Reproductive Health and Nutrition

.: PREFACE
ÖN SÖZ
PREFACE
Editör: Prof. Dr. Yasemin AKDEVELİOĞLUa, Editör Yardımcısı: Dr. Öğr. Üyesi Sabriye ARSLANa
aGazi Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
Article Language: TR
''Doğurganlık yolculuğunuzun tabağınızdakilerle başladığına inanıyoruz...''

Üreme sağlığı, bireylerin yaşam kalitesini ve toplumsal refahını doğrudan etkileyen temel bir sağlık göstergesidir. Kadın ve erkeklerde üreme fonksiyonlarının sağlıklı bir şekilde sürdürülebilmesi; hormonal denge, genetik yatkınlıklar ve yaşam tarzı gibi birçok faktörle ilişkilidir. Modern yaşamın getirdiği değişimlerle birlikte hareketsiz bir yaşam tarzı, Batı tarzı beslenme alışkanlıklarının takip edilmesi ve obezite oranlarındaki dramatik artış; üreme sağlığını olumsuz yönde etkilemektedir. Dünya Sağlık Örgütü, yaklaşık 80 milyon çifti etkileyen infertiliteyi önemli bir halk sağlığı problemi olarak görmektedir. Benzer şekilde doğurganlık çağındaki kadınların yaklaşık %6-19'unda görülen polikistik over sendromu oldukça yaygın bir hastalık olarak karşımıza çıkmaktadır.

Beslenme, yaşam tarzı ile ilgili faktörler arasında yer alan önemli ve kontrol edilebilir unsurlarından biri olarak öne çıkmaktadır. Tüm besin ögesi gereksinimlerini karşılayan yeterli ve dengeli bir diyet, optimal hormonal dengeyi koruma, sağlıklı ovülasyon ve sperm üretimini teşvik ederek gebelik şansını artırmaya yardımcı olabilir. Beslenme, üreme sisteminin gelişimi ve sürdürülmesinde (fertilizasyon), fetüsün sağlıklı büyümesi ve gelişimi (gebelik sonuçları), sağlıklı ovülasyon, düzenli adet döngüleri (menstüral siklus) ve menopoz sağlığı konularında kritik bir role sahiptir.

Beslenme ve üreme sağlığı arasındaki karmaşık ilişkiyi ortaya koymak amacıyla hazırladığımız bu kitapta, Merve ATEŞ, M. Funda CEVHER AKDULUM ve Ahmet ERDEM, makalelerinde hem erkek hem de kadınlarda diyetin; doğurganlık, hormonal denge ve genel üreme sağlığı üzerindeki önemine değinirken; Büşra BAŞAR GÖKCEN de makalesinde, özellikle maternal yetersiz beslenmenin, obezite ve makro/mikro besin ögesi eksikliklerinin fetal beyin gelişimini doğrudan etkileyebileceğini belirtmiş, her iki makalede de özellikle yüksek doz mikro besin ögesi takviyelerinin potansiyel yan etkilerinin söz konusu olabileceğine vurgu yapılmıştır.

Emine YASSIBAŞ, kadınlarda oosit gelişimi, embriyo kalitesi ve implantasyon gibi süreçleri etkileyen obezitenin; düşük testosteron, spermatogenez bozukluğu ve erektil disfonksiyon gibi mekanizmalar yoluyla erkek üreme fonksiyonunu da olumsuz yönde etkileyebileceğini belirtmiş ve obezitenin fertilite üzerinde oluşturduğu olumsuz etkileri azaltmaya yönelik uygulanan ağırlık kaybı müdahalelerinin potansiyel faydalarını ele almıştır. Günümüzde yaygın olarak maruz kaldığımız endokrin bozucular, hormonal ve metabolik süreçleri bozarak üreme sağlığını olumsuz yönde etkileyebilir. Bu durumun mikrobiyal çeşitliliği de etkileyebileceğine değinen Özge CEMALİ, beslenme alışkanlıkları ve yaşam tarzı değişikliklerinin endokrin bozuculara maruziyeti azaltmada etkili bir strateji olabileceğini vurgulamıştır.

Feride AYYILDIZ, üreme sistemlerinin mikrobiyotasının üreme sağlığının iyileştirilmesinde ve yönetilmesinde önemli bir faktör olarak son yıllarda oldukça fazla ilgi çektiğini, disbiyosizin; sperm kalitesi, oosit gelişimi ve gebelik sonuçları üzerinde olumsuz etkilerinin olduğunu, potansiyel bir tedavi seçeneği olarak probiyotiklerin kullanılabileceğini, ancak uzun vadeli etkilerine ve belirli üreme sağlığı sorunlarına yönelik daha fazla kanıta ihtiyaç duyulduğunu belirtmiştir. Emine KOÇYİĞİT, oksidatif stresin, glikasyon son ürünlerinin birikiminin ve kronik inflamasyonun infertiliteyle ilişkisini ele almıştır. Ayçıl ÖZTURAN ŞİRİN de kadınlarda özellikle PKOS, ovulasyon kalitesi ve gebelik sonuçları üzerine olumlu etkiler gösterebilen inositolün, erkek üreme sağlığında ise sperm kalitesini artırmada ve oksidatif stresin olumsuz etkilerini azaltmada çinko ve selenyumun öne çıktığını vurgulamıştır. Her iki yazar da mikro besin ögelerinin uzun süreli kullanımına ve optimal dozlarına ilişkin daha fazla çalışmanın yapılması gerekliliğine işaret etmişlerdir.

Emine ELİBOL makalesinde özellikle doymuş ve trans yağ asitlerinin infertilite riskini artırıcı, omega-3 gibi çoklu doymamış yağ asitlerinin de üreme sağlığını iyileştirici etkilerine yer vermiştir. Betül SUKAN KARAÇAĞIL ve Nilüfer ACAR TEK, fitokimyasalların üreme sağlığı üzerindeki faydalı ve potansiyel zarar verici etkilerinin tam olarak belirlenemediğini, özellikle farklı bireylerde gösterdikleri etkilerdeki değişkenlik ve yan etki potansiyeli hakkında daha fazla çalışmaya ihtiyaç olduğunu vurgulamışlardır. Elif ÇELİK ve Feray GENÇER BİNGÖL, erkek üreme sağlığı üzerine biyoaktif besin bileşenlerinin oksidatif stresi azaltarak; sperm sayısı, hareketliliği ve canlılığında artış sağlayabildiğini, ancak yüksek dozlarının olumsuz etkilerinin tam olarak anlaşılması ve güvenli dozların belirlenmesi konusunda daha fazla araştırma yapılması gerektiğini, Teslime Özge ŞAHİN, Neslihan ARSLAN ve Özge YEŞİLDEMİR de antioksidanlar açısından zengin sebzeler, meyveler, yağlı tohumlar ve balık tüketiminin oksidatif stresi azaltarak sperm parametreleri üzerinde olumlu etkiler gösterdiğini vurgulamış olup işlenmiş etlerin, doymuş ve trans yağ asidi içeriği yüksek besinlerin tüketiminin; sperm kalitesini ve üreme hormon düzeylerini etkileyerek infertiliteye neden olabileceğine dikkat çekmişlerdir. Ayşe Derya BAYAZIT ile birlikte hazırlamış olduğumuz makalede de kadın üreme sağlığı ve fonksiyonlarında beslenmenin önemini besin grupları bazında ele aldık.

Kitabımızda yer alan Gamze YURTDAŞ DEPBOYLU, Sabriye ARSLAN, Hatice BÖLÜKBAŞI ve Menşure Nur ÇELİK tarafından kaleme alınan her üç makalede de Akdeniz diyeti gibi sağlıklı beslenme modellerinin infertilite ve endometriozis tedavisindeki olumlu etkilerine değinilmiştir. Büşra TOTAN DÖYEN ile birlikte hazırladığımız makalemizde de, PKOS'lu kadınların diyet tedavisinde düşük glisemik indeksli, posa içeriği yüksek, antioksidanlardan zengin ve doymuş yağdan fakir bir beslenme modelinin faydalarını irdeledik. Büşra ATABİLEN de menopoz döneminde semptomların yönetimi, kardiyovasküler sağlık, kemik mineral yoğunluğunun korunması ve meme kanseri riskinin azaltılmasında Akdeniz diyetinin önemini ortaya koymuştur.

Özetle, bu kitapta beslenmenin erkek ve kadın fertilitesini (ovulasyon bozuklukları, hormonal dengesizlik ve sperm kalitesi) ve bebek gelişimini (bilişsel ve bağışıklık fonksiyonları, metabolik bozukluklar) nasıl etkileyebileceğine dair yeni bilgilere yer verilmiştir. Bu bilgilerin; sağlık profesyonellerini, kanıta dayalı diyet müdahalelerine (uygun diyet tavsiyesi, takviye stratejileri ve yaşam tarzı değişiklikleri sunma) ve kişiselleştirilmiş beslenme yaklaşımlarına uygun olarak optimal üreme sağlığını korumak, gebelik şansını ve gebelik sonuçlarını iyileştirmek için yeni stratejiler geliştirmeye teşvik edeceğine ümit ediyorum.

Bu kitabın yayına hazırlanmasında emeğini ve desteğini esirgemeyen, editör yardımcım Sabriye ARSLAN başta olmak üzere tüm yazarlara ve bu alanda çalışan tüm araştırmacılara teşekkür eder, üreme sağlığı sorunlarına çözüm getirebilecek nitelikte yapılacak yüksek kanıt düzeyine sahip beslenme ve diyetetik alanındaki çalışmaların artarak devam etmesini dilerim. ''Üreme Sağlığı ve Beslenme'' konulu bu kitabı; beni her zaman destekleyen ve bu günlere gelmemde büyük fedakârlıklar gösteren canım annem Güner DEMİRCİOĞLU'na ve canım babam Osman DEMİRCİOĞLU'na ithaf ediyorum.

Prof. Dr. Yasemin AKDEVELİOĞLU
Editör
Gazi Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye

Üreme sağlığı, üreme sistemiyle ilgili tüm konularda tam fiziksel, ruhsal ve sosyal refah durumunu ifade eder. Hem erkekler hem de kadınlar için önemli olup, üreme sağlığı temel bir haktır. Üreme sağlığı; aile planlaması, gebelik öncesi bakım, infertilite, gebelik, doğum ve kanserler de dâhil olmak üzere çok çeşitli konuları kapsar. Bu nedenle üreme sağlığı yalnızca bireyin değil toplumların sürdürülebilir sağlığı açısından da büyük önem taşır. Bunun yanısıra sağlıklı nesillerin yetişmesi, bireylerin üreme sağlığını korumaları ve geliştirmeleri ile doğrudan ilişkilidir. Bu süreçlerin tümünde beslenme, hem bireylerin sağlığı hem de gelecek nesillerin sağlığı açısından kritik bir role sahiptir.

Bu kitap, üreme sağlığı ve beslenme arasındaki ilişkiyi güncel bilimsel veriler ışığında ele almaktadır. Bu eserin, sağlık profesyonelleri, akademisyenler, öğrenciler ve konuya ilgi duyan herkes için değerli bir kaynak olacağına inanıyorum. Kitabın hazırlanmasında emeği geçen başta editörümüz Prof. Dr. Yasemin AKDEVELİOĞLU olmak üzere katkı veren tüm yazarlara ve Türkiye Klinikleri ekibine teşekkür eder, okuyucularımıza faydalı olmasını dilerim.

Saygılarımla.

Dr. Öğr. Üyesi Sabriye ARSLAN
Editör Yardımcısı
Gazi Üniversitesi Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü, Ankara, Türkiye
''We believe that your fertility journey begins with what's on your plate...''

Reproductive health is a fundamental health indicator that directly affects the quality of life of individuals and societal welfare. The healthy maintenance of reproductive functions in both women and men is related to many factors such as hormonal balance, genetic predispositions, and lifestyle. With the changes brought about by modern life, a sedentary lifestyle, the adoption of Western dietary habits, and the dramatic increase in obesity rates negatively impact reproductive health. The World Health Organization considers infertility, which affects approximately 80 million couples, a significant public health issue. Similarly, polycystic ovary syndrome, which is observed in approximately 6-19% of women of childbearing age, is a common disease.

Nutrition stands out as one of the important and controllable factors among lifestylerelated aspects. A sufficient and balanced diet that meets all nutrient requirements can help increase the chances of pregnancy by maintaining optimal hormonal balance, promoting healthy ovulation, and sperm production. Nutrition plays a critical role in the development and maintenance of the reproductive system (fertilization), the healthy growth and development of the fetus (pregnancy outcomes), healthy ovulation, regular menstrual cycles, and menopausal health.

In this book, prepared to reveal the complex relationship between nutrition and reproductive health, Merve ATEŞ, M. Funda CEVHER AKDULUM, and Ahmet ERDEM discuss the importance of diet on fertility, hormonal balance, and overall reproductive health in both men and women. Büşra BAŞAR GÖKCEN, in her article, emphasizes that maternal malnutrition, obesity, and macro/micro nutrient deficiencies can directly affect fetal brain development, highlighting the potential side effects of highdose micronutrient supplements in both articles.

Emine YASSIBAŞ notes that obesity affects processes such as oocyte development, embryo quality, and implantation in women, while negatively impacting male reproductive functions through mechanisms such as low testosterone, spermatogenesis disorders, and erectile dysfunction. She also discusses the potential benefits of weight loss interventions aimed at reducing the negative effects of obesity on fertility. Endocrine disruptors, which we are commonly exposed to today, can negatively affect reproductive health by disrupting hormonal and metabolic processes. Özge CEMALİ highlights that changes in dietary habits and lifestyle can be an effective strategy to reduce exposure to endocrine disruptors.

Feride AYYILDIZ mentions that the microbiota of reproductive systems has attracted considerable interest in recent years as an important factor in improving and managing reproductive health. She states that dysbiosis has negative effects on sperm quality, oocyte development, and pregnancy outcomes, and that probiotics may be a potential treatment option, although more evidence is needed regarding their longterm effects and specific reproductive health issues. Emine KOÇYİĞİT addresses the relationship between oxidative stress, the accumulation of glycation end products, and chronic inflammation with infertility. Ayçıl ÖZTURAN ŞİRİN emphasizes that inositol can have positive effects on ovulation quality and pregnancy outcomes in women, while zinc and selenium stand out in improving sperm quality and reducing the negative effects of oxidative stress in male reproductive health. Both authors indicate the need for more studies on the long-term use and optimal doses of micronutrients.

In her article, Emine ELİBOL discusses the infertility risk-increasing effects of saturated and trans fatty acids, as well as the reproductive health-improving effects of polyunsaturated fatty acids like omega-3. Betül SUKAN KARAÇAĞIL and Nilüfer ACAR TEK emphasize that the beneficial and potentially harmful effects of phytochemicals on reproductive health are not fully understood, and that more research is needed regarding variability in their effects among different individuals and their potential side effects. Elif ÇELİK and Feray GENÇER BİNGÖL state that bioactive food components can reduce oxidative stress in male reproductive health, leading to increased sperm count, motility, and viability, but more research is needed to understand the adverse effects of high doses and to determine safe dosages. Teslime Özge ŞAHİN, Neslihan ARSLAN, and Özge YEŞİLDEMİR highlight that the consumption of antioxidant-rich vegetables, fruits, oilseeds, and fish has positive effects on sperm parameters by reducing oxidative stress, while the consumption of processed meats and foods high in saturated and trans fatty acids can lead to infertility by affecting sperm quality and reproductive hormone levels. In the article we prepared together with Ayşe Derya BAYAZIT, we discussed the importance of nutrition in women's reproductive health and functions based on food groups.

In this book, the three articles written by Gamze YURTDAŞ DEPBOYLU, Sabriye ARSLAN, Hatice BÖLÜKBAŞI, and Menşure Nur ÇELİK all discuss the positive effects of healthy eating models, such as the Mediterranean diet, on the treatment of infertility and endometriosis. In our article prepared with Büşra TOTAN DÖYEN, we explored the benefits of a low glycemic index, high fiber, antioxidant-rich, and low saturated fat diet model for women with PCOS. Büşra ATABİLEN has also emphasized the importance of the Mediterranean diet in managing symptoms during menopause, maintaining cardiovascular health, preserving bone mineral density, and reducing the risk of breast cancer.

In summary, this book includes new information on how nutrition can affect the fertility of both men and women (ovulation disorders, hormonal imbalances, and sperm quality) and fetal development (cognitive and immune functions, metabolic disorders). It is hoped that this information will encourage health professionals to develop new strategies to maintain optimal reproductive health, improve the chances of pregnancy, and enhance pregnancy outcomes through evidence-based dietary interventions (appropriate dietary recommendations, supplementation strategies, and lifestyle changes) and personalized nutrition approaches.

I would like to express my gratitude to all the authors and researchers in this field, especially my assistant editor, Sabriye ARSLAN, for their invaluable efforts and support in preparing this book for publication. I hope that studies in the field of nutrition and dietetics, which can provide solutions to reproductive health issues with a high level of evidence, will continue to increase. I dedicate this book on ''Reproductive Health and Nutrition'' to my beloved mother, Güner DEMİRCİOĞLU, who has always supported me and made great sacrifices in helping me reach this point, and to my dear father, Osman DEMİRCİOĞLU.

Prof. Dr. Yasemin AKDEVELİOĞLU
Editor
Gazi University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Türkiye

Reproductive health refers to a state of complete physical, mental, and social wellbeing in all matters related to the reproductive system. It is essential for both men and women and is recognized as a fundamental human right. Reproductive health encompasses a wide range of topics, including family planning, preconception care, infertility, pregnancy, childbirth, and reproductive cancers. Therefore, reproductive health is not only crucial for individual well-being but also for the sustainable health of societies. Furthermore, raising healthy generations is directly linked to individuals' ability to protect and improve their reproductive health. Nutrition plays a critical role throughout these processes, both for individual health and for the health of future generations.

This book examines the relationship between reproductive health and nutrition in light of current scientific evidence. I believe this work will serve as a valuable resource for healthcare professionals, academics, students, and anyone interested in the subject. I would like to extend my gratitude to all contributing authors, especially our editor, Prof. Dr. Yasemin AKDEVELİOĞLU, and the Türkiye Klinikleri team, for their efforts in preparing this book. I hope it proves beneficial to our readers.

Sincerely.

Assist. Prof. Dr. Sabriye ARSLAN
Associate
Editor Gazi University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Türkiye

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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com