Kozlov A I
D. Anuchin Research Institute and Museum of Anthropology, Lomonosov Moscow State University, Moscow, Russia.
Vopr Pitan. 2019;88(1):5-16. doi: 10.24411/0042-8833-2019-10001. Epub 2018 Nov 13.
By the end of the 2010-s the prevalence of obesity among the indigenous people of the North approached to the all-Russia one and the speed of the spread of other metabolic disorders exceeded the average all-country levels. Aim of this review is to analyze data on the increase in consumption and variety of sugars coupled with a genetic specificity of regulation of saccharidase activity and their possible impact on the matters. Results. It have been shown that the traditional protein-lipid-based northern type diet has substantially changed and now contains a high proportion of carbohydrates. The carbohydrate per capita consumption among the indigenous people of the North has reached the all-Russia average level (40 kg per year) which exceeds the European average of 36.2 kg per year. The variety of food disaccharides has also considerably increased. The daily consumption of sucrose, at the beginning of the 20th century it was the only sugar contained in the store-bought foods, increased from 30 g in the 1930s to 63-65 g in the 1990s. In addition, the proportion of sucrose dropped to 60-70 per cent, while the contribution of other disaccharides (lactose, trehalose) reached 30-40 per cent. Daily starch consumption has also increased and got close to the national average (males 228.5 g, females 157.5 g per day). Such a diet in itself increases the risk of metabolic disorders and obesity. The high prevalence of the genotypes that determine reduced levels or inability to produce sucrase-isomaltase, lactase, trehalase, salivary and pancreatic amylases among northerners becomes a negative cofactor. The evolutionary driven and embodied in genotype reduced ability of the indigenous Arctic people to digest complex carbohydrates is in a conflict with the growing consumption of sugars and starchy foods in modern conditions. The northern people have a high proportion of carriers of the AG deletion in SI gene (3.5-14.3% against 0.05-0.2% among Europeans) which determines malabsorption of sucrose. The CC/LCT genotype (96.6% in northerners, 36-49% in Russians) presumes lactose intolerance and is associated with the risk of childhood obesity. The occurrence of A allele in the rs2276064 locus of TREH gene (trehalose intolerance; 31.3-58.9% in northerners, 1.9% in Europeans) increases the probability of the onset of type 2 diabetes mellitus. According to preliminary estimates, 28-52% of the northerners completely lost AMY gene that precludes or drastically reduces the ability to digest starch. A reduction in the number of copies of AMY gene (the average number of copies AMY2A - 4, in, in northerners it is 1.0-1.4) is associated with overweight and obesity. Conclusion. The analysis shows that, in the case of the modern indigenous northerners, nutritional and genetic risks of metabolic disorders accumulate.
到2010年代末，北方原住民中的肥胖患病率接近全俄罗斯水平，其他代谢紊乱的传播速度超过全国平均水平。本综述的目的是分析糖类消费增加和种类多样的数据，以及糖苷酶活性调节的遗传特异性及其对相关问题可能产生的影响。结果。研究表明，传统的以蛋白质 - 脂质为主的北方型饮食已发生显著变化，现在碳水化合物比例很高。北方原住民的人均碳水化合物消费量已达到全俄罗斯平均水平（每年40千克），超过欧洲年均36.2千克的水平。食物中二糖的种类也大幅增加。蔗糖的日消费量，在20世纪初它是市售食品中唯一含有的糖类，从20世纪30年代的30克增加到90年代的63 - 65克。此外，蔗糖的比例降至60 - 70%，而其他二糖（乳糖、海藻糖）的占比达到30 - 40%。每日淀粉消费量也有所增加，接近全国平均水平（男性每天228.5克，女性每天157.5克）。这样的饮食本身就增加了代谢紊乱和肥胖的风险。北方人中决定蔗糖酶 - 异麦芽糖酶、乳糖酶、海藻糖酶、唾液淀粉酶和胰淀粉酶水平降低或无法产生的基因型的高流行率成为一个负面辅助因素。北极原住民受进化驱动且体现在基因型上的消化复杂碳水化合物能力的降低，与现代条件下糖类和淀粉类食物消费的增加相冲突。北方人群中SI基因AG缺失携带者比例很高（3.5 - 14.3%，而欧洲人为0.05 - 0.2%），这决定了蔗糖吸收不良。CC/LCT基因型（北方人为96.6%，俄罗斯人为36 - 49%）意味着乳糖不耐受，并与儿童肥胖风险相关。TREH基因rs2276064位点A等位基因的出现（海藻糖不耐受；北方人为31.3 - 58.9%，欧洲人为1.9%）增加了2型糖尿病发病的概率。据初步估计，28 - 52%的北方人完全缺失AMY基因，这排除或大幅降低了消化淀粉的能力。AMY基因拷贝数的减少（AMY2A基因拷贝数平均为4，北方人为1.0 - 1.4）与超重和肥胖相关。结论。分析表明，对于现代北方原住民而言，代谢紊乱的营养和遗传风险正在累积。
