanent Link https://elocus.lib.uoc.gr//dlib/f/f/a/metadata-dlib-1357206862-387362-11882.tkl Bookmark and Share
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