Simopoulos A P
Ann N Y Acad Sci. 1987;499:4-13. doi: 10.1111/j.1749-6632.1987.tb36193.x.
Obesity is considered to be a major nutritional disorder in the U.S. and in many parts of the industrialized world. The physiology of the obese and their propensity for chronic disease has been of growing interest over the past few years, and an extensive literature has begun to accumulate. Obesity is a heterogeneous disorder. When viewed in the broadest sense, it has been considered a disorder of energy balance. The development of obesity in humans is of complex etiology, involving genetic and environmental components that affect regulatory and metabolic events. The prevalence of overweight and obesity in a population depends on the particular reference or standard of desirable weight selected for use. A trend toward increasing height and weight has been evident among adults for several centuries, and among children as early as the 7th year of life in developed countries. Overweight persons are at increased risk for coronary artery disease, high blood pressure, diabetes mellitus, and cancer. The degree of overweight that carries additional risk without affecting mortality needs to be defined. Overweight most likely contributes in varying degrees to morbidity in different societies, because the risk for most common chronic diseases is multifactorial. In defining overweight and obesity, morbidity, in addition to mortality, ought to be taken into consideration. The multidisciplinary approach to the study of obesity--borrowing concepts and techniques from endocrinology, neurobiology, genetics, and nutrition--should yield new insights into how environmental factors such as diet and physical expenditure interact to influence energy metabolism and body composition.
肥胖被认为是美国以及工业化世界许多地区的一种主要营养失调症。在过去几年里,肥胖者的生理学及其患慢性病的倾向越来越受到关注,大量文献也开始积累。肥胖是一种异质性疾病。从最广泛的意义来看,它被视为能量平衡失调。人类肥胖的发生病因复杂,涉及影响调节和代谢过程的遗传和环境因素。人群中超重和肥胖的患病率取决于所选用的理想体重的特定参考标准或标准。几个世纪以来,成年人中身高和体重呈增长趋势,在发达国家,儿童早在7岁时就出现了这种趋势。超重者患冠状动脉疾病、高血压、糖尿病和癌症的风险增加。需要确定在不影响死亡率的情况下具有额外风险的超重程度。超重很可能在不同社会中对发病率有不同程度的影响,因为大多数常见慢性病的风险是多因素的。在定义超重和肥胖时,除了死亡率之外,还应考虑发病率。采用多学科方法研究肥胖——借鉴内分泌学、神经生物学、遗传学和营养学的概念和技术——应该能对饮食和体力活动等环境因素如何相互作用以影响能量代谢和身体组成产生新的认识。