颠覆百年经典理论,哈佛大学研究指出:暴饮暴食不是肥胖的主要原因

2022-02-01 生物世界 生物世界

随着经济发展和生活水平的提高,在全世界范围内,肥胖已经成为了一个主要公共健康问题。据世界卫生组织(WHO)统计,全球有近20亿人超重或肥胖,从1975到2016年,全球肥胖率翻了近3倍,每年因超重或肥

随着经济发展和生活水平的提高,在全世界范围内,肥胖已经成为了一个主要公共健康问题。据世界卫生组织(WHO)统计,全球有近20亿人超重或肥胖,从1975到2016年,全球肥胖率翻了近3倍,每年因超重或肥胖导致的死亡高达280万。

实际上,肥胖的人不仅生活不便、运动能力下降,还更易患代谢性疾病和心脑血管疾病。许多研究表明,肥胖与十多种癌症的发病风险增加和预后及生存率降低有关。

为了应对日益严重的肥胖流行趋势,美国农业部发布的 2020-2025 年膳食指南告诉我们,减肥需要成年人减少从食物和饮料中获得的热量,并增加通过体育活动所消耗的热量。

这种体重管理方法是基于具有百年历史的“能量平衡模型”,该模型指出,体重增加是由于摄入的能量多于消耗的能量。在当今世界,周围环绕着美味可口、大量销售、廉价的加工食品,人们很容易摄入远超实际需求的热量。而如今久坐不动的生活方式进一步加剧了这种不平衡。

根据这一模型的观点,暴饮暴食,加上身体活动不足,正在推动肥胖症的流行。尽管几十年来的公共卫生信息都在劝告人们少吃多运动,但肥胖和肥胖相关疾病的发病率却一直在稳步上升。

然而,“能量平衡模型”将肥胖视为一种能量平衡障碍,这种观点重申了物理学原理,却没有考虑体重增加的生物学机制。

近日,来自哈佛大学医学院、威尔康奈尔医学院、哥本哈根大学、美国国立卫生研究院等机构的17位国际公认的科学家、临床研究人员和公共卫生专家组成的专家团队在 The American Journal of Clinical Nutrition 期刊发表了题为:The carbohydrate-insulin model: a physiological perspective on the obesity pandemic(碳水化合物-胰岛素模型:肥胖大流行的生理学视角)的文章。

该研究则支持“碳水化合物-胰岛素模型”,该模型认为,肥胖是一种代谢紊乱,更多的与“吃的是什么”有关,而不是“吃了多少”。这也解释了为什么许多人少吃多运动却没能成功减肥。

“碳水化合物-胰岛素模型”提出了一个大胆的主张:暴饮暴食不会导致肥胖;变胖的过程会导致暴饮暴食。当前肥胖流行是由于激素对食物质量变化的反应:特别是高血糖负荷的食物,它们从根本上改变了我们的新陈代谢。

总的来说,文章作者指出了“能量平衡模型”的根本缺陷,认为“碳水化合物-胰岛素模型”能够更好地解释肥胖和体重增加,也为更有效、更持久的体重管理策略指明了道路:应当更加关注吃什么,而不是吃多少。

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该研究的领导者,波士顿儿童医院内分泌学家、哈佛医学院教授 David Ludwig 博士解释了为什么“能量平衡模型”并不能帮助我们理解体重增加的生物学原因:例如,在生长突增的青少年时期,可能会每天摄入1000卡路里的食物,但这是暴饮暴食导致了生长突增,还是生长突增导致饥饿和暴饮暴食?

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David Ludwig 教授

与“能量平衡模型”相反,“碳水化合物-胰岛素模型”则大胆地宣称:暴饮暴食不是肥胖的主要原因,该模型将当前的肥胖流行归咎于现代饮食模式,其特征是过度食用高血糖负荷的食物:特别是加工过的、可快速消化的碳水化合物。这些食物会引起激素的反应,从根本上改变我们的新陈代谢,导致脂肪储存、体重增加和肥胖。

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当我们吃高度加工的碳水化合物时,身体会增加胰岛素分泌并抑制胰高血糖素分泌。反过来,这会向脂肪细胞发出信号以储存更多热量,从而减少可用于为肌肉和其他代谢活跃组织提供的能量消耗。大脑认为身体没有获得足够的能量,这反过来又会导致饥饿感。此外,在身体试图节省能量消耗时,新陈代谢可能会因此减慢。因此,即使我们继续获得多余的脂肪,我们也倾向于保持饥饿感。

图片

碳水化合物-胰岛素模型

因此,要了解肥胖的流行,不仅需要考虑我们吃了多少食物,还需要考虑我们吃的食物类型是如何影响我们的激素和新陈代谢。“能量平衡模型”断言所有来自食物的热量对身体来说都是相似的,这忽略了这个难题的关键部分。

实际上,“碳水化合物-胰岛素模型”并不是一个最新提出的新模型,它最早可以追溯到1900年代,但是这篇由哈佛大学医学院、威尔康奈尔医学院、哥本哈根大学、美国国立卫生研究院等机构的17位国际公认的科学家、临床研究人员和公共卫生专家组成的作者团队发表的观点文章,是对“碳水化合物-胰岛素模型”迄今最为全面的表述。

总的来说,这篇文章总结了支持“碳水化合物-胰岛素模型”的越来越多的证据。此外,作者还确定了一系列可检验的假设,以区分这两种模型以指导未来的研究。

采用“碳水化合物-胰岛素模型”,而不是“能量平衡模型”,对于体重管理和肥胖症治疗具有根本性的影响。“碳水化合物-胰岛素模型”不是敦促人们少吃,而是提出了另一条更关注我们究竟吃了什么东西的途径。减少现在充斥再在食物供应中的可快速消化的碳水化合物的消耗量,会减少人体储存脂肪的潜在动力。这样我们就可以在更少饥饿感和挣扎的情况下减轻体重。

最后,文章作者还指出,需要进一步的研究来最终测试这两种模型,这也会带来更准确的新模型。为此,他们呼吁进行建设性讨论,以及和具有不同观点的科学家之间合作,以在严格和公正的研究中检验对“碳水化合物-胰岛素模型”的预测。

论文链接:

https://doi.org/10.1093/ajcn/nqab270

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    2022-06-21 ilzira

    二甲双瓜到底能不能减肥

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    2022-03-16 ms8000002131411968

    应该多吃粗加工食物

    0

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    2022-02-12 ms8000002131411968

    多吃粗粮,看来有道理

    0

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    2022-02-03 robbert123

    学习

    0

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    2022-02-03 amyloid
  7. [GetPortalCommentsPageByObjectIdResponse(id=1227871, encodeId=ce91122e871bc, content=二甲双瓜到底能不能减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210302/6b0b2d3a0add41aab0b7131586b1293c/d9a578def59f463dbe18f6b25cd983dc.jpg, createdBy=57862311617, createdName=ilzira, createdTime=Tue Jun 21 23:25:11 CST 2022, time=2022-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1203026, encodeId=3294120302642, content=应该多吃粗加工食物, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee616470317, createdName=ms8000002131411968, createdTime=Wed Mar 16 10:04:46 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192588, encodeId=56501192588ce, content=多吃粗粮,看来有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee616470317, createdName=ms8000002131411968, createdTime=Sat Feb 12 08:27:27 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1190029, encodeId=af03119002942, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82d31990773, createdName=robbert123, createdTime=Thu Feb 03 22:54:31 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417437, encodeId=9e11141e43748, content=<a href='/topic/show?id=29ad60210f3' target=_blank style='color:#2F92EE;'>#暴饮暴食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60210, encryptionId=29ad60210f3, topicName=暴饮暴食)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09a33274256, createdName=redcrab, createdTime=Thu Feb 03 12:19:41 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557539, encodeId=cce4155e53956, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Feb 03 12:19:41 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189729, encodeId=3bf71189e2919, content=今年体会自己吃不同食物后的状态差很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f3b5710562, createdName=ms8000000741976209, createdTime=Wed Feb 02 15:58:24 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189643, encodeId=ae88118964309, content=着经济发展和生活水平的提高,在全世界范, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Wed Feb 02 08:47:00 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189639, encodeId=04a91189639fb, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Wed Feb 02 08:12:17 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189637, encodeId=25a5118963eaa, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200810/0211a5fce7a24a7c895f1e57931d0edc/ed3cb065338b4f5488854eda07fda74c.jpg, createdBy=06915408233, createdName=世人都晓-神仙好, createdTime=Wed Feb 02 08:00:06 CST 2022, time=2022-02-02, status=1, ipAttribution=)]
    2022-02-02 ms8000000741976209

    今年体会自己吃不同食物后的状态差很多

    0

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    2022-02-02 查查佳佳

    着经济发展和生活水平的提高,在全世界范

    0

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    2022-02-02 学医无涯

    学习一下

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1227871, encodeId=ce91122e871bc, content=二甲双瓜到底能不能减肥, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210302/6b0b2d3a0add41aab0b7131586b1293c/d9a578def59f463dbe18f6b25cd983dc.jpg, createdBy=57862311617, createdName=ilzira, createdTime=Tue Jun 21 23:25:11 CST 2022, time=2022-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1203026, encodeId=3294120302642, content=应该多吃粗加工食物, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee616470317, createdName=ms8000002131411968, createdTime=Wed Mar 16 10:04:46 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1192588, encodeId=56501192588ce, content=多吃粗粮,看来有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee616470317, createdName=ms8000002131411968, createdTime=Sat Feb 12 08:27:27 CST 2022, time=2022-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1190029, encodeId=af03119002942, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82d31990773, createdName=robbert123, createdTime=Thu Feb 03 22:54:31 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417437, encodeId=9e11141e43748, content=<a href='/topic/show?id=29ad60210f3' target=_blank style='color:#2F92EE;'>#暴饮暴食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60210, encryptionId=29ad60210f3, topicName=暴饮暴食)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09a33274256, createdName=redcrab, createdTime=Thu Feb 03 12:19:41 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557539, encodeId=cce4155e53956, content=<a href='/topic/show?id=7bec398e2e6' target=_blank style='color:#2F92EE;'>#哈佛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39872, encryptionId=7bec398e2e6, topicName=哈佛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1c7014916331, createdName=amyloid, createdTime=Thu Feb 03 12:19:41 CST 2022, time=2022-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189729, encodeId=3bf71189e2919, content=今年体会自己吃不同食物后的状态差很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5f3b5710562, createdName=ms8000000741976209, createdTime=Wed Feb 02 15:58:24 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189643, encodeId=ae88118964309, content=着经济发展和生活水平的提高,在全世界范, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Wed Feb 02 08:47:00 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189639, encodeId=04a91189639fb, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Wed Feb 02 08:12:17 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1189637, encodeId=25a5118963eaa, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200810/0211a5fce7a24a7c895f1e57931d0edc/ed3cb065338b4f5488854eda07fda74c.jpg, createdBy=06915408233, createdName=世人都晓-神仙好, createdTime=Wed Feb 02 08:00:06 CST 2022, time=2022-02-02, status=1, ipAttribution=)]
    2022-02-02 世人都晓-神仙好

    学习了

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