Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?
Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?
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DOI：
10.1111/obr.12251
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发表时间：
2015-02-01
期刊：
影响因子：
8.9
通讯作者：
Dulloo, A. G.
中科院分区：
文献类型：
--
作者：
Montani, J. -P.;Schutz, Y.;Dulloo, A. G.
尽管节食在肥胖症管理中的预后不良，这通常导致反复尝试减肥，因此体重循环，但在过去几十年中，节食的流行率持续增加，与肥胖症的流行率稳步增加平行。然而，节食和体重循环并不局限于肥胖或超重的人，因为体重正常的各个人群中也有很大一部分人试图减肥。这些人包括认为自己太胖的年轻人和老年人以及儿童和青少年（由于媒体，父母和社会压力），体重敏感的竞技体育运动员（即强制性体重类别，重力和美学运动）或苗条形象是专业优势的表演者。特别值得关注的是，有证据表明，反复节食和体重循环对健康的一些潜在负面影响更容易在正常体重的人身上看到，而不是在超重或肥胖的人身上。特别是，几个代谢和心血管疾病的危险因素与体重循环在正常体重的个人已被确定从横截面和前瞻性研究，以及从实验诱导的体重循环的研究。此外，对实验性体重循环的研究结果强化了这样一种观念，即在体重恢复期间，心血管风险变量（如血压、心率、交感神经活动、血糖、血脂和胰岛素）的波动可能反复超过正常值，给心血管系统带来额外的压力。由于“肥胖”环境和媒体对苗条身材的压力（甚至针对儿童）的对立力量，饮食引起的体重循环的流行正在增加，节食和体重循环可能成为日益严重的公共卫生问题。
Despite the poor prognosis of dieting in obesity management, which often results in repeated attempts at weight loss and hence weight cycling, the prevalence of dieting has increased continuously in the past decades in parallel to the steadily increasing prevalence of obesity. However, dieting and weight cycling are not limited to those who are obese or overweight as substantial proportions of the various population groups with normal body weight also attempt to lose weight. These include young and older adults as well as children and adolescents who perceive themselves as too fat (due to media, parental and social pressures), athletes in weight-sensitive competitive sports (i.e. mandatory weight categories, gravitational and aesthetic sports) or among performers for whom a slim image is professionally an advantage. Of particular concern is the emergence of evidence that some of the potentially negative health consequences of repeated dieting and weight cycling are more readily seen in people of normal body weight rather than in those who are overweight or obese. In particular, several metabolic and cardiovascular risk factors associated with weight cycling in normal-weight individuals have been identified from cross-sectional and prospective studies as well as from studies of experimentally induced weight cycling. In addition, findings from studies of experimental weight cycling have reinforced the notion that fluctuations of cardiovascular risk variables (such as blood pressure, heart rate, sympathetic activity, blood glucose, lipids and insulin) with probable repeated overshoots above normal values during periods of weight regain put an additional stress on the cardiovascular system. As the prevalence of diet-induced weight cycling is increasing due to the opposing forces of an 'obesigenic' environment and the media pressure for a slim figure (that even targets children), dieting and weight cycling is likely to become an increasingly serious public health issue.