Hwalla Nahla, Jaafar Zeinab
Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut 1107 2020, Lebanon.
Diagnostics (Basel). 2020 Dec 25;11(1):24. doi: 10.3390/diagnostics11010024.
Obesity is a multi-factorial disease and its prevention and management require knowledge of the complex interactions underlying it and adopting a whole system approach that addresses obesogenic environments within country specific contexts. The pathophysiology behind obesity involves a myriad of genetic, epigenetic, physiological, and macroenvironmental factors that drive food intake and appetite and increase the obesity risk for susceptible individuals. Metabolically, food intake and appetite are regulated via intricate processes and feedback systems between the brain, gastrointestinal system, adipose and endocrine tissues that aim to maintain body weight and energy homeostasis but are also responsive to environmental cues that may trigger overconsumption of food beyond homeostatic needs. Under restricted caloric intake conditions such as dieting, these processes elicit compensatory metabolic mechanisms that promote energy intake and weight regain, posing great challenges to diet adherence and weight loss attempts. To mitigate these responses and enhance diet adherence and weight loss, different dietary strategies have been suggested in the literature based on their differential effects on satiety and metabolism. In this review article, we offer an overview of the literature on obesity and its underlying pathological mechanisms, and we present an evidence based comparative analysis of the effects of different popular dietary strategies on weight loss, metabolic responses and diet adherence in obesity.
肥胖是一种多因素疾病，其预防和管理需要了解其背后复杂的相互作用，并采用一种整体系统方法，在特定国家背景下应对致胖环境。肥胖背后的病理生理学涉及无数遗传、表观遗传、生理和宏观环境因素，这些因素驱动食物摄入和食欲，并增加易感个体的肥胖风险。在新陈代谢方面，食物摄入和食欲通过大脑、胃肠系统、脂肪和内分泌组织之间复杂的过程和反馈系统进行调节，这些系统旨在维持体重和能量平衡，但也会对可能引发超出稳态需求的食物过度消费的环境线索做出反应。在节食等热量摄入受限的情况下，这些过程会引发促进能量摄入和体重反弹的代偿性代谢机制，给坚持节食和减肥尝试带来巨大挑战。为了减轻这些反应并增强节食依从性和减肥效果，文献中根据不同饮食策略对饱腹感和新陈代谢的不同影响提出了不同的饮食策略。在这篇综述文章中，我们概述了关于肥胖及其潜在病理机制的文献，并对不同流行饮食策略对肥胖患者体重减轻、代谢反应和节食依从性的影响进行了基于证据的比较分析。
