Kuller L H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15102.
Ann Epidemiol. 1994 Mar;4(2):119-27. doi: 10.1016/1047-2797(94)90057-4.
This article first reviews the relationship between intake of saturated fat and cholesterol and atherosclerosis; then the relationship between fat intake, obesity, and disease; and finally, some of the determinants of obesity and weight gain. The percentage of saturated fat and cholesterol in the diet is the major determinant of atherosclerosis and coronary heart disease among populations. In addition, fat intake is directly related to obesity. The degree of obesity is a major determinant of blood glucose and insulin, high-density-lipoprotein cholesterol, and triglycerides. Weight gain, especially after adolescence, and high fat intake may contribute, to a greater extent, to metabolically active intra-abdominal fat and risk of disease. Fat in diet, weight gain, or obesity may play an important role in sex-steroid hormone metabolism. Hormonal changes may contribute to an increased risk of breast cancer. The risks associated with eating fat may be related to the time of development of obesity (i.e., weight gain) and the balance between effects on sex-steroid hormone metabolism and insulin-glucose metabolism.
本文首先回顾饱和脂肪和胆固醇的摄入量与动脉粥样硬化之间的关系；接着阐述脂肪摄入、肥胖与疾病之间的关系；最后介绍肥胖和体重增加的一些决定因素。饮食中饱和脂肪和胆固醇的百分比是人群中动脉粥样硬化和冠心病的主要决定因素。此外，脂肪摄入与肥胖直接相关。肥胖程度是血糖、胰岛素、高密度脂蛋白胆固醇和甘油三酯的主要决定因素。体重增加，尤其是青春期后体重增加，以及高脂肪摄入，在更大程度上可能导致代谢活跃的腹部脂肪堆积和患病风险增加。饮食中的脂肪、体重增加或肥胖可能在性类固醇激素代谢中起重要作用。激素变化可能导致患乳腺癌风险增加。与食用脂肪相关的风险可能与肥胖（即体重增加）的发展时间以及对性类固醇激素代谢和胰岛素 - 葡萄糖代谢的影响之间的平衡有关。
