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You eat the same things as your friend, but why are you fat when he’s weak? Can the reason why you constantly crave carbohydrates in your 30s be hidden in your 3-year-old eating habit? Are you sure that even though you are at your ideal weight at the weigh-in, you do not have health problems?

Turkey Medicals member Metabolism Faculty of Medicine Prof. Doctor in Antalya Turkey, emphasized how wrong it is to constantly calculate calories, see probiotics as the exact solution, or measure health only by looking at body weight, and touched on interesting results in Turkish scientific studies. The star explains the mistake of the Taken-for-granted calorie calculation made about weight loss: there is no such thing. Our body protects fat and muscle tissue with extremely complex mechanisms. So there is no scientific background to simply calculate calories, especially to apply uniform diets, to say, “weight is lost when you completely cut off carbohydrates or fat.” was said.

Current approaches to many problems, from diabetes to obesity, thyroid to neuroendocrine tumors, were discussed. At the press conference held within the scope of the Congress, Experts who conveyed the latest approaches to diagnosis and treatment of Endocrinology and metabolic diseases touched on important issues.

Department of Endocrinology and Metabolism of Faculty of Medicine of Hacettepe University Doctor in Ankara, gave specific information, while criticizing the approaches popularized today on weight loss, stressed that they do not have a scientific background. Prof. “Losing weight in a healthy way is not possible just by calculating the calories taken-Given,” says the star. Here are important explanations…


How does food and air pollution affect our hormones?

Today, we know that those who live in cities with dirty air have a greater risk of becoming obese and developing diabetes than in rural areas. Beyond that, recent studies show that testosterone, the male hormone, is declining in men living in large cities with air pollution. But in addition, today, foods are also becoming an important factor in terms of diseases. After World War II, we see differences in our lifestyle, and with these differences, we see an increase in not only endocrine and metabolic diseases, but also diseases of the immune system, cancer, disorders that we call inflammatory diseases, and nervous and mental diseases, up to autism. In this increase, the most important effects of the foods we take from the environment are microbes in our intestines. This area of science is moving very fast. The fact is that today we know that there are good and bad germs in our intestines; we know that both these microbes themselves and some of the substances they secrete affect the permeability of our gut. So much so that when you have good germs in your gut, when you get the same calorie food as someone who doesn’t, one of you gets weight, the other can’t. So, interestingly, microbes talk to many organs inside our bodies, especially our brain and liver. So we need to maintain the diversity of these hundred trillion microbes in our gut. This diversity has begun to decline significantly today.

A recent study looks at the intestinal diversity of individuals living in the United States and natives living in the Amazons, and it seems that those living in the Amazons have 2-4 times more diversity in their intestines. We see the importance of protecting this diversity in every study. One factor in maintaining this is nutrition, but in addition, our genes and metabolism fall into this equation. Our genes affect our metabolism, the nutrients we take and our environment affect it; in other words, it works with extremely complex mechanisms, which we human beings are always looking for simple answers to complex questions. For example, by measuring body weight, by measuring body mass index (BMI), we are trying to progress as “walk a lot, eat a little, lose weight”. Let me give you an example: for example, if you add an extra ice cream to your diet every day, you get 3,500 extra calories a week out of 500 calories. When you hit it on the moon, you need to gain 2 pounds every month. Then according to this account, you should be fattening a person by 24 pounds a year by giving them ice cream every day. But there’s nothing like that. Our body protects fat and muscle tissue with extremely complex mechanisms.Nov. Therefore, there is no scientific background to simply calculate calories, especially to apply uniform diets, to say that we will completely cut out carbohydrates or fat.


Our bodies have a tango of the hormone leptin and the hormone ghrelin. I’m one of the first physicians in the world to use the hormone leptin on humans, and we were very excited when we saw our first data. We did our work in America and got incredible results. In our studies during the same period, we showed for the first time in the world how ghrelin changed not only once a day, but also how many times in 24 hours, by frequent blood sampling method. In obese and weak people, we measured ghrelin 207 times, taking blood every 7 minutes for 24 hours a day. Leptin and ghrelinde; before each meal, the hormone ghrelin rises and you get hungry. Then you eat and it falls. In doing this study, we kept obese and weak individuals in an environment where they could eat as much as they wanted, and we never interfered with their diet. In our study, we found that the obese need to eat much more at night than the weak. So we thought hunger hormones were increasing, and we took measurements. But interestingly, people who were weak had higher hunger hormones at night than those who were obese. But the obese were eating more. This also means; we can’t solve this with one hunger hormone or one satiety hormone!

There’s more than one mechanism in our brain. When you start shutting down one of these mechanisms, the body immediately opens another mechanism and protects itself. Therefore, if you are not at peace with your body and do not implement a sustainable policy, you will not get anywhere with a uniform diet. I’m a physician who gives obesity conferences all over the world, and I always say this: when you go to a bookstore in the world in the United States and Turkey, you always see that there are nutrition and diet books in the front row. If the weight problem is improving with the recommendations of these books, How is Turkey still number one on obesity in Europe or why are there more than 2 billion obese people in the world? So these are not the solutions, and the case is not solved in such a simple mechanism.

In your speech, you mentioned that a new term may come in place of body mass index (BMI); metabolic Body Mass Index… can you explain this a little bit?

Can we use MVKI, metabolic body mass index, instead of BMI? In fact, now we know BMI as the parameter that best shows fat in your body. But one in every 5 people does not seem to have an association with BMI and your risk of disease. Why? Because BMI does not reliably show how much fat is in the body in one out of every 5 people. So there are people among us who have a normal BMI and have a metabolism associated with the disease. But one in every 5 obese people is actually obese, although they do not have a risk of disease, sugar or heart disease. This shows us that it’s not just about how you measure body weight, it’s about what’s inside your metabolism. Therefore, if we are going to talk about individual specific treatment, nutrition, medicine, medicine in the future, we need to understand the difference of our metabolism here. Thousands of metabolic products in our blood also play a role in understanding this difference.


A new study published in October in the journal Cell Metabolism says that when we put 49 of these metabolic products in our blood at the bottom (there are fatty acids, amino acids, vitamins, sugar… etc.) better than BMI, we can see if that person will be obese in the future. Perhaps in the near future, by measuring Mvki with just a drop of blood, we will be able to figure out whether we will be sick in the future. These tests are currently being conducted at the research level. The data is very exciting. They’ve been following 2 thousand Twins for 13 years. At 3 points, they map all their genes, look at all their body fat, height and weight, measure all their metabolics. They aim to show health and aging in twins because the effect of genes and environment is more comfortable in Twins. For example, there are more than a hundred candidate genes that determine obesity. These genes are associated with BMI, but only 2 percent of the difference in BMI is explained by genes. And those genes are only associated with your BMI, but they don’t show it if your metabolism is bad. So Metabolom will definitely take part in our individual medicine approach in the medicine of the future.


We call them TOFI: thin outside, fat inside… these people looks weak from the outside, but there’s a marked fat around the internal organs, but it is a very expensive method to measure Mr everyone that you need to do and it’s not possible. So if we can solve the balance of metabolism from metallonomy without looking at these expensive methods, it doesn’t matter how much BMI is.

How are the studies in Turkey?

We have now started studies on the gut microbiome. These studies must be done in Turkey, because we have a very different nutritional variety according to the regions.

Microbes in our body, like hormones, constantly fluctuate in number and variety, for example, the hormone leptin has a rhythm; it rises into the night. Now we are talking about a hundred trillion microbes in this microbiome, and we see that the number and diversity of good and bad microbes during the day varies according to the hours, which is a biological clock. Like the circadian rhythm, we get it day and night according to light, but these are microbes in the dark. How can they have such a rhythm? This rhythm also comes from the relationship between what time of day you eat and your genetics and metabolism. Interesting ways are also tried in the study; gaita (feces) samples are taken from people, microbes are looked at. Then this person is sent to the United States. The participant travels 13 hours and is in a jetlag state. And then a sample of the microbiome in this state is taken. I’m transferring this sample to a mouse model that doesn’t have any germs in its intestines, the mouse gets fat and its sugar rises. So we can say that travel and jetlag increase the risk of chronic diseases, and it has this effect on microbes.

So how does this fluctuation of microbes during the day affect psychology?

It’s not just the microbes themselves, it’s the chemicals they release. So they also communicate with hormones in the brain. Two weeks ago, as the European Endocrine Society, we held a meeting on microbes, hormones, Basic Science in France. There we talked about the relationship of these microbes with depression because they affect mood in a very dramatic way. Therefore, in those who say “I have fluctuations” as a mood, what they eat that day, microbes in the gut can be effective. But it’s all clearly shown in animal studies, and we’re not at a point where we can put a more precise cause-and-effect relationship in humans. So you have to be careful about it. So his job is not to go to” definitely Use Probiotics.” Maybe five years from now, but there’s no study result that I can say, “be sure to take this probiotic.”


In a Normal birth, the baby comes out, passing through the mother’s canal, picking up better and useful bacteria. But when you take the baby from the abdomen by caesarean section, the baby takes bacteria that can be harmful from the skin and comes out. In the same way, these beneficial bacteria pass through the breast with breastfeeding. So there’s a dramatic difference between feeding milk from a bottle instead of sucking it from a breast. In a person up to the age of three, we call it your germ signature, the number and variety of microbes are settled, and what you do after that is more limited. So in our society, habits such as using antibiotics in childhood, eating too many carbohydrates are very wrong. And hormones have something to do with the sense of taste. If you eat a lot of carbohydrates when you are 2-3 years old, you always want carbohydrates at 33 years old. At this point, it is very important that families are informed.

What do you say about PCOS (Polycystic Ovary Syndrome)?

PCOS (Polycystic Ovary Syndrome) is a lifelong syndrome. It is believed that there is an early programming in the womb when the baby is exposed to some of the mother’s hormones, including male hormones. So when you’re in your mother’s womb, it seems to be programmed whether you’re going to have PCOS when you’re approaching puberty. After that, how fast you gain weight in childhood, at what age you enter puberty, your hormone balance after that is affected, and by the age of 15, these things become clear. After that, there is an increase in male hormones, menstrual irregularities, ovulation problems, and as your age progresses, metabolic problems also begin to add to this along with insulin resistance. But the beautiful thing is that if you keep nutrition healthy from childhood and put physical activity into work, you can also regulate your ovulation in such a way that you may not need any medication in the future.

The fat in our bodies speaks to every organ. The fact that the oil is more or less in the right place makes us difficult. For example, your ovaries say, “ovulation is a luxury job for the brain. If everything else in the body is going well, I will ovulate, if it is not going well, I will not ovulate.” The body can prevent ovulation, especially when the abdomen is too much fat around you. In the same way, think of a woman who is a professional athlete, this time she says that she will not ovulate again because there is little fat in this area. So here’s what the body really wants; “You’ll provide me with a normal amount of adipose tissue in the right place.” The same goes for men; weight increases, waist circumference thickens, male hormone drops. We need to listen, understand and manage the conversation between adipose tissue and other organs. This is possible. If this is done at an early age, there are many people who are fine without taking medication, who manage themselves, whose hormone values go within the normal range.

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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


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Medically Reviewed by Professor Doctor Alper Demirbaş
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