Bischoff Stephan C, Boirie Yves, Cederholm Tommy, Chourdakis Michael, Cuerda Cristina, Delzenne Nathalie M, Deutz Nicolaas E, Fouque Denis, Genton Laurence, Gil Carmen, Koletzko Berthold, Leon-Sanz Miguel, Shamir Raanan, Singer Joelle, Singer Pierre, Stroebele-Benschop Nanette, Thorell Anders, Weimann Arved, Barazzoni Rocco
University of Hohenheim, Department of Nutritional Medicine, Stuttgart, Germany.
University of Clermont Auvergne, Human Nutrition Unit, Department of Clinical Nutrition, CHU Clermont-Ferrand, France.
Clin Nutr. 2017 Aug;36(4):917-938. doi: 10.1016/j.clnu.2016.11.007. Epub 2016 Nov 16.
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens. Obesity is usually accompanied by an increased muscle mass. This might explain why obesity, under particular circumstances such as cancer or high age, might have protective effects, a phenomenon named the 'obesity paradox'. However, loss of muscle mass or function can also occur, which is associated with poor prognosis and termed 'sarcopenic obesity'. Therefore, treatment recommendations may need to be individualized and adapted to co-morbidities. Since obesity is a chronic systemic disease it requires a multidisciplinary approach, both at the level of prevention and therapy including weight loss and maintenance. In the present personal review and position paper, authors from different disciplines including endocrinology, gastroenterology, nephrology, pediatrics, surgery, geriatrics, intensive care medicine, psychology and psychiatry, sports medicine and rheumatology, both at the basic science and clinical level, present their view on the topic and underline the necessity to provide a multidisciplinary approach, to address this epidemic.
营养过剩和久坐不动的生活方式会导致超重或肥胖，超重或肥胖被定义为可能损害健康的异常或过多脂肪堆积。根据世界卫生组织的数据，1980年至2008年间，全球肥胖患病率几乎翻了一番。2008年，世界卫生组织欧洲区域超过50%的男性和女性超重，约23%的女性和20%的男性肥胖。全面的诊断和治疗方法应包括营养治疗，以实现最佳的代谢和营养结果，并从选定的营养方案中获得潜在的特定疾病益处。肥胖通常伴随着肌肉量的增加。这可能解释了为什么在某些特定情况下，如癌症或高龄，肥胖可能具有保护作用，这一现象被称为“肥胖悖论”。然而，肌肉量或功能的丧失也可能发生，这与预后不良相关，被称为“肌肉减少性肥胖”。因此，治疗建议可能需要个性化，并根据合并症进行调整。由于肥胖是一种慢性全身性疾病，它需要多学科方法，包括预防和治疗层面，如体重减轻和维持。在本个人综述和立场文件中，来自不同学科的作者，包括内分泌学、胃肠病学、肾病学、儿科学、外科学、老年医学、重症监护医学、心理学和精神病学、运动医学和风湿病学，在基础科学和临床层面，就该主题发表了他们的观点，并强调了提供多学科方法来应对这一流行病的必要性。
