An integrative view of obesity
An integrative view of obesity
复制标题
DOI：
10.3945/ajcn.2009.28473b
复制
发表时间：
2010-01-01
影响因子：
7.1
通讯作者：
Heber, David
中科院分区：
文献类型：
--
作者：
Heber, David
肥胖是身体脂肪过多的结果，而不仅仅是肌肉或脂肪的多余重量。脂肪细胞在适应饥饿、运动能量学和对病原体的免疫防御中起作用。持续的正能量平衡导致脂肪细胞过度积累，在腹部，导致慢性炎症。虽然已经进行了有益的研究与培养的脂肪细胞，一个整合的方法来调节腹部脂肪组织涉及反馈的自分泌和旁分泌效应分泌的脂肪细胞，免疫系统，和血流通过脂肪组织。许多脂肪因子，趋化因子和细胞因子反馈到其他身体系统，以调节能量平衡和免疫功能。对胃肠道和中枢神经系统相互作用的研究，以及对中枢神经系统中奖赏回路的心理生理学考虑，表明了对饥饿的普遍适应，这与为预防和治疗肥胖而提出的那些策略（即食物限制和增加体力活动）相反。含有隐藏脂肪和糖的美味食物的致胖环境会促进代谢综合征和肥胖，而含有抗炎植物化学物质的水果和蔬菜可以抵消代谢综合征。因此，以植物为基础的饮食以及增加身体活动和社会支持的无缝整合，以改变现代饮食和生活方式，为解决肥胖流行病带来了最大的希望。公共卫生和医学营养方法都可以从肥胖的综合观点中受益。美国临床营养杂志2010;91（增刊）：280 S-3S。
Obesity is the result of the accumulation of excess body fat and not simply excess weight that can be muscle or fat. Adipocytes function in the adaptation to starvation, in exercise energetics, and in the immune defense against pathogens. Sustained positive energy balance results in excessive accumulation of adipocytes, which, in the abdomen, leads to chronic inflammation. Although informative studies have been performed with cultured adipocytes, an integrative approach to the regulation of abdominal adipose tissue involves feedback from autocrine and paracrine effectors secreted by adipocytes, the immune system, and blood flow through adipose tissue. Numerous adipokines, chemokines, and cytokines feed back to other bodily systems to regulate both energy balance and immune function. Studies of the interactions of the gastrointestinal tract and the central nervous system, as well as psychophysiological considerations of reward circuitry in the central nervous system, have shown a general adaptation to starvation that is opposed to those strategies being proposed for the prevention and treatment of obesity, ie, food restriction and increased physical activity. The obesogenic environment of highly palatable foods with hidden fats and sugars can promote metabolic syndrome and obesity, whereas fruit and vegetables with anti-inflammatory phytochemicals can counteract metabolic syndrome. Therefore, a plant-based diet and the seamless integration of increased physical activity and social support to alter modern diets and lifestyles hold out the greatest hope for the solution of the obesity epidemic. Both public health and medical nutrition approaches can benefit from this integrative view of obesity. Am J Clin Nutr 2010;91(suppl):280S-3S.