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饮食与污染物:引发肥胖症流行的元凶?

Diet and Contaminants: Driving the Rise to Obesity Epidemics?

机构信息

Division of Internal Medicine, Hospital of Bisceglie, Italy - International Society of Doctors for Environment (ISDE), Arezzo, Italy.

Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy.

出版信息

Curr Med Chem. 2019;26(19):3471-3482. doi: 10.2174/0929867324666170518095736.

Abstract

The obesity epidemic is spreading worldwide without reversal trend and despite specific policies oriented to dietary habits and lifestyle, which seem to have modest effects. Genetic factors only partly explain the rise, whereas environmental factors seem to play a key role, mainly by gene-environment interactions through epigenetic mechanisms. A number of animal and human studies point to maternal diet, intestinal microbiota and chemicals introduced as contaminants with food, all factors able to increase the risk of obesity. Widely diffused toxics (mainly BPA, phthalates, pesticides) are able to promote obesity in children and adults, mainly by acting on the differentiation pathway linking multipotent stromal stem cell to mature adipocyte, modulating epigenetic factors and influencing a series of mechanisms finally leading to altered dietary habits, increased adipocyte formation and fat storage. Furthermore, the adipose tissue is an important target for several chemicals (mainly POPs) which represent a threat to metabolic health. In conclusion, besides excessive individual energy intake and inadequate lifestyle, other broadly diffused and modifiable factors (mainly ingestion of toxic chemicals with food) seem to have a critical role in the rapid epidemiological growing of obesity, also considering trans-generational transmission of risk and later development of obesity due to exposure during early life. Further studies are needed, to better assess interactions between cumulative effects of toxic food contaminants and modification of diet and lifestyle, and to verify the efficacy of primary prevention strategies acting on all these factors and potentially able to reverse the continuous rising of the obesity epidemic.

摘要

肥胖症在全球范围内蔓延,且没有逆转的趋势,尽管有针对饮食习惯和生活方式的特定政策,但这些政策似乎效果甚微。遗传因素只能部分解释肥胖的上升,而环境因素似乎起着关键作用,主要通过基因-环境相互作用通过表观遗传机制。许多动物和人类研究表明,母体饮食、肠道微生物群和作为污染物引入食物的化学物质,所有这些因素都能增加肥胖的风险。广泛传播的有毒物质(主要是双酚 A、邻苯二甲酸酯、农药)能够促进儿童和成人肥胖,主要是通过作用于将多能基质干细胞分化为成熟脂肪细胞的途径,调节表观遗传因素并影响一系列最终导致饮食习惯改变、脂肪细胞形成和脂肪储存增加的机制。此外,脂肪组织是许多化学物质(主要是持久性有机污染物)的重要靶标,这些化学物质对代谢健康构成威胁。总之,除了个体摄入过多的能量和生活方式不当之外,其他广泛传播和可改变的因素(主要是摄入含有有毒化学物质的食物)似乎在肥胖症的快速流行中起着关键作用,还考虑到风险的跨代传递和由于生命早期暴露而导致的肥胖的后期发展。需要进一步研究,以更好地评估有毒食物污染物的累积效应与饮食和生活方式改变之间的相互作用,并验证针对所有这些因素的初级预防策略的有效性,这些策略可能有助于扭转肥胖症的持续流行。

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