Nutrigenomics Research Group, UCD Conway Institute, and Institute of Food and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland.
School of Medicine, University College Dublin, Dublin, Republic of Ireland.
Rev Endocr Metab Disord. 2023 Oct;24(5):921-936. doi: 10.1007/s11154-023-09821-5. Epub 2023 Jul 5.
Obesity is a heterogenous disease accompanied by a broad spectrum of cardiometabolic risk profiles. Traditional paradigms for dietary weight management do not address biological heterogeneity between individuals and have catastrophically failed to combat the global pandemic of obesity-related diseases. Nutritional strategies that extend beyond basic weight management to instead target patient-specific pathophysiology are warranted. In this narrative review, we provide an overview of the tissue-level pathophysiological processes that drive patient heterogeneity to shape distinct cardiometabolic phenotypes in obesity. Specifically, we discuss how divergent physiology and postprandial phenotypes can reveal key metabolic defects within adipose, liver, or skeletal muscle, as well as the integrative involvement of the gut microbiome and the innate immune system. Finally, we highlight potential precision nutritional approaches to target these pathways and discuss recent translational evidence concerning the efficacy of such tailored dietary interventions for different obesity phenotypes, to optimise cardiometabolic benefits.
肥胖是一种异质性疾病，伴有广泛的心血管代谢风险谱。传统的饮食体重管理模式没有考虑个体之间的生物学异质性，并且灾难性地未能对抗肥胖相关疾病的全球流行。需要超越基本体重管理的营养策略，转而针对患者特定的病理生理学。在这篇叙述性综述中，我们概述了驱动患者异质性的组织水平病理生理过程，以形成肥胖症中不同的心血管代谢表型。具体来说，我们讨论了不同的生理学和餐后表型如何揭示脂肪、肝脏或骨骼肌内的关键代谢缺陷，以及肠道微生物组和固有免疫系统的综合参与。最后，我们强调了针对这些途径的潜在精准营养方法，并讨论了最近关于这种针对不同肥胖表型的饮食干预的有效性的转化证据，以优化心血管代谢益处。
