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肥胖的成因

Pathways to obesity.

作者信息

Jéquier E

机构信息

Institute of Physiology, University of Lausanne, Switzerland.

出版信息

Int J Obes Relat Metab Disord. 2002 Sep;26 Suppl 2:S12-7. doi: 10.1038/sj.ijo.0802123.

Abstract

The prevalence of obesity is increasing worldwide, which indicates that the primary cause of obesity lies in environmental and behavioural changes rather than in genetic modifications. Among the environmental influences, the percentage of fat energy of the everyday diet and the lack of physical activity are two important factors, which contribute to explain the rising prevalence of obesity. In this review, several lines of evidence are presented to illustrate why dietary fat does affect obesity development. There are four factors which support a link between dietary fat and obesity development:The thermic effect of nutrients, expressed as percentage of their energy content, is 2-3% for lipids, 6-8% for carbohydrates and 25-30% for proteins. This means that the efficiency of nutrient utilization (calculated as 100%-the thermic effect of the nutrient) is higher for fat than for carbohydrate or protein.Postingestive fuel selection favours the oxidation of dietary proteins and carbohydrates, whereas dietary fats are preferentially stored as triacylglycerol in adipose tissue. Alcohol, by inhibiting lipid oxidation, indirectly favours the storage of dietary fats.High-fat diet promotes excessive energy intake by passive overconsumption; the fat-induced appetite control signals are too weak or too delayed to prevent excessive energy intake from a fatty meal. The only proof that dietary fats contribute to weight gain is to test the long-term effect of ad libitum low-fat diets. Most studies on low-fat diets show that they induce a modest weight loss in obese individuals, but their long-term effect from a public health perspective is limited, probably due to a low compliance to the dietary advice.

摘要

全球肥胖症的患病率正在上升,这表明肥胖症的主要原因在于环境和行为变化,而非基因变异。在环境影响因素中,日常饮食中脂肪能量的占比以及缺乏体育活动是两个重要因素,这有助于解释肥胖症患病率不断上升的现象。在本综述中,列举了几条证据来说明膳食脂肪为何确实会影响肥胖症的发展。有四个因素支持膳食脂肪与肥胖症发展之间的联系:营养物质的热效应,以其能量含量的百分比表示,脂质为2%-3%,碳水化合物为6%-8%,蛋白质为25%-30%。这意味着脂肪的营养物质利用效率(计算方法为100%减去营养物质的热效应)高于碳水化合物或蛋白质。摄食后燃料选择有利于膳食蛋白质和碳水化合物的氧化,而膳食脂肪则优先作为三酰甘油储存在脂肪组织中。酒精通过抑制脂质氧化,间接促进膳食脂肪的储存。高脂肪饮食通过被动过度摄食促进能量摄入过多;脂肪诱导的食欲控制信号过于微弱或延迟,无法阻止从高脂餐中摄入过多能量。膳食脂肪导致体重增加的唯一证据是测试随意摄入低脂饮食的长期效果。大多数关于低脂饮食的研究表明,它们会使肥胖个体适度减重,但从公共卫生角度来看,其长期效果有限,可能是由于对饮食建议的依从性较低。

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