Müller Manfred J, Bosy-Westphal Anja, Heymsfield Steven B
F1000 Med Rep. 2010 Aug 9;2:59. doi: 10.3410/M2-59.
There is evidence for the idea that there is biological (active) control of body weight at a given set point. Body weight is the product of genetic effects (DNA), epigenetic effects (heritable traits that do not involve changes in DNA), and the environment. Regulation of body weight is asymmetric, being more effective in response to weight loss than to weight gain. However, regulation may be lost or camouflaged by Western diets, suggesting that the failure of biological control is due mainly to external factors. In this situation, the body's 'set point' (i.e., a constant 'body-inherent' weight regulated by a proportional feedback control system) is replaced by various 'settling points' that are influenced by energy and macronutrient intake in order for the body to achieve a zero energy balance. In a world of abundance, a prudent lifestyle and thus cognitive control are preconditions of effective biological control and a stable body weight. This idea also impacts future genetic research on body weight regulation. Searching for the genetic background of excess weight gain in a world of abundance is misleading since the possible biological control is widely overshadowed by the effect of the environment. In regard to clinical practice, dietary approaches to both weight loss and weight gain have to be reconsidered. In underweight patients (e.g., patients with anorexia nervosa), weight gain is supported by biological mechanisms that may or may not be suppressed by hyperalimentation. To overcome weight loss-induced counter-regulation in the overweight, biological signals have to be taken into account. Computational modeling of weight changes based on metabolic flux and its regulation will provide future strategies for clinical nutrition.
有证据支持这样一种观点,即体重在给定的设定点存在生物学(主动)控制。体重是遗传效应(DNA)、表观遗传效应(不涉及DNA变化的可遗传特征)和环境的产物。体重调节是不对称的,对体重减轻的反应比对体重增加更有效。然而,西方饮食可能会使这种调节丧失或被掩盖,这表明生物控制的失败主要是由于外部因素。在这种情况下,身体的“设定点”(即由比例反馈控制系统调节的恒定“身体固有”体重)被各种“稳定点”所取代,这些稳定点受能量和常量营养素摄入的影响,以便身体实现能量平衡为零。在物质丰富的世界里,谨慎的生活方式以及认知控制是有效生物控制和稳定体重的前提条件。这一观点也影响了未来关于体重调节的基因研究。在物质丰富的世界里寻找体重过度增加的遗传背景是具有误导性的,因为可能的生物控制被环境的影响广泛掩盖。在临床实践方面,必须重新考虑减肥和增重的饮食方法。对于体重过轻的患者(如神经性厌食症患者),增重受到生物机制的支持,这些机制可能会被过度营养抑制,也可能不会。为了克服超重患者体重减轻引起的反调节,必须考虑生物信号。基于代谢通量及其调节的体重变化计算模型将为临床营养提供未来的策略。