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Ernährung und Nahrungsergänzungsmittel zur Prävention

Nutrition and dietary supplements for prevention

  • Leitthema
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Der Gynäkologe Aims and scope

Zusammenfassung

Eine adäquate Ernährung und ein gesunder Lebensstil können das Risiko für Krebs und kardiovaskuläre Erkrankungen wirksam beeinflussen. Epidemiologischen Daten zufolge bestehen bei Frauen mit der geringsten Adhärenz im Hinblick auf Ernährungs- und Lebensstilempfehlungen eine 3‑fach erhöhte Krebsmortalität und ein 4‑fach erhöhtes Risiko für kardiovaskulären Tod. Erwiesenermaßen geht die Wirkung von Ernährung und Lebensstil weit über die Beeinflussung klassischer Risikofaktoren hinaus, beispielsweise über Effekte auf die Inflammation, epigenetische Prozesse und das Darmmikrobiom. Daher ist die Verbesserung von Ernährungs- und Lebensstilgewohnheiten ein wesentliches Ziel in der Prävention chronischer Erkrankungen. Ernährungsinterventionen sollten darauf abzielen, tierische Lebensmittel durch Obst, Gemüse, Hülsenfrüchte und Vollkornprodukte zu ersetzen und die Alkoholzufuhr einzuschränken. Darüber hinaus sollten ein stabiles Körpergewicht möglichst im Normbereich und ein normaler Taillenumfang angestrebt werden. Gesunde Frauen können den Mikronährstoffbedarf ganz wesentlich über eine adäquate Ernährung decken. Bei Älteren kann die Vitamin B12-Versorgung aufgrund einer atrophischen Gastritis und der Vitamin-D-Status durch Rückgang der körpereigenen Syntheseleistung unzureichend sein. Anders als Medikamente können Nahrungsergänzungsmittel ohne Wirksamkeitsnachweis durch klinische Studien auf den Markt gebracht werden. Derzeit ist die Evidenz für den Einsatz von Supplementen unzureichend, weshalb die pauschale Verwendung im Alltag nicht empfohlen wird. Der regelmäßige Gebrauch von Supplementen ohne ärztliche Rücksprache ist eine Gratwanderung zwischen Nutzen und Risiko aufgrund inadäquater Dosierungen, unbekannter Nebenwirkungen und Wechselwirkungen mit Medikamenten.

Abstract

An appropriate diet and a healthy lifestyle may effectively reduce the risk for cancer and cardiovascular disease. According to epidemiological data, women with the lowest adherence to nutrition and lifestyle recommendations are characterized by a 3‑fold higher increase of dying from cancer and a 4‑fold increase with regard to cardiovascular death. Evidently the impact of diet and lifestyle on cancer and cardiovascular disease goes beyond the effects of classical risk factors and may target inflammatory processes, epigenetic modification, and the intestinal microbiome. Hence, improving dietary and lifestyle habits is a major goal in terms of chronic disease prevention. The basis of dietary intervention should always be a shift from food of animal origin to fruits, vegetables, legumes, and whole grain products, while alcohol intake should be limited. Furthermore, a stable weight that is ideally within the normal range and a normal waist circumference are recommended. In healthy women, the micronutrient intake can essentially be met by adequate nutrition. In older women, vitamin B12 deficiency due to atrophic gastritis and lower plasma levels of vitamin D due to reduced endogenous synthesis capacity of the skin are common. However, in contrast to pharmaceuticals, the efficacy of dietary supplements in clinical trials must not be demonstrated prior to marketing. At present, the evidence for the use of most supplements is insufficient; therefore, general use in daily practice is not recommended. Regular intake of supplements without consulting a physician carries the risk of unknown side effects, inadequate dosages, and possible drugs interactions.

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  1. Präventive Medizin, Universitäres Herzzentrum Hamburg GmbH (UHZ), Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52 – Haus N36, 20246, Hamburg, Deutschland

    B.‑C. Zyriax

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Zyriax, B. Ernährung und Nahrungsergänzungsmittel zur Prävention. Gynäkologe 49, 236–242 (2016). https://doi.org/10.1007/s00129-016-3854-9

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