Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
Nutr Res Rev. 2019 Dec;32(2):282-293. doi: 10.1017/S0954422419000143. Epub 2019 Jul 12.
Psychosocial stress, uncontrolled eating and obesity are three interrelated epidemiological phenomena already present during youth. This broad narrative conceptual review summarises main biological underpinnings of the stress-diet-obesity pathway and how new techniques can further knowledge. Cortisol seems the main biological factor from stress towards central adiposity; and diet, physical activity and sleep are the main behavioural pathways. Within stress-diet, the concepts of comfort food and emotional eating are highlighted, as cortisol affects reward pathways and appetite brain centres with a role for insulin, leptin, neuropeptide Y (NPY), endocannabinoids, orexin and gastrointestinal hormones. More recently researched biological underpinnings are microbiota, epigenetic modifications and metabolites. First, the gut microbiota reaches the stress-regulating and appetite-regulating brain centres via the gut-brain axis. Second, epigenetic analyses are recommended as diet, obesity, stress and gut microbiota can change gene expression which then affects appetite, energy homeostasis and stress reactivity. Finally, metabolomics would be a good technique to disentangle stress-diet-obesity interactions as multiple biological pathways are involved. Saliva might be an ideal biological matrix as it allows metagenomic (oral microbiota), epigenomic and metabolomic analyses. In conclusion, stress and diet/obesity research should be combined in interdisciplinary collaborations with implementation of several -omics analyses.
心理社会压力、不受控制的饮食和肥胖是三种相互关联的流行病学现象,在青年时期就已经存在。本广泛叙述性概念综述总结了压力-饮食-肥胖途径的主要生物学基础,以及新技术如何进一步加深我们对这一途径的了解。皮质醇似乎是压力向中心性肥胖发展的主要生物学因素;而饮食、体力活动和睡眠则是主要的行为途径。在压力-饮食关系中,强调了舒适食物和情绪性进食的概念,因为皮质醇会影响奖励途径和食欲脑区,其中涉及胰岛素、瘦素、神经肽 Y (NPY)、内源性大麻素、食欲素和胃肠道激素。最近研究的生物学基础还有微生物组、表观遗传修饰和代谢物。首先,肠道微生物组通过肠-脑轴到达调节压力和食欲的大脑中枢。其次,建议进行表观遗传学分析,因为饮食、肥胖、压力和肠道微生物组可以改变基因表达,从而影响食欲、能量平衡和应激反应性。最后,代谢组学将是一种很好的技术,可以理清压力-饮食-肥胖的相互作用,因为涉及到多个生物学途径。唾液可能是一种理想的生物基质,因为它允许进行宏基因组(口腔微生物组)、表观基因组和代谢组学分析。总之,应通过多组学分析,将压力和饮食/肥胖研究相结合,开展跨学科合作。
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