The University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Med Hypotheses. 2011 Dec;77(6):1114-20. doi: 10.1016/j.mehy.2011.09.016. Epub 2011 Oct 6.
The epidemic of overweight and obesity around the world and in the US is a major public health challenge, with 1.5 billion overweight and obese adults worldwide, and 68% of US adults and 31% of US children and adolescents overweight or obese. Obesity leads to serious health consequences, including an increased risk of type 2 diabetes mellitus and heart disease. Current preventive and medical treatments include lifestyle modification, medication, and bariatric surgery in extreme cases; however, they are either not very efficacious or are very expensive. Obesity is a complex condition involving the dysregulation of several organ systems and molecular pathways, including adipose tissue, the pancreas, the gastrointestinal tract, and the CNS. The role of the CNS in obesity is receiving more attention as obesity rates rise and treatments continue to fail. While the role of the hypothalamus in regulation of appetite and food intake has long been recognized, the roles of the CNS reward systems are beginning to be examined as the role of environmental influences on energy balance are explored. Omega-3 polyunsaturated fatty acids are essential nutrients that play a beneficial role in several disease processes due to their anti-inflammatory effects, modulation of lipids, and effects on the CNS. Omega-3 fatty acids, specifically EPA and DHA, have shown promising preliminary results in animal and human studies in the prevention and treatment of obesity. Given their effects on many of the pathways involved in obesity, and specifically in the endocannabinoid and mesocorticolimbic pathways, we hypothesize that EPA and DHA supplementation in populations can reduce the reward associated with food, thereby reduce appetite and food intake, and ultimately contribute to the prevention or reduction of obesity. If these fatty acids do harbor such potential, their supplementation in many parts of the world may hold great promise in reducing the global burden of obesity.
全球及美国的超重和肥胖流行是一个主要的公共卫生挑战，全世界有 15 亿超重和肥胖成年人，68%的美国成年人和 31%的美国儿童和青少年超重或肥胖。肥胖会导致严重的健康后果，包括 2 型糖尿病和心脏病风险增加。目前的预防和医疗治疗包括生活方式改变、药物治疗和极端情况下的减肥手术；然而，它们要么效果不是很好，要么非常昂贵。肥胖是一种涉及多个器官系统和分子途径失调的复杂疾病，包括脂肪组织、胰腺、胃肠道和中枢神经系统。随着肥胖率的上升和治疗方法的持续失败，中枢神经系统在肥胖中的作用越来越受到关注。虽然下丘脑在调节食欲和食物摄入方面的作用早已被认识，但随着对环境对能量平衡的影响的探索，中枢神经系统奖励系统的作用开始被研究。ω-3 多不饱和脂肪酸是必需的营养物质，由于其抗炎作用、脂质调节作用和对中枢神经系统的作用，在几种疾病过程中发挥有益作用。ω-3 脂肪酸，特别是 EPA 和 DHA，在预防和治疗肥胖的动物和人类研究中显示出有希望的初步结果。鉴于它们对肥胖涉及的许多途径的影响，特别是在内源性大麻素和中脑边缘通路中的作用，我们假设在人群中补充 EPA 和 DHA 可以减少与食物相关的奖励，从而降低食欲和食物摄入量，并最终有助于预防或减少肥胖。如果这些脂肪酸确实具有这种潜力，那么在世界许多地方补充这些脂肪酸可能在减轻全球肥胖负担方面具有很大的潜力。
