Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK.
Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV1 5FB, UK.
Nutrients. 2024 Aug 15;16(16):2714. doi: 10.3390/nu16162714.
The prevalence of obesity globally has tripled over the last half century, and currently affects around 650 million adults and 340 million children and adolescents (ages 5-19 years). Obesity contributes towards >50 co-morbidities and premature mortality. Obesity is a highly stigmatised condition that is associated with much mental and emotional distress and dysfunction. Thus, obesity is a major contributor to healthcare expenditure globally. Traditionally, the management of obesity stratifies into three major groups that include metabolic (bariatric) surgery, pharmacotherapies, and lifestyle (primarily dietary) strategies. Although listed as a separate category, dietary strategies for obesity remain a central component of any management plan, and often complement other surgical and pharmacotherapeutic options. Indeed, the effectiveness of any management approach for obesity relies upon successful behavioural changes, particularly relating to eating behaviours. In this concise review, we explore the foundational pillars of dietary strategies for obesity: sleep, listening, routine, de-stressing and optimisation of social conditions. We then discuss the importance of balancing dietary macronutrients (including dietary fibre, carbohydrates, protein and ultra-processed foods [UPFs]) as a key dietary strategy for obesity. Although we focus on general principles, we should provide bespoke dietary strategies for our patients, tailored to their individual needs. Rather than judging the utility of a diet based simply on its associated magnitude of weight loss, we should adopt a more holistic perspective in which a dietary strategy is valued for its overall health benefits, including the nurturing of our gut microbiota, to enable them to nurture and protect us.
在过去的半个世纪里，肥胖在全球的流行率增加了两倍，目前影响着大约 6.5 亿成年人和 3.4 亿儿童和青少年（5-19 岁）。肥胖会导致 50 多种合并症和过早死亡。肥胖是一种高度受歧视的疾病，与许多精神和情绪困扰和功能障碍有关。因此，肥胖是全球医疗保健支出的主要原因之一。传统上，肥胖的管理分为三大类，包括代谢（减肥）手术、药物治疗和生活方式（主要是饮食）策略。尽管被列为单独的类别，但饮食策略仍然是任何管理计划的核心组成部分，并且通常补充其他手术和药物治疗选择。事实上，肥胖管理的任何方法的有效性都依赖于成功的行为改变，特别是与饮食习惯相关的行为改变。在这篇简明的综述中，我们探讨了肥胖饮食策略的基础支柱：睡眠、倾听、常规、减轻压力和优化社交条件。然后，我们讨论了平衡饮食宏量营养素（包括膳食纤维、碳水化合物、蛋白质和超加工食品[UPFs]）作为肥胖饮食策略的重要性。虽然我们关注的是一般原则，但我们应该为我们的患者提供定制的饮食策略，根据他们的个人需求进行调整。我们不应该仅仅根据相关的体重减轻程度来判断饮食的效用，而应该采取更全面的观点，即饮食策略因其整体健康益处而受到重视，包括对我们肠道微生物群的培育，以使其能够滋养和保护我们。
