有证据表明存在一个调节人体体重的设定值吗?

Manfred J Müller, Anja Bosy-Westphal, Steven B Heymsfield
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引用次数: 56

摘要

有证据表明,在给定的设定值上,存在对体重的生物(主动)控制。体重是遗传效应(DNA)、表观遗传效应(不涉及DNA变化的可遗传性状)和环境的产物。体重的调节是不对称的,对体重减轻的反应比对体重增加的反应更有效。然而,调控可能被西方饮食所忽略或掩盖,这表明生物控制的失败主要是由于外部因素。在这种情况下,身体的“设定点”(即由比例反馈控制系统调节的恒定“身体固有”体重)被各种“稳定点”所取代,这些“稳定点”受能量和宏量营养素摄入量的影响,以使身体达到零能量平衡。在一个物质丰富的世界里,谨慎的生活方式和认知控制是有效的生物控制和稳定体重的先决条件。这一观点也影响了未来关于体重调节的基因研究。在一个物质丰富的世界里寻找体重增加的遗传背景是有误导性的,因为可能的生物控制被环境的影响所掩盖。就临床实践而言,减肥和增重的饮食方法都必须重新考虑。在体重过轻的患者(如神经性厌食症患者)中,体重增加是由生物机制支持的,这种机制可能被高营养抑制也可能不被高营养抑制。为了克服体重减轻引起的超重反调节,必须考虑到生物信号。基于代谢通量及其调控的体重变化计算模型将为临床营养提供未来的策略。
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Is there evidence for a set point that regulates human body weight?

There is evidence for the idea that there is biological (active) control of body weight at a given set point. Body weight is the product of genetic effects (DNA), epigenetic effects (heritable traits that do not involve changes in DNA), and the environment. Regulation of body weight is asymmetric, being more effective in response to weight loss than to weight gain. However, regulation may be lost or camouflaged by Western diets, suggesting that the failure of biological control is due mainly to external factors. In this situation, the body's 'set point' (i.e., a constant 'body-inherent' weight regulated by a proportional feedback control system) is replaced by various 'settling points' that are influenced by energy and macronutrient intake in order for the body to achieve a zero energy balance. In a world of abundance, a prudent lifestyle and thus cognitive control are preconditions of effective biological control and a stable body weight. This idea also impacts future genetic research on body weight regulation. Searching for the genetic background of excess weight gain in a world of abundance is misleading since the possible biological control is widely overshadowed by the effect of the environment. In regard to clinical practice, dietary approaches to both weight loss and weight gain have to be reconsidered. In underweight patients (e.g., patients with anorexia nervosa), weight gain is supported by biological mechanisms that may or may not be suppressed by hyperalimentation. To overcome weight loss-induced counter-regulation in the overweight, biological signals have to be taken into account. Computational modeling of weight changes based on metabolic flux and its regulation will provide future strategies for clinical nutrition.

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