Department of Internal Medicine, Division of Endocrinology, Erasmus MC, 3015 GD Rotterdam, The Netherlands.
Int J Mol Sci. 2023 Feb 25;24(5):4551. doi: 10.3390/ijms24054551.
The metabolic syndrome is a cluster of overlapping conditions resulting in an increased incidence of type 2 diabetes, cardiovascular disease, and cancer. In the last few decades, prevalence of the metabolic syndrome in the Western world has reached epidemic proportions and this is likely due to alterations in diet and the environment as well as decreased physical activity. This review discusses how the Western diet and lifestyle (Westernization) has played an important etiological role in the pathogenesis of the metabolic syndrome and its consequences by exerting negative effects on activity of the insulin-insulin-like growth factor-I (insulin-IGF-I) system. It is further proposed that interventions that normalize/reduce activity of the insulin-IGF-I system may play a key role in the prevention and treatment of the metabolic syndrome. For successful prevention, limitation, and treatment of the metabolic syndrome, the focus should be primarily on changing our diets and lifestyle in accordance with our genetic make-up, formed in adaptation to Paleolithic diets and lifestyles during a period of several million years of human evolution. Translating this insight into clinical practice, however, requires not only individual changes in our food and lifestyle, starting in pediatric populations at a very young age, but also requires fundamental changes in our current health systems and food industry. Change is needed: primary prevention of the metabolic syndrome should be made a political priority. New strategies and policies should be developed to stimulate and implement behaviors encouraging the sustainable use of healthy diets and lifestyles to prevent the metabolic syndrome before it develops.
代谢综合征是一组相互重叠的病症，会导致 2 型糖尿病、心血管疾病和癌症的发病率增加。在过去几十年中，代谢综合征在西方世界的流行程度已达到流行程度，这可能是由于饮食和环境的改变以及体力活动的减少所致。本篇综述讨论了西方饮食和生活方式（西化）如何通过对胰岛素-胰岛素样生长因子-I（胰岛素-IGF-I）系统的活性产生负面影响，在代谢综合征的发病机制及其后果中发挥重要的病因作用。进一步提出，使胰岛素-IGF-I 系统的活性正常化/降低的干预措施可能在代谢综合征的预防和治疗中发挥关键作用。为了成功预防、限制和治疗代谢综合征，应主要侧重于根据我们的遗传构成来改变我们的饮食和生活方式，这种遗传构成是在人类进化几百万年的时间里适应旧石器时代的饮食和生活方式而形成的。然而，将这一见解转化为临床实践，不仅需要在儿童时期就开始改变我们的食物和生活方式，而且还需要对我们当前的卫生系统和食品工业进行根本性的改变。需要进行改变：预防代谢综合征应成为政治优先事项。应制定新的战略和政策，以鼓励和实施鼓励可持续使用健康饮食和生活方式的行为，在代谢综合征发展之前进行预防。
