Blum Kenneth, Chen Thomas J H, Meshkin Brian, Downs B William, Gordon Cory A, Blum Seth, Mengucci Julie F, Braverman Eric R, Arcuri Vanessa, Varshavskiy Michael, Deutsch Roger, Martinez-Pons Manuel
Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1083, USA.
Adv Ther. 2006 Nov-Dec;23(6):1040-51. doi: 10.1007/BF02850224.
Obesity is the second largest preventable cause of death in the United States. Even though it was classified as a disease in 1985, traditionally, obesity has been treated primarily as a behavioral problem that requires only modifications in diet and exercise. Similar to research on obesity, clinical studies have elucidated the role of biologic and genetic factors in alcoholism and other conditions previously classified as behavioral. These studies showed that behavioral adjustments alone may not address underlying genetic causes. We hypothesize that biologic and genetic factors must be addressed synergistically while behavioral modifications are implemented to adequately treat obese patients. We hypothesize that a predisposition to glucose craving and obesity is due to inadequate dopaminergic activity in the reward center of the brain. This defect drives individuals to engage in activities of behavioral excess, which, in turn, enhance brain dopamine function. Consumption of large quantities of alcohol or carbohydrates (carbohydrate bingeing) stimulates production and usage of dopamine within the brain; the term reward deficiency syndrome (RDS) may be used to categorize such biologic influences on behavior. We propose that a novel approach to nutritional supplementation may be required to target the role of RDS in obesity. In this regard, GenoTrim, a DNA-customized nutritional solution, has been developed and is currently under investigation in several clinical studies. Through its mechanism of action, GenoTrim addresses the genetic influence of RDS on obesity. In this cross-sectional study, 24 subjects were studied after they had completed a case report format questionnaire. For this assessment, we used a novel assessment tool-a path analysis. This statistical regression model is used to (1) examine the effectual relationships between various systems within a multisystem matrix, and (2) measure the contributory roles of those relationships in obesity, enabling the development of targeted and effective therapeutic interventions.
肥胖是美国第二大可预防的死因。尽管在1985年它被归类为一种疾病，但传统上，肥胖主要被视为一个行为问题，只需要在饮食和运动方面进行调整。与肥胖研究类似，临床研究已经阐明了生物学和遗传因素在酒精中毒以及其他先前被归类为行为问题的病症中的作用。这些研究表明，仅靠行为调整可能无法解决潜在的遗传原因。我们假设，在对肥胖患者进行充分治疗时，必须在实施行为改变的同时协同解决生物学和遗传因素。我们假设，对葡萄糖渴望和肥胖的易感性是由于大脑奖励中心多巴胺能活性不足所致。这种缺陷驱使个体从事行为过度的活动，而这反过来又会增强大脑多巴胺功能。大量饮酒或摄入碳水化合物（碳水化合物暴饮暴食）会刺激大脑内多巴胺的产生和使用；奖励缺乏综合征（RDS）这一术语可用于对这种对行为的生物学影响进行分类。我们提出，可能需要一种新的营养补充方法来针对RDS在肥胖中的作用。在这方面，已经开发出一种名为GenoTrim的定制DNA营养解决方案，目前正在多项临床研究中进行调查。通过其作用机制，GenoTrim解决了RDS对肥胖的遗传影响。在这项横断面研究中，24名受试者在完成一份病例报告格式问卷后接受了研究。对于此次评估，我们使用了一种新工具——路径分析。这种统计回归模型用于（1）检查多系统矩阵中各个系统之间的有效关系，以及（2）衡量这些关系在肥胖中的贡献作用，从而能够制定有针对性且有效的治疗干预措施。
