\u00c7\u00f6lyak hastal\u0131\u011f\u0131nda tek tedavinin glutenin diyetten tamamen \u00e7\u0131kar\u0131lmas\u0131 oldu\u011funu belirten uzmanlar, glutensiz \u00fcr\u00fcnlerde etiket bilgisinin tek ba\u015f\u0131na yeterli g\u00fcvence sa\u011flamayabilece\u011fine dikkat \u00e7ekiyor.<\/p>\n
\u00dcsk\u00fcdar \u00dcniversitesi Sa\u011fl\u0131k Bilimleri Fak\u00fcltesi Beslenme ve Diyetetik B\u00f6l\u00fcm\u00fcnden Ar\u015f. G\u00f6r. Dr. Hatice \u00c7olak \u00c7etinkaya, \u00e7\u00f6lyak hastal\u0131\u011f\u0131, gluten hassasiyeti ve glutensiz beslenmenin p\u00fcf noktalar\u0131na ili\u015fkin de\u011ferlendirmelerde bulundu.<\/p>\n
\u00c7etinkaya, \u00e7\u00f6lyak hastal\u0131\u011f\u0131 ile gluten hassasiyetinin ayn\u0131 \u015fey olmad\u0131\u011f\u0131n\u0131 belirterek, glutensiz diyete ba\u015flamadan \u00f6nce mutlaka \u00e7\u00f6lyak taramas\u0131 yap\u0131lmas\u0131 gerekti\u011fini s\u00f6yledi.<\/p>\n
\u00c7\u00f6lyak hastal\u0131\u011f\u0131 ile gluten hassasiyeti ayn\u0131 \u015fey de\u011fil<\/strong><\/p>\n \u00c7\u00f6lyak hastal\u0131\u011f\u0131n\u0131n gluten proteinine kar\u015f\u0131 geli\u015fen kronik otoimm\u00fcn bir ince ba\u011f\u0131rsak hastal\u0131\u011f\u0131 oldu\u011funu belirten Dr. Hatice \u00c7olak \u00c7etinkaya, gluten t\u00fcketimi sonras\u0131nda ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin ince ba\u011f\u0131rsa\u011f\u0131n emilim y\u00fczeylerine zarar verdi\u011fini ifade etti.<\/p>\n \u00c7etinkaya, \u201c\u00c7\u00f6lyak hastalar\u0131nda gluten t\u00fcketimi sonras\u0131nda ba\u011f\u0131\u015f\u0131kl\u0131k sistemi ince ba\u011f\u0131rsa\u011f\u0131n emilim y\u00fczeylerine zarar verir ve besin emilim bozukluklar\u0131 geli\u015febilir. Hastal\u0131k; ishal, kar\u0131n a\u011fr\u0131s\u0131, \u015fi\u015fkinlik, kilo kayb\u0131, demir eksikli\u011fi anemisi, osteoporoz ve halsizlik gibi \u00e7ok farkl\u0131 belirtilerle ortaya \u00e7\u0131kabilmektedir. Tan\u0131da serolojik testler ve gerekti\u011finde ince ba\u011f\u0131rsak biyopsisi kullan\u0131lmaktad\u0131r. \u00c7\u00f6lyak hastal\u0131\u011f\u0131n\u0131n bug\u00fcn i\u00e7in tek tedavisi glutenin diyetten tamamen \u00e7\u0131kar\u0131lmas\u0131d\u0131r\u201d dedi.<\/p>\n \u00c7\u00f6lyak d\u0131\u015f\u0131 gluten hassasiyetinin farkl\u0131 bir tablo oldu\u011funu ifade eden \u00c7etinkaya, \u201c\u00c7\u00f6lyak d\u0131\u015f\u0131 gluten hassasiyeti, gluten t\u00fcketimi sonras\u0131 \u015fi\u015fkinlik, kar\u0131n a\u011fr\u0131s\u0131, gaz, yorgunluk veya ba\u015f a\u011fr\u0131s\u0131 gibi belirtilerin ortaya \u00e7\u0131kt\u0131\u011f\u0131 ancak \u00e7\u00f6lyak hastal\u0131\u011f\u0131nda g\u00f6r\u00fclen otoimm\u00fcn yan\u0131t\u0131n ve ince ba\u011f\u0131rsak hasar\u0131n\u0131n bulunmad\u0131\u011f\u0131 bir durumdur. Gluten hassasiyetinde \u00e7\u00f6lyak antikorlar\u0131 genellikle negatif saptan\u0131r ve ba\u011f\u0131rsak biyopsisinde vill\u00f6z atrofi g\u00f6r\u00fclmez. Bu nedenle \u00e7\u00f6lyak hastal\u0131\u011f\u0131 ile gluten hassasiyeti aras\u0131ndaki temel fark; \u00e7\u00f6lyakta ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin ba\u011f\u0131rsak dokusuna zarar veren otoimm\u00fcn bir s\u00fcre\u00e7 olu\u015fturmas\u0131, gluten hassasiyetinde ise benzer semptomlara ra\u011fmen kal\u0131c\u0131 ba\u011f\u0131rsak hasar\u0131n\u0131n bulunmamas\u0131d\u0131r\u201d diye konu\u015ftu.<\/p>\n Glutensiz diyete ba\u015flamadan \u00f6nce test yapt\u0131r\u0131n<\/strong><\/p>\n Belirtilerin birbirine \u00e7ok benzedi\u011fine dikkat \u00e7eken \u00c7etinkaya, yaln\u0131zca \u015fik\u00e2yetlere bak\u0131larak \u00e7\u00f6lyak hastal\u0131\u011f\u0131 ile gluten hassasiyetinin ay\u0131rt edilemeyece\u011fini vurgulad\u0131.<\/p>\n \u00c7etinkaya, \u201cKlinisyenler her iki durumu yaln\u0131zca belirtilere bakarak birbirinden ay\u0131rt edemezler. Bu nedenle glutensiz diyete ba\u015flamadan \u00f6nce mutlaka \u00e7\u00f6lyak taramas\u0131 yap\u0131lmal\u0131d\u0131r. \u00c7\u00fcnk\u00fc diyet ba\u015fland\u0131ktan sonra \u00e7\u00f6lyak testleri g\u00fcvenilir sonu\u00e7 vermez\u201d ifadelerini kulland\u0131.<\/p>\n Glutenin gizli kaynaklar\u0131na dikkat<\/strong><\/p>\n Glutenin yaln\u0131zca ekmek ve makarna gibi \u00fcr\u00fcnlerde bulunmad\u0131\u011f\u0131n\u0131 belirten \u00c7etinkaya, bu\u011fday, arpa ve \u00e7avdardan \u00fcretilen bir\u00e7ok g\u0131dan\u0131n gluten i\u00e7erebildi\u011fini s\u00f6yledi.<\/p>\n \u00c7etinkaya, \u201cGluten; ba\u015fl\u0131ca bu\u011fday, arpa ve \u00e7avdarda bulunan bir protein grubudur ve bu tah\u0131llardan \u00fcretilen bir\u00e7ok g\u0131dada yer almaktad\u0131r. Ekmek, makarna, bulgur, eri\u015fte, kek, b\u00f6rek, kurabiye, simit, pizza hamuru ve un i\u00e7eren haz\u0131r g\u0131dalar glutenin en yayg\u0131n kaynaklar\u0131d\u0131r. Ayr\u0131ca malt ve malt \u00f6z\u00fc i\u00e7eren \u00fcr\u00fcnler, bira ve baz\u0131 kahvalt\u0131l\u0131k gevrekler de gluten i\u00e7erebilmektedir\u201d dedi.<\/p>\n Do\u011fal olarak glutensiz besinlere de de\u011finen \u00c7etinkaya, \u201cDo\u011fal olarak glutensiz besinler aras\u0131nda ise pirin\u00e7, m\u0131s\u0131r, patates, karabu\u011fday, kinoa, baklagiller, sebzeler, meyveler, yumurta, et ve s\u00fct \u00fcr\u00fcnleri yer almaktad\u0131r. Yulaf do\u011fal olarak gluten i\u00e7ermese de \u00fcretim s\u0131ras\u0131nda \u00e7apraz bula\u015f riski ta\u015f\u0131yabildi\u011finden sertifikal\u0131 glutensiz \u00fcr\u00fcnler tercih edilmelidir. Glutenin en s\u0131k g\u00f6zden ka\u00e7an kaynaklar\u0131 aras\u0131nda soya sosu, malt sirkesi, sucuk, salam, haz\u0131r \u00e7orba ve bulyonlar yer almaktad\u0131r. Ayr\u0131ca baz\u0131 ila\u00e7lar, takviyeler, kozmetik \u00fcr\u00fcnler ve restoranlarda kullan\u0131lan ortak frit\u00f6z ya\u011flar\u0131 da \u00e7apraz bula\u015f riski olu\u015fturabilmektedir\u201d diye konu\u015ftu.<\/p>\n Glutensiz etiketi her zaman yeterli olmayabilir<\/strong><\/p>\n Uluslararas\u0131 standartlara g\u00f6re glutensiz \u00fcr\u00fcnlerin belirli s\u0131n\u0131rlar i\u00e7erisinde gluten i\u00e7ermesine izin verildi\u011fini kaydeden Dr. Hatice \u00c7olak \u00c7etinkaya, t\u00fcketicilerin bilin\u00e7li olmas\u0131 gerekti\u011fini s\u00f6yledi.<\/p>\n \u00c7etinkaya, \u201cAvrupa Birli\u011fi, FDA ve Codex Alimentarius standartlar\u0131na g\u00f6re \u2018glutensiz\u2019 \u00fcr\u00fcnlerin 20 ppm veya daha d\u00fc\u015f\u00fck gluten i\u00e7ermesi gerekmektedir. Bu s\u0131n\u0131r \u00e7\u00f6lyak hastalar\u0131n\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu i\u00e7in g\u00fcvenli kabul edilmektedir. Ancak \u00e7al\u0131\u015fmalar hem do\u011fal glutensiz \u00fcr\u00fcnlerde hem de \u2018glutensiz\u2019 etiketli baz\u0131 \u00fcr\u00fcnlerde \u00e7apraz bula\u015f nedeniyle beklenenden y\u00fcksek gluten d\u00fczeyleri bulunabilece\u011fini g\u00f6stermektedir\u201d dedi.<\/p>\n Yaln\u0131zca etiket bilgisinin yeterli olmad\u0131\u011f\u0131n\u0131 vurgulayan \u00c7etinkaya, \u201c\u00dc\u00e7\u00fcnc\u00fc taraf sertifikal\u0131 \u00fcr\u00fcnlerin tercih edilmesi, i\u00e7erik listelerinin d\u00fczenli kontrol edilmesi ve \u00f6zellikle d\u0131\u015far\u0131da yemek t\u00fcketiminde \u00e7apraz bula\u015f riskine dikkat edilmesi \u00f6nerilmektedir\u201d ifadelerini kulland\u0131.<\/p>\n Haz\u0131r glutensiz \u00fcr\u00fcnlere a\u015f\u0131r\u0131 y\u00f6nelim hata olabilir<\/strong><\/p>\n Glutensiz diyet uygulayan bireylerde vitamin ve mineral eksikliklerinin s\u0131k g\u00f6r\u00fclebildi\u011fini ifade eden \u00c7etinkaya, i\u015flenmi\u015f glutensiz \u00fcr\u00fcnlerin a\u015f\u0131r\u0131 t\u00fcketimine kar\u015f\u0131 uyar\u0131da bulundu.<\/p>\n \u00c7etinkaya, \u201cGlutensiz diyetin beslenme a\u00e7\u0131s\u0131ndan yetersiz oldu\u011fu ve s\u0131k s\u0131k vitamin-mineral eksiklikleriyle ili\u015fkili oldu\u011fu bilinmektedir\u201d dedi.<\/p>\n \u00d6zellikle haz\u0131r glutensiz \u00fcr\u00fcnlerin a\u015f\u0131r\u0131 t\u00fcketilmesinin \u015feker ve ya\u011f al\u0131m\u0131n\u0131 art\u0131rabilece\u011fini belirten \u00c7etinkaya, \u201c\u00d6zellikle glutensiz haz\u0131r \u00fcr\u00fcnler t\u00fcketildi\u011finde a\u015f\u0131r\u0131 \u015feker ve ya\u011f al\u0131m\u0131na da zemin haz\u0131rlanabilmektedir. Sa\u011fl\u0131kl\u0131 bir beslenme d\u00fczeninde taze, do\u011fal ve m\u00fcmk\u00fcn oldu\u011funca i\u015flenmemi\u015f besinlerin \u00f6n planda tutulmas\u0131 \u00f6nerilmektedir. Karabu\u011fday, kinoa, kahverengi pirin\u00e7 ve baklagiller gibi kaynaklar d\u00fczenli olarak t\u00fcketilmeli; demir, kalsiyum, magnezyum, D vitamini, E vitamini, folat ve baz\u0131 B grubu vitaminleri d\u00fczenli olarak takip edilmelidir\u201d diye konu\u015ftu.<\/p>\n \u00c7etinkaya, glutensiz beslenmeye ge\u00e7i\u015f sonras\u0131 baz\u0131 bireylerde a\u015f\u0131r\u0131 et ve hayvansal protein t\u00fcketimine y\u00f6nelim g\u00f6r\u00fclebildi\u011fini belirterek, kuru baklagiller, ya\u011fl\u0131 tohumlar ve di\u011fer bitkisel protein kaynaklar\u0131n\u0131n diyete eklenmesini \u00f6nerdi.<\/p>\n Kahvalt\u0131da do\u011fal besinler \u00f6n planda olmal\u0131<\/strong><\/p>\n Glutensiz beslenen bireyler i\u00e7in kahvalt\u0131n\u0131n san\u0131ld\u0131\u011f\u0131ndan daha \u00e7e\u015fitli haz\u0131rlanabilece\u011fini s\u00f6yleyen \u00c7etinkaya, klasik T\u00fcrk kahvalt\u0131s\u0131n\u0131n do\u011fal olarak glutensiz se\u00e7enekler i\u00e7erdi\u011fini belirtti.<\/p>\n \u00c7etinkaya, \u201cYumurta, peynir, zeytin, domates, salatal\u0131k ve ye\u015filliklerden olu\u015fan klasik T\u00fcrk kahvalt\u0131s\u0131 do\u011fal olarak glutensiz bir se\u00e7enektir; ancak ekmek tercih edilecekse sertifikal\u0131 glutensiz ekmek kullan\u0131lmal\u0131d\u0131r. Bunun sertifikal\u0131 glutensiz yulaf; s\u00fct veya yo\u011furt ile haz\u0131rlan\u0131p \u00fczerine meyve, tar\u00e7\u0131n, ceviz veya chia tohumu eklenerek besleyici bir kahvalt\u0131ya d\u00f6n\u00fc\u015ft\u00fcr\u00fclebilir. Omlet ve menemen \u00e7e\u015fitleri de g\u00fcvenli ve doyurucu se\u00e7enekler aras\u0131ndad\u0131r\u201d dedi.<\/p>\n Sebzeli omletler, yo\u011furtla haz\u0131rlanan meyveli kaseler, smoothie se\u00e7enekleri ve glutensiz unlarla haz\u0131rlanan pankeklerin de kahvalt\u0131 alternatifi olabilece\u011fini kaydeden \u00c7etinkaya, yaln\u0131zca paketli glutensiz \u00fcr\u00fcnlere ba\u011f\u0131ml\u0131 kalmak yerine do\u011fal besinlerle \u00e7e\u015fitlilik olu\u015fturman\u0131n daha dengeli bir yakla\u015f\u0131m sa\u011flayaca\u011f\u0131n\u0131 ifade etti.<\/p>\n Glutensiz tariflerde un kar\u0131\u015f\u0131mlar\u0131 tercih edilmeli<\/strong><\/p>\n Glutensiz unlar\u0131n besin de\u011ferleri ve pi\u015firme \u00f6zelliklerinin birbirinden farkl\u0131 oldu\u011funu belirten \u00c7etinkaya, tariflerde tek un yerine birka\u00e7 farkl\u0131 glutensiz unun birlikte kullan\u0131lmas\u0131n\u0131n daha ba\u015far\u0131l\u0131 sonu\u00e7 verebilece\u011fini s\u00f6yledi.<\/p>\n \u00c7etinkaya, \u201cAra\u015ft\u0131rmalarda nohut ve bezelye unlar\u0131n\u0131n y\u00fcksek lif i\u00e7erdi\u011fi; karabu\u011fday, kinoa ve yulaf unlar\u0131n\u0131n ise esansiyel amino asitleri sa\u011flayan kaliteli protein kaynaklar\u0131 oldu\u011fu belirtilmi\u015ftir. Karabu\u011fday unu, B vitamini, mineral ile antioksidan a\u00e7\u0131s\u0131ndan zengindir. \u00d6zellikle krep, g\u00f6zleme ve h\u0131zl\u0131 ekmek tariflerinde kullan\u0131lmaktad\u0131r. Nohut unu y\u00fcksek protein ve lif i\u00e7eri\u011fi sayesinde tortilla, k\u00f6fte ve tuzlu tariflerde tercih edilirken; badem unu d\u00fc\u015f\u00fck glisemik indeksli yap\u0131s\u0131yla kurabiye ve kek tariflerinde \u00f6ne \u00e7\u0131kmaktad\u0131r\u201d dedi.<\/p>\n Pirin\u00e7 unu, kinoa unu ve Hindistan cevizi ununun da farkl\u0131 tariflerde kullan\u0131labilece\u011fini aktaran \u00c7etinkaya, \u201cGluten hamura elastikiyet ve yap\u0131 kazand\u0131rd\u0131\u011f\u0131 i\u00e7in glutensiz tariflerde ba\u011flay\u0131c\u0131 maddelere ihtiya\u00e7 duyulmaktad\u0131r. Bu ama\u00e7la en s\u0131k ksantan gam, psyllium kabu\u011fu ve yumurta kullan\u0131lmaktad\u0131r. Ayr\u0131ca tek bir un yerine 2\u20133 farkl\u0131 glutensiz unun birlikte kullan\u0131lmas\u0131, doku ve lezzet a\u00e7\u0131s\u0131ndan daha ba\u015far\u0131l\u0131 sonu\u00e7lar sa\u011flamaktad\u0131r\u201d diye konu\u015ftu.<\/p>\n \u00c7ocuklarda sunum ve lezzet uyumu kolayla\u015ft\u0131r\u0131yor<\/strong><\/p>\n \u00c7\u00f6lyakl\u0131 \u00e7ocuklarda glutensiz diyetin ba\u011f\u0131rsak sa\u011fl\u0131\u011f\u0131n\u0131n d\u00fczelmesinde kritik rol oynad\u0131\u011f\u0131n\u0131 belirten \u00c7etinkaya, \u00e7ocuklar\u0131n diyete uyumunda lezzet ve sunumun b\u00fcy\u00fck \u00f6nem ta\u015f\u0131d\u0131\u011f\u0131n\u0131 s\u00f6yledi.<\/p>\n \u00c7etinkaya, \u201cYeni tan\u0131 alan \u00e7ocuklar\u0131n y\u00fczde 50’sinden fazlas\u0131 ilk y\u0131l i\u00e7erisinde ba\u011f\u0131rsak iyile\u015fmesi ya\u015famaktad\u0131r. Baz\u0131 \u00e7ocuklarda iyile\u015fme \u00fc\u00e7\u00fcnc\u00fc aydan itibaren ba\u015flayabilmektedir. Bu nedenle glutensiz diyetin erken d\u00f6nemde uygulanmas\u0131 son derece \u00f6nemlidir\u201d dedi.<\/p>\n \u00c7ocuklar i\u00e7in e\u011flenceli ve sa\u011fl\u0131kl\u0131 alternatiflerin tercih edilmesini \u00f6neren \u00c7etinkaya, \u201cKarabu\u011fday ve pirin\u00e7 unu ile haz\u0131rlanan mini pizzalar, glutensiz yulafla yap\u0131lan kakaolu enerji toplar\u0131, muzlu karabu\u011fday waffle, m\u0131s\u0131r unlu f\u0131r\u0131n nugget, meyveli kinoa pudingi ve nohut unu ile haz\u0131rlanan g\u00f6zlemeler hem besleyici hem de \u00e7ocuklar\u0131n ilgisini \u00e7ekebilecek se\u00e7enekler aras\u0131nda yer almaktad\u0131r\u201d ifadelerini kulland\u0131.<\/p>\n","protected":false},"excerpt":{"rendered":" Uzmanlar, \u00e7\u00f6lyak hastal\u0131\u011f\u0131 ile gluten hassasiyetinin ayn\u0131 \u015fey olmad\u0131\u011f\u0131n\u0131 belirterek, glutensiz diyete ba\u015flamadan \u00f6nce mutlaka \u00e7\u00f6lyak taramas\u0131 yap\u0131lmas\u0131 gerekti\u011fini vurguluyor.<\/p>\n","protected":false},"author":6,"featured_media":30858,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[2136,8009,10741],"class_list":["post-30857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik","tag-beslenme","tag-colyak","tag-gluten"],"yoast_head":"\n