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对低能量摄入的适应:婴儿、儿童和成人对低摄入量的反应及限度

Adaptation to low energy intakes: the responses and limits to low intakes in infants, children and adults.

作者信息

Shetty P S

机构信息

Department of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, UK.

出版信息

Eur J Clin Nutr. 1999 Apr;53 Suppl 1:S14-33. doi: 10.1038/sj.ejcn.1600741.

Abstract

Reduction in energy intake below the acceptable level of requirement for an individual results in a series of physiological and behavioural responses, which are considered as an adaptation to the low energy intake. This ability of the human body to adapt to a lowering of the energy intake is without doubt beneficial to the survival of the individual. However, what is more controversial is the view held by some that the body can metabolically adapt in a beneficial manner to a lowered intake and consequently that the requirements for energy are variable given the same body size and composition and physical activity levels. Much of this confusion is the result of considerable evidence from studies conducted in well-nourished adults who, for experimental or other reasons, have lowered their intakes and consequently demonstrated an apparently enhanced metabolic efficiency resulting from changes in metabolic rates which are disproportionate to the changes in body weight. Similar increases in metabolic efficiency are not readily seen in individuals who on long-term marginal intakes, probably from childhood, have developed into short-statured, low-body-weight adults with a different body composition. It would thus appear that the generally used indicator of metabolic efficiency in humans, that is a reduced oxygen consumption per unit fat free mass, is fraught with problems since it does not account for variations in contributions from sub-compartments of the fat free mass which include those with high metabolism at rest such as brain and viscera and those with low metabolism at rest such as muscle mass. Metabolic rate per unit fat free mass thus, does not reflect true variations in metabolic efficiency and is due largely to variations in body composition. This finding combined with the evidence that behavioural adaptation in habitual physical activity patterns which occurs on energy restriction is not necessarily beneficial to the individual raises doubts about the role of adaptation to low intakes in determining one's requirement for energy. The evidence is overwhelming that both in children and adults, changes in body size and composition as well as in levels of habitual physical activity may be the most important consequences of a lowered energy intake and cannot be assumed to be a part of a beneficial adaptation that influences energy requirements.

摘要

能量摄入量降至个体可接受的需求水平以下会引发一系列生理和行为反应,这些反应被视为对低能量摄入的一种适应。人体适应能量摄入降低的这种能力无疑对个体的生存有益。然而,更具争议性的是一些人的观点,即身体能够以有益的方式在代谢上适应摄入量的降低,因此在相同的身体大小、组成和身体活动水平下,能量需求是可变的。这种困惑很大程度上源于对营养良好的成年人进行的研究的大量证据,这些成年人出于实验或其他原因降低了摄入量,结果显示由于代谢率的变化与体重变化不成比例,代谢效率明显提高。在长期处于边缘摄入量的个体中,可能从童年开始就发育成身材矮小、体重低且身体组成不同的成年人,却不容易看到类似的代谢效率提高。因此,人类代谢效率通常使用的指标,即每单位去脂体重的氧气消耗量降低,似乎存在问题,因为它没有考虑去脂体重各亚部分贡献的变化,这些亚部分包括静息代谢率高的如大脑和内脏,以及静息代谢率低的如肌肉量。因此,每单位去脂体重的代谢率并不能反映代谢效率的真正变化,主要是由于身体组成的变化。这一发现与能量限制时习惯性身体活动模式的行为适应不一定对个体有益的证据相结合,引发了人们对适应低摄入量在确定一个人的能量需求中所起作用的怀疑。有压倒性的证据表明,无论在儿童还是成年人中,身体大小和组成以及习惯性身体活动水平的变化可能是能量摄入量降低的最重要后果,不能被假定为影响能量需求的有益适应的一部分。

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