Outcome success in obesity
Outcome success in obesity
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DOI：
10.1038/oby.2001.142
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发表时间：
2001-11-01
期刊：
影响因子：
--
通讯作者：
Klein, S
中科院分区：
文献类型：
--
作者：
Klein, S
有意识的减肥可以改善许多与肥胖相关的医疗并发症。此外，这些有益作用中的许多与体重减轻的量具有剂量依赖性关系，并且仅在初始体重的5%至10%的适度体重减轻后开始。没有确凿的证据表明减肥会降低肥胖者的死亡率。减肥对心血管疾病危险因素（胰岛素抵抗、糖尿病、血脂异常和高血压）的治疗作用在临床试验中受到了最多的关注。发生冠心病的危险与伴随的危险因素负担直接相关。适度的减肥可以同时影响整个风险因素。负能量平衡和体重减轻均能改善肥胖2型糖尿病患者的胰岛素敏感性和血糖控制。大多数研究发现，体重减轻可降低血清甘油三酯、总胆固醇和低密度脂蛋白胆固醇浓度，并增加血清高密度脂蛋白胆固醇浓度。体重的恢复导致甘油三酯和胆固醇浓度的复发。体重减轻，不依赖于钠限制，降低收缩压和舒张压。饮食干预是减肥治疗的基石。大多数减肥饮食在两个主要方面有所不同：能量含量和常量营养素组成。控制食物中的常量营养素含量、能量密度和份量可以帮助减少能量摄入，促进减肥。
Intentional weight loss improves many of the medical complications associated with obesity. Moreover, many of these beneficial effects have a dose-dependent relationship with the amount of weight lost and begin after only modest weight losses of 5% to 10% of initial body weight. There is no conclusive evidence that weight loss decreases mortality in obese people. The therapeutic effect of weight loss on risk factors for cardiovascular disease (insulin resistance and,diabetes, dyslipidemia, and hypertension) has received the most attention in clinical trials. The hazard of developing coronary heart disease is directly related to the concomitant burden of risk factors. Modest weight loss can affect the entire cluster of risk factors simultaneously. Both negative energy balance and weight loss improve insulin sensitivity and glycemic control in obese patients with type 2 diabetes. Most studies have found that weight loss decreases serum triglyceride, total cholesterol, and low-density lipoprotein cholesterol concentrations and increases serum high-density lipoprotein cholesterol concentration. Regain of weight leads to relapse in triglyceride and cholesterol concentrations. Weight loss, independent of sodium restriction, decreases systolic and diastolic blood pressure. Dietary intervention is the cornerstone of weight-loss therapy. Most diets proposed for losing weight vary in two principal dimensions: energy content and macronutrient composition. Manipulation of food macronutrient content, energy density, and portion size can help decrease energy intake and facilitate weight loss.