The Human Energy Balance: Uncovering the Hidden Variables of Obesity.

IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Nikolaos Theodorakis, Maria Nikolaou
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引用次数: 0

Abstract

Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance-caloric intake versus expenditure-remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a multitude of physiological and environmental factors. Genetic predispositions, variations in basal metabolic rates, adaptive thermogenesis, physical activity, and nutrient losses via fecal and urinary excretion contribute to interindividual differences in energy homeostasis. Additionally, factors such as meal timing, macronutrient composition, gut microbiota dynamics, and diet-induced thermogenesis (DIT) further modulate energy utilization and metabolic efficiency. This Perspective explores key physiological determinants of the energy balance, while also highlighting the clinical significance of thrifty versus spendthrifty metabolic phenotypes. Key strategies for individualized weight management include precision calorimetry, circadian-aligned meal timing, the use of protein- and whole food diets to enhance DIT, and increases in non-exercise activity, as well as mild cold exposure and the use of thermogenic agents (e.g., capsaicin-like compounds) to stimulate brown adipose tissue activity. A comprehensive, personalized approach to obesity management that moves beyond restrictive caloric models is essential to achieving sustainable weight control and improving long-term metabolic health. Integrating these multifactorial insights into clinical practice will enhance obesity treatment strategies, fostering more effective and enduring interventions.

人体能量平衡:揭示肥胖的隐性变量。
肥胖已经成为一种全球流行病,造成了与体重有关的疾病负担的增加,并使世界各地的医疗保健系统紧张。虽然能量平衡的基本原则——热量摄入与消耗——仍然是体重调节的核心,但由于多种生理和环境因素,现实世界的结果往往偏离简单的预测。遗传易感性、基础代谢率的变化、适应性产热、身体活动以及通过粪便和尿液排泄造成的营养损失导致了能量稳态的个体间差异。此外,进餐时间、常量营养素组成、肠道微生物群动态和饮食诱导产热(DIT)等因素进一步调节能量利用和代谢效率。本观点探讨了能量平衡的关键生理决定因素,同时也强调了节俭与挥霍代谢表型的临床意义。个体化体重管理的关键策略包括精确量热法、与昼夜节律一致的进餐时间、使用蛋白质和全食物饮食来提高DIT、增加非运动活动、以及轻度低温暴露和使用产热剂(如辣椒素类化合物)来刺激棕色脂肪组织活动。一种全面的、个性化的肥胖管理方法,超越限制热量模型,对于实现可持续的体重控制和改善长期代谢健康至关重要。将这些多因素的见解整合到临床实践中,将增强肥胖治疗策略,促进更有效和持久的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.80
自引率
0.00%
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0
审稿时长
6 weeks
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