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Decree CIs bel Nana Romani HANCU, NICO} isan ot ISBN 978-606512-026-6 Volt ISBN 978.606.512029-7 © ‘Nicole Hancu, Gabricla Roman oan Ande Verein, 2010 NICOLAEMANCU GABRIELAROMAN JOAN ANDREI VERESTU DIABETUL ZAHARAT, NUTRITIA SI BOLILE METABOLICE COLABORATORE: (ta-Napoea, 2010 Coles autor ‘Tennoredactare design: MGV Tnsilvania “Apr 2010; Bun de par august 2070 Format: 7100/16 Coli de tipar. St Bitura ECHINOX se Traian Grozivesc 12 300305 Ci. Napoca wowace 0 Mot: Orc ct made e bsee _PREFATA labora unui trata nto spate est posibil ind un grup profesional tinge 0 expariaa corespunatoare, éublati de curjul extroverin Colstval sir dabandicambee condi, astfl inst continuing bengca ‘sine de 3 publica monograi am decselaborara primoi Taga complet al spell abet, ntti boli metabolic. a Tratatal” een inl nd wa concep, valida apo nto sine torte Tipractic, barat pe o indolungatsexpeiens clinica. El este necesar petra ‘Sinezle concep, intro speciaitate ati de namie, devin obligato iu cee asus roll de procagonist (© mentune special facem pena excepionala contribute adust de mai tines eolgs: Camelia Bal, Anca Cerghizan, Cristina Nit si Adriana ‘su Ee a asigrat doar ssifin munch de seeetariat, dar au eonceput ‘5 redictat un numdr impresionant de eepitole, Cuantifieares eforlut lr, ementona fn CV, purtine morale profesional. “Mulynins dni Sorin eels (Director MOV Transivania) si dom Eugen Pop (Director Edius Eshinox), cae ne-auinsmpinatenaziasmol co lid lesb, caracterstiespeoesionalismulu de ial eas Misiunea ,Tratatalu estes contribue a opiizareaactului medica in secialitata nas i, prin aceasta a snatea cel pe care Ti ingrijim. Ce ost msi nbil deci atare misiune? NicolteHinew Cj Naps Gabriel Roman Iu, 2010 loan Andrei Veresiu CUPRINS PARTEAINTAL INTRODUCERE IN AUTRITIESIBOLILE METABOLICE | Bote metab pmo intr pair, ipo Nk Hi 2 Rog ei pic mete rion Cosa, Cali Bal 5. Mode even mie tlle maotie—Corma Bala Marne Cast 4 Sul devi ote mbar Nir in Aan a, Cm al Steer eet tie ae an «Edna np i le mene poplaial—Cori aa 1. Agel psc sate tile meattie- Come Bala ree Macon {Nominee de pening ni inch Toa dnd! Veh ARTES DOUA: NUTUTIAOFTIMA AADULTULET 9. Nasi: gi nna Gaba Roma 10 Bale tore uti Cala Rn, Arne Fi Gai hip rnc Molds Lorie Soma! 1 Compressed Moar, Gabril amar 12 Tabu de our = Gal Ghigo 15 Topi matin nail (Seti) Gabi Rowan, Anis Mari dine adr Live DMs Fin aio Molina Sie, Geog 14. Nasi toni, irs mperan obec o pole ests ples — Mele Hance 15 idem bei -Gabrle Rama 16, Bloptgse anpslog moron heii - Cont a 1 Rise oes compli oma —Cai al 18 Oran seeeiue ages ee, betel ing ~ Niaize Mon 2, Seep abr racic da ii Na Hon 21 Manan clini cone pnd - Care Roman, Nie Hn 22 Mingo lie competi come Carco Bale icin i ree aa ool pom - Ni ne 2 Prine ~ Gb amon 25. Aspe lia, socal orion - mpl connie sox Craton PARTEA A PATRA DISUIPIDEMILE 24 Nom sani is mpi al dil bes Ca Ns, Neo anc 27. Fpemisg dpe Csi Mid 28 Eola palin onus deni ~ Costing Nd 28a sn farce sper = Cristi iN Haw ‘M, Rca ipo competi cami Ni Ne Mie 31. Seen dings yeas lpr Crna Ni Near Hn 32 Simi tri paca peor ing —Cren Ma ince 53. Mangement cli! lpr Cris i Mila Hi “4 Mumgemes clini! copie coori dcr ~ Cina Nk 35 fie beet tree incom dsp - Cig Mew in 36. agin een Cristina Nt 17, Pens dfn mv rea: amet cami maitre rina Nik Mite He PARTEAACINCEA: SINDROMULAIEPABOLIC 8 Naolepsmpoan sin tatele—Ne e 40. Eioqteee sink metabo Crm Bala ri id 41, Ric sino moe woah mati Anes Coan 42 Tallin sini meso sere eign le sip Non ince 2. Manges inc tena meta, Apes polit —Nle Mi Ww PARTEA ASAE NUTRITIA, BOLILE METABOLICE SI AISCLL CARDIOVASCULAR “4. Defies meio. impoat cpdeilga rican ~Cisin N 45. ale mableton Siro 4, Nuria scl carmel" Ane Cohan 4. Arde ina cul cadonsicarnmstai pet plat Nila Hac, Cina Nt Aon a PARTEAA SATE: NUTRIPIA, BOLILE METABOLICE $1 CANCERLI. 8, Nui eel ile ne Ahlan i, er Spt hana Rm Crain i 50. Die tara, ret acca ny, Aba Rae, esa Nh Si. Aspect fle peice Meno ac, Crna Abana PARTEAAOPTA: DIABETUL ZAMARAT: NOZOLOGHE, ETIOPATOGENEZA,TABLOU CLINIC, DIAGNOSTIC, COMPLICIT Mesy intention: Rll i Nias Pals in decpetiy insider ein pana) SL Namlpe, tenon ise npr stl dab ba, © pblent de Ste ae Neo Hina $3. Fpiemiolpa ibaa coisa An ere ‘4. ipaogeee. iol mpg ab rat Stan 55. Seemingly dps Newlae Hi $6 Ton ln par cline In dn Do Gila Roman rubies rat ert unin nce sh wi 58 Coop te Mons Noga 59, Compile comic: Senate etpegeen Nae Hn Crs Ni Al Stan (Reopen —Siafone 61 Neat bts ae afc rene Sih an (©: Newopata dates ~ oa ne: Hein Gora ee £2. Pir bet aa Amdt eet (6 Oteins,xintomsl meats ibe ahat Carica Roman Nel Ha 6 Coop erase abel afd eri, le Stan £8 Stet nals ale pap — Ade For ‘Dati rena fot de Cone 71. Ake compas msi mie: demos, sda, pune fc ecosmisia § muscu, tol topes, HIV, potent ieteplor I esos ca dake arto Blo 12 Tubas de comport ant ~ Circ Bl, dhe Meco, dni 75.Depreni ae poten iis — Coral oo 1. ape pole Cara Bla, na Meco df herman AREA A NOU {NGRUIREA PERSOANELOR CU DIABET ZAHLARAT 75s gi", enol mira, meas eice ~ Nicolae Hn, 176 Opinizaes apical devia - Gaba Roman 7 nine icteric Hac, a Andes er 1 Tanlindonl~ de Coin 12 omni Ni, ele Hace nora comida La Duna Ate anise ny, nor SGLE2 om loc spore 2, ‘olsvli ~ Coneti Bat $5. Tapln prereset Sian ‘Tame strane ine Coe \Renpetieempestie Adria Fs ‘kup rapt Crm Bola Mentors aed, suomi, sons) meine gmisk omic“ Gaita Roman Maca Croc vi ‘on essen pensar ih ml ahr maw abd 21.Comtol gem fn nel aati Joan det Met 93 Como hem tel aa 9 min Gaia Ramin ‘4.Conol semi pie specie ca Coon 9 Paclria onrelpoeic nets una cln, a po 5 Mase tomon cae nusn sleems asa Corgan [7 Manigemenl cin compara die ian Manca Ng ‘7 Management in eta Sa ce 00 Managment al ean! an A ote 101 Mammen cline pri dates Ane Vor 102 Con esol nit arnt Ane Vrgn 103 Conta pin bt aarat- Cin Mk Nel Hcy 104 Como pode in dal abt abl Raman Moa 8c 10 Colter Jaa and ee Ie Mmaement ine al empl wate — fa An Hori, Ain ‘Shan, Moi Noga 107 Mage tinal teri on aoe eho Fado 108 Mingponenlctse a! dinette scale Ca 109 Mnsponeil tse! wie denon Ra 10 Mangels! soe conpici ance mete Ca Baa 114 meets Adame Far 112 Manic la a urbe Se canpenanetaimenur Cir Bla Andes Mca Afi here 113 Managment til eps a afer robles pias - Camel ae 114 pelle ae: dpe bie perma at bat — Come Boa 1S in ele eit Come Bale ie Area coping in tate Corea Bal Sie abt, resp ot abet abet ip 1~ Corei Baa is Ame ccosmic opnoure comanre ln dibeoog; Frogs Nao de dae aa spt leplate~ Ae Carpe vit 119 Rol esos inmate art abnloit —nsa Cniae 12Norsog nce inoue aia vi ~ Comal Bala 122 epeseog pogo Corl Baa 125 Patogne Recpolgs pope te de ic ale ipogcnilor "Rss pie peace eam Cool a 128 Hippie Ces a9 Bieri La Dee vu CUPRINS VOLUMUL 1 PREPATA n LISTA DE ABREVIERT xt PARES INTAL INTRODUCERE IN NUTRITIE $1 BOLILE METABOLICE ...0.1 1 Balle metabolic i nuaiinae, delimit. paula, impostantt~ Mole Hance 2 2, Folia nut, principale ei mtaboice— Mariana Coca, Cometic Bala 25 3. Metode de investigate in nari boil metabolce Comelio Bala, Mariana Coca. 97 4, Si devi i blile metsboice~ Nicolae Hane, Adriana Rus, Comelia Bala 152 5. Intaducere in genticaboilc mcabolice~ Sia lance 203 6, Educaiaespeutica in bolle metabolice populaionale Comela Baa 218 7. Aspootepaosociale in uti bolle meuboise— Comelia Bala Andrea Moca 232 8. Noni generale d epidemiolopie linc yi bustasisich Tan Aare Vert 254 PARTEAA DOUA: NUTRITIA OPTIMA A ADULTULUL 2 9. Nut: eeneraliigcadns nozoigic Gabriela Roman 276 10, Bazele teoetice ale mui ~ Gabriela Ron, Adriana Fodor Gabriela Ghinpjeans Licrimioare Moldovan, Lorin Sensis 310 11, Comporamentlalimentar Andee Moca, Gabriela Roma... 597 12. Tulbra de ussiie— Gabrieta Ghmpejcnt cy 13. Terapia medicala nutional (dietoterapsa)~ Gait Roman, Ancye Marian, Adriana Fodor, Livia Dum Mirela Flores Licramioara Moldovan, Sivia lane, Georgete Ince «9 Contin iva aientsloe sis INDEX ALFABETIC sa LISTA AUTORI ‘Nicolae Hanew Gabrieta Roman Cen Cine de Das Nai Bo Mebce oan Andre Veresia Mase opecaist Cnt ‘Ca Napce Cornelia Bala Sef uc Nace Adriana Fodor ‘nese Metin Fama Jab Haga Livia Dama conrad De Nae, Bl Meaie hs Nao Silvia tance Mire Flores [Licrimionra Moldovan Med seit ioe Spi ii de Uses. Cosa apn’ Cp Noe ‘Anca Marian ‘Cuan Adriana Rusu on Cn ge Data Nai Bo Mette ne GeorgetaIncew (Chapa Gabriela Ghimpoteane Mariana Coca Spi Cin sean de Ue Cosine Andreia Mocan CiaNapocs Lorint Sentigotah Mise Medi Je ibe x SHT3R AcAT AilCoA act ADA ADAG ADN ADP AG. AGL, AGMN AGPN ‘AgRP ‘aii Al ALA ALAT ‘Axe ADOA,B ARN ASAT stp BIA LISTA DE ABREVIERI Receptor pentru seroon (Colstr!ail wansferaza Colesterol-acit-ansfeaza rmonuladrenocortotop American Diabetes Association ‘Ate-Detved Average Glucose Acalderoxebonucleic Menon dost Acie grsi Aca ri ber ‘Aca gras monoesatua ‘Acai gai polinsature ‘Agouthrlaed peptide ‘Axa hipotalamo-hipofizart ‘Apo adzovat (Adequate Intake) ‘Aci af linolec ‘Nlaninaminouaneferaza ‘Acid linoeie conjugat, Apoipoprtcing A 8 Aca! ibonelec Asparataminoansteraza Adenosine-S triphosphate Bic-impedang eleeica Boli meubelic populaionale Ctoacdoca diabetes Adenozt-3smenofefatal ile Coronary Artery Risk Development in Young Adak CCadex Commitee on Food Adve and Contaninans CColecstokiine| (Centers for Disease Control and Prevention CConsum energetic de repaus CChetuialaenrgetica total (Coesterol exter transfer protein (Casa Natonala de Asiguri de Sinatate xitt ZA (engl. ADD) EAF BAR ASD 0G ECLIA EDTA EEF ESA EIA ENEP EPA EPIC ESPEN FADH FAO FDA FFA Corcotopia-oessing hormone ‘Tomogzata computeriata CCapsctatea tual delegare a er emofiares contin verovenoass Dietary Approaehes to Stop Hypertension Diabetes Congo nd Complication Teal, Disfunefaerdoeliala Absorb fond ‘Acid docosahexaenoic ‘Apa dala marcas ‘Apora dietetic dereferins “Apo dietetic de refer Deviate standars ‘Manual de Diagnostic Statistic» Tulburior Mental ora zie admins Energia neces activi fice Necesaresuimativ media (Estimated Average Requirement) European Association forthe Study of Diabetes Eteetocandiogn lecocheniluminesconce immunoassay Ethylenediaminctavaacetie sed ees asset exereipuli ie volun Autortate Europea penis Sigrana Aimentsloe Enzyme immuncassay Energi nonencrei fie Acid eicosapentaenoic European Prospective Investigation nto Cancer Societatea Europeans pens Nuite Clinics si Metabolism | fetal termi a limentelor fvin adenine dniceoide od and Agricutre Organization Food and Drug Administration roe at aids xiv FMD Fsivarr GABA GADA a cL aur. Gu GNA was Hhale Ale) Hel HIVSIDA HLA HMG-CoA ceductza HOMA OMAR, HPLC HR HTA TARC ic ea DF ee fee 10F- 52 6 IMA mvc Ir ns Flow-mediaod vasodilation (vasodiataia meio ets) Frogumly Sampled Inravenous Glucose Tolerance Test Ack gamamminobutie ‘glutamic acid deearborylase ‘Glycemic index (indertglicemic) ‘Glyeemie load (ineazeare licemica) ‘Glucagon like pepide-1 ‘Glucose anspor Glomerulonetia acuta ‘Genome wide association studies Hemoglobina glicas Ale Acid clr Human Immunodeficiency Virus (Virus! Imuno- BM a pas map a apr aN a a TIT profesional social din cre fave pare La ees Se das pct ‘rideniologe 4 Aboraren in proto a BMP se fice pin idence, era i stile obetivelr igi ari preoc, eens i extensiv, prin mangement clinic, sup psiolope ambiental ani, sock Profesional ean elt ‘+ Orguizateasistentel BMP se ce a dou aivelr micro rgaiatorie (catpa de dane) 9) mserearganentone (ein esa de db, nuvi bok mabe, + Profna BMP este o med sau pin care paca actors poste 1 dimint Din ace rts et ecmandat cst de ee Expert OMS in apr especie ‘+ nporane BMP raul din 1) impact lr mp, 2) din eet liu ace pet 3) in onl tess nei, Cuprins |. Definireatemenilr;locu in putologia moderns 2. Paiute etiopatogenctice 3. Heterogenitatea clinico-metaotica 4 Abordarea in practic: rad ngs 5. Profs blir metbolice {6 Imporanta nari 9 boll metbolie 4. Aspecte orgaizatorice DEFINIREA TERMENILOR; LOCUL IN PATOLOGIA MODERNA, Nutt definestetotaitateaproceseor implicate in apo asi rea alimenelor in copa faetionai organismal, and un go detemninan {Mi in tres deste cts fn ca de Dol. oli metabolcererezinta un sruphetexogen de fein din care tn ultimele deceni sau impus dabotlzabrar,disipigemile, obctata sindromul metabolic. Ele se mai numese bol metaolie poplationale dato 1 earacterulu lor epidemic, ind expres nozologied unt paoogi m= She tae yin emer pare prt deme, supeinzitor de dinaict i extrem de amenintosre penta ssn ‘mul, sprezent i vitor Patloyia metabolic mai cuprinde anomie Fe, Cu, Ca Mg, hem Ju, ape, elector i etl acido-bazc, ecu servile Inksute ddemotaotism. Acosta no a crater populainal dar parip i nuneroe Ss aspect ale patologie,confimind cee ce aurea eu premial NOBEL, Pauling spunea eu mole decei norms cu excepinacidentsle do lula, resulptsogil este metaboit” Li nda lor bolle metaboicepopuljionale cbuieconsideate ca ‘arte important allo cxnige populations. in detemninismal yi evolu roma nutia are un olde rent mirime. Bole metablie i nutiia a {ost ofa eeunoscute in Romina in anol 1988, cind datorits efoto profesorlu flan Mine, Minsierl Sins a satuatspeciaates Dies, ‘Ni, Boll Metiboie Tngortana nut a balilor metaboice popustionle rer din preocuparea aoe pe care Organiza Mons» Sth (OMS) re {ap de BOLILE CRONICE POPULATIONALE, Astfl, n Raprtl Exper Jor sti din anu 2002 [1) se precizear: “Boll cronicecorelaté nia ts alma! mare impact petra vantaten public tt torment costal direct entry sctette 3 guverm. i termes anor do site pw car ‘produc. Acestea Inelud OBEZITATEA, DIABETUL, BOLILE CARDIOVAS. (CULARE, CANCERUI, OSTEOPOROZA SI BOLILE DENTARE" ‘Am onside uit edaes integral a sea ct, din rmdtaree mati: +” Bali ronze popula repent, nan 2001, 40% din = ‘ologaglobels mondial find rspuratoae de P4 din moral ‘ues global. Frecvena lr va cel a 57% in in anl 2020, ‘evnd 75% in maraitatea generals, 7% din cea prin eatopatic Ischemic, 75% din ex produ pri accident vaselarecestale {70% din moran pin dsbetal ahs, 60% din ceast rey fer vaaved le in rile ners de deol (1 + Riscul pent producere boli eroncepopuljonale este indus in special de alimentajia nesnstost, sedentaism si fumat, ack desi de vat nestndos. In acclasi imp, Experi OMS pre ‘ek ci hiperensunes aerials bez i dispel sunt ‘ctr de ise penta bolle cardiovascular isabel zara (1). “+ oli cronice populatonale po f prevent prin modiieaea st ae mae ern ee paring Tul de wap, optnizarea nutri, combiteressedentarimulg 4 Tumatlu. Prin aciste metode fost posibils prevent dshe- ‘alu cu $8%, a cardgpatil scheme ev 80%, cat gi «30% din sancee (1. ‘+ Sudiul INTERHEART a demonstrat ncn infarct i= caricpoate feds 80% prin consum crescut de leu $i fructe, pracicarea exer fies sare dene [2) + In cami obiecavelor nationale amencane. pent "ssatea cardiovascular” idea cu impact perry anu 2020 est revi ‘optimizarea 3 pata componente sl stl de vig fast, in-

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