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  • 机译 在整个生命过程中的营养过渡和肥胖预防
    摘要:The aim of this paper is to discuss concepts regarding the nutrition transition (NT), the several stages it has encompassed over human history, dietary shifts it is associated with and its implications to the life-course approach for obesity prevention. NT is a phenomenon characterized by an inversion of the nutrition profile, that is, an increase in obesity and a reduction in undernutrition. Obesity and associated chronic diseases are the most important expressions of NT today. Some important dietary changes happened in the last decades as a result of the complex determinants of NT, such as urbanization, the economic growth dynamic, cultural and behavioral shifts. The NT has involved an increased consumption of caloric beverages, ultra-processed products, animal foods, edible oils and soft drinks, accompanied by a significant reduction in the consumption of fruits, vegetables, pulses and milk. Global obesity prevalence increased from 4.8% in 1980 to 9.8% in 2008 for men, and from 7.9% in 1980 to 13.8% in 2008 for women, representing 205 million men and 297 million women with obesity and 1.46 billion with overweight in 2008. The context of the NT needs to be taken into account when developing effective obesity prevention strategies across the life-course.
  • 机译 巴西针对预防儿童肥胖的国家计划
    摘要:In Brazil, overweight and obesity are increasing in all age and income groups. Currently, 7.3% of children under 5 years of age, 30% of children aged 5–9 and 20% of preadolescents aged 10–19 are overweight. In the primary health-care (PHC) environment, activities are carried out to monitor eating habits and nutrition, as well as to prevent unhealthy habits and promote healthy eating behaviors consistent with the dietary guidelines for Brazilian children. Comprehensive care is being provided to overweight individuals. The Brazilian Breastfeeding and Complementary Feeding Strategy was launched in 2009 to support health teams to counsel families about healthy feeding, focused on child health and obesity prevention. Within the school environment, the School Health Program offers activities that are developed by PHC teams together with education professionals to focus on assessing health conditions, prevention and health promotion. To improve the nutritional profile of processed foods, terms of cooperation have been signed with the food industry to reduce fat and sodium content. Food industry advertising and marketing to infants and young children are now regulated by the Brazilian Regulation for the Marketing of Foods to Infants and Young Children.
  • 机译 墨西哥国家营养健康协议中针对超重和肥胖的公共卫生策略
    摘要:Overweight and obesity are major world global health challenges of the 21st century. Mexico is not an exception. Approximately 70% of the adult Mexican population has an excessive body weight. The prevalence of obesity and overweight in Mexican school children aged 5–11 is also high: one child in four is overweight. In light of the seriousness of the situation, the solutions for this problem are based on modification of the environments and change of individual habits and behaviors related to nutrition and physical activity. As a result, the Mexican government, public sector and academy established three common goals and 10 priority objectives that are expressed in the National Agreement for Nutritional Health—Strategy to Control Overweight and Obesity. The obesity problem requires interventions and policies that reside outside of the health sector domain, key aspects of this public health policy was agreement among all stakeholders on cross-cutting actions. The best examples of National Agreement's inter-sectorial action implementation is in the school setting and Code of ‘Self Regulation' on Advertising of Food and Non-Alcoholic Beverages to Children introduced by the food and beverage industry. The ultimate goal of this national policy is to provide the strategic plan for healthy weight and better health, by promoting healthy lifestyles focused on correct diet and physical activity in all life stages, from pregnancy and early childhood and on into adulthood by a multi stakeholder approach. Although there have been great achievements in some areas of implementation, there are still challenges to confront.
  • 机译 必须制止美洲儿童肥胖病的流行:政府和泛美卫生组织的领导至关重要
    摘要:The Pan American Health Organization's approach to preventing child obesity is built on (1) documenting and monitoring the problem and its social and economic impacts; (2) advocating for prevention and control policies through the life-course, within and outside of the health sector; (3) leading initiatives on healthy diet and active living and educating policy makers and the public about obesogenic environments, including policies to reduce the marketing of food and beverages to children; (4) enabling healthy environments for daily life activities, especially for children in schools and community settings; (5) strengthening capacity for integrated management of obesity and noncommunicable diseases with emphasis on primary health care; and (6) mobilizing partners and resources to combat the problem.
  • 机译 在整个生命过程中预防儿童肥胖的教育:研讨会结论
    摘要:The objectives of this paper are to present the conclusions from the workshop ‘Education for childhood obesity prevention: a life-course approach', coordinated by the Pan-American Health Organization and the Pan-American Health and Education Foundation, and held on 14 June 2012 in Aruba, as part of the II Pan-American Conference on Childhood Obesity (). This workshop focused on the need to recognize the life-course framework and education as a social determinant of health to address the childhood obesity epidemic through diverse education-based initiatives. Workshop participants agreed that both education per se and the education sector are key for obesity prevention and must form part of multidisciplinary interventions and collaboration between schools, families and the entire society. Capacity building in obesity prevention is required and should include the entire learning community, teachers, leaders, health-care providers, related services personnel, university professors and other interested community members. Obesity prevention initiatives should also engage key community institutions outside the formal education system, including early childhood centers, churches, pediatric/family medicine clinics, among others, to support family nutrition education, healthy food access and daily physical activity—all of which are key to promote a child's ‘healthy weight'.
  • 机译 第十四届国际肥胖问题年度研讨会-高脂喂养:比以前想象的要糟糕
    • 作者:D RichardP Boisvert
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:
  • 机译 发育,大脑可塑性和奖赏:早期的高脂饮食暴露使人更容易肥胖-主持人的观点
    • 作者:C-D Walker
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:The significant increase in childhood obesity has become a particular concern, and it is recognized that the programming of obesity can arise from events occurring in the peri-conception period, prenatally and/or during the early postnatal period. In particular, high intake of dietary fat by the mother has long-term effects that are worse than once thought. This symposium was designed to outline some of the important consequences of maternal high-fat feeding during gestation and lactation, as well as exposure to a high-fat diet (HFD) after weaning, on the programming of homeostatic and hedonic regulation of food intake in both rodents and nonhuman primates (NHPs). Although a consensus emerges that high-fat feeding in early development increases the risk of developing obesity and the metabolic syndrome in adulthood, there is less agreement on the mechanisms through which this risk is conferred. Epigenetic modifications in specific gene promoters within the dopaminergic reward pathways and on the histone code will be discussed. We will also examine the effects of metabolic hormones such as leptin and ghrelin to shape the early development of hypothalamic projections that are critical to control food intake; finally, the importance of placental function in increasing obesity risk in NHP fetus from HFD mothers will be debated.
  • 机译 炎症,异位脂肪和脂质代谢:从椅子上看
    • 作者:F PicardY Deshaies
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:How meals containing large amounts of lipids induce insulin resistance in the short and long term remains a topic of intense research. Speakers of the afternoon session showed recent findings on the modulation of mitochondria-induced oxidative stress by energy substrates, both in chronic and acute (single high-fat intake) contexts, which have enabled a better understanding of insulin action at the molecular and cellular levels. These advances are highly amenable to being combined with innovative, elegant imaging techniques to look at the fate of these energy substrates at the in vivo level within optimally defined experimental protocols, both in human and nonhuman models.
  • 机译 孕妇高脂饮食摄入对后代神经发育和行为的影响
    摘要:Maternal diet and metabolic state are important factors in determining the environment experienced during perinatal development. Epidemiological studies and evidence from animal models provide evidence that a mother's diet and metabolic condition are important in programming the neural circuitry that regulates behavior, resulting in a persistent impact on the offspring's behavior. Potential mechanisms by which maternal diet and metabolic profile influence the perinatal environment include placental dysfunction and increases in circulating factors such as inflammatory cytokines, nutrients (glucose and fatty acids) and hormones (insulin and leptin). Maternal obesity and high-fat diet (HFD) consumption exposure during development have been observed to increase the risk of developing serious mental health and behavioral disorders including anxiety, depression, attention deficit hyperactivity disorder and autism spectrum disorder. The increased risk of developing these behavioral disorders is postulated to be due to perturbations in the development of neural pathways that regulate behavior, including the serotonergic, dopaminergic and melanocortinergic systems. It is critical to examine the influence that a mother's nutrition and metabolic profile have on the developing offspring considering the current and alarmingly high prevalence of obesity and HFD consumption in pregnant women.
  • 机译 产妇饮食:非人类灵长类动物和人类发育过程中表观基因组调节的调节剂
    摘要:The importance of diet in health and disease has been well characterized in the past decades. Although the earlier focus of diet research was in the context of undernutrition and the importance of adequate nutrient intake to prevent malnutrition, in the current era of epidemic obesity the focus of our efforts has evolved toward understanding the effects of excess caloric intake. The current surge in childhood obesity rates suggests a correlation of maternal metabolic syndrome and obesity with programming of the fetal epigenome for metabolic diseases later in life. Alterations of the fetal genome, epigenome and metabolome have been well documented in cases of maternal malnutrition, including both overnutrition and undernutrition. It is of great interest and importance to understand how these divergent maternal factors regulate/program the fetus for metabolic diseases, and we and others have observed that epigenetic modifications to the fetal and placental epigenome accompany these reprogramming events. The following review summarizes recent studies on the effects of maternal diet and obesity on fetal epigenetics contributing to adult diseases later in life by taking advantage of state-of-the-art genomic, epigenomic and metagenomic techniques in nonhuman primate model systems.
  • 机译 下丘脑发育的营养程序设计:关键时期和机会之窗
    • 作者:S G Bouret
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:Obesity is increasing at an alarming rate throughout the world, particularly among children. Epidemiological and experimental data have suggested that suboptimal nutrition and growth during prenatal and/or postnatal life can have a significant role in the development of obesity and related diseases. Similarly, exposure to malnutrition during perinatal life can result in lifelong metabolic disorders. Although the precise biological mechanisms governing metabolic programming have not been fully elucidated, there is growing evidence that obesity and other metabolic diseases may result from a change in the underlying developmental program of the hypothalamic pathways that regulate energy balance. The hypothalamus undergoes tremendous growth beginning in the embryonic period and continuing through adolescence, and an alteration in perinatal nutrition can affect various developmental processes, including neurogenesis and axon growth, which can lead to abnormal hypothalamic development. Metabolic hormones, particularly leptin, are capable of transmitting signals to the developing hypothalamus in response to alterations in the nutritional environment and may underlie potential maladaptive responses to early metabolic perturbations. A better understanding of the optimal perinatal hormonal and nutritional environment during hypothalamic development may help ameliorate and reverse the metabolic malprogramming of the fetus and/or neonate.
  • 机译 高脂饮食会改变多巴胺和阿片类药物系统:对发育的影响
    • 作者:T M Reyes
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:Consumption of a high-fat diet has been linked to obesity, dyslipidemia and cardiovascular disease. Less well appreciated are adverse effects on the brain and behavior. Recent research has shown that consumption of a high-fat diet can alter gene expression within the brain, and the dopamine and opioid neurotransmitter systems appear to be vulnerable to dysregulation. This review will focus on recent reports in both humans and animal models that describe adverse effects of high-fat diet consumption on the central reward circuitry. In addition, the importance of different development windows will be discussed, with effects observed in both the prenatal/perinatal time period and with chronic high-fat diet consumption in adulthood.
  • 机译 高脂负荷:骨骼肌胰岛素抵抗的机制
    摘要:Skeletal muscle from sedentary obese patients is characterized by depressed electron transport activity, reduced expression of genes required for oxidative metabolism, altered mitochondrial morphology and lower overall mitochondrial content. These findings imply that obesity, or more likely the metabolic imbalance that causes obesity, leads to a progressive decline in mitochondrial function, eventually culminating in mitochondrial dissolution or mitoptosis. A decrease in the sensitivity of skeletal muscle to insulin represents one of the earliest maladies associated with high dietary fat intake and weight gain. Considerable evidence has accumulated to suggest that the cytosolic ectopic accumulation of fatty acid metabolites, including diacylglycerol and ceramides, underlies the development of insulin resistance in skeletal muscle. However, an alternative mechanism has recently been evolving, which places the etiology of insulin resistance in the context of cellular/mitochondrial bioenergetics and redox systems biology. Overnutrition, particularly from high-fat diets, generates fuel overload within the mitochondria, resulting in the accumulation of partially oxidized acylcarnitines, increased mitochondrial hydrogen peroxide (H2O2) emission and a shift to a more oxidized intracellular redox environment. Blocking H2O2 emission prevents the shift in redox environment and preserves insulin sensitivity, providing evidence that the mitochondrial respiratory system is able to sense and respond to cellular metabolic imbalance. Mitochondrial H2O2 emission is a major regulator of protein redox state, as well as the overall cellular redox environment, raising the intriguing possibility that elevated H2O2 emission from nutrient overload may represent the underlying basis for the development of insulin resistance due to disruption of normal redox control mechanisms regulating protein function, including the insulin signaling and glucose transport processes.
  • 机译 2型糖尿病异常脂肪酸分配中白色和棕色脂肪组织的代谢缺乏弹性
    摘要:Type 2 diabetes (T2D) is characterized by a general dysregulation of postprandial energy substrate partitioning. Although classically described in regard to glucose metabolism, it is now evident that metabolic inflexibility of plasma lipid fluxes is also present in T2D. The organ that is most importantly involved in the latter metabolic defect is the white adipose tissue (WAT). Both catecholamine-induced nonesterified fatty acid mobilization and insulin-stimulated storage of meal fatty acids are impaired in many WAT depots of insulin-resistant individuals. Novel molecular imaging techniques now demonstrate that these defects are linked to increased dietary fatty acid fluxes toward lean organs and myocardial dysfunction in humans. Recent findings also demonstrate functional abnormalities of brown adipose tissues in T2D, thus suggesting that a generalized adipose tissue dysregulation of energy storage and dissipation may be at play in the development of lean tissue energy overload and lipotoxicity.
  • 机译 获得标签:追踪饮食脂肪的实用研究策略
    • 作者:J E LambertE J Parks
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:The observation that events occurring after consumption of a meal can directly affect metabolic risk has been gaining interest over the past 40 years. As a result, the desire for investigators to conduct postprandial studies has also increased. Study design decisions pertaining to the choice of meal quantity and composition are more difficult than may be readily apparent, and there is now ample evidence available in the literature to suggest that what is fed on the test day significantly affects postprandial metabolism and can therefore influence interpretation of results. In addition, events occurring before the testing day (food intake and activities) can also have an impact on the observed postprandial response. The goal of this review is to present aspects of study design critical to the investigation of postprandial metabolism. These details include subject preparation, meal quantity, form and composition, as well as sampling protocols for measuring metabolites. Key factors and practical examples are provided to minimize the impact of nonresearch variables on subject variability. Finally, aspects related to using stable isotope tracers to measure metabolism of meal fat are discussed, including choice of tracer form, dose and delivery in food. Given that fed-state events contribute significantly to chronic disease risk, improved methods to study the absorption and disposal of food energy will support the development of strategies designed to prevent and treat diseases associated with overconsumption of nutrients.
  • 机译 高脂饮食的临床效果和高脂喂养导致体重增加
    • 作者:N GuptaM D Jensen
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 2期
    摘要:Overfeeding high-fat (HF) meals results in both short-term and long-term effects that vary depending upon adiposity status (obese vs nonobese) and family history of type 2 diabetes. Although more than 4 weeks of overeating produces mild insulin resistance, whether the same is true of a single, HF meal is not clear. We reviewed overfeeding studies of 4–8 weeks duration, studies of single HF meals and our own (unpublished) plasma insulin and glucose concentration data from 59 nonobese and 15 overweight/obese volunteers who consumed either a normal-fat (NF) breakfast or a breakfast matched for carbohydrate and protein, but with an additional 80 g of monounsaturated fat (HF). Four to eight weeks of overfeeding a HF diet causes an ∼10% reduction in insulin sensitivity. Some authors report that a single HF meal is associated with greater postprandial insulin concentrations, whereas other investigators have not confirmed such a response. We found that plasma glucose concentrations peaked later following a HF breakfast than a NF breakfast in both obese and nonobese adults and that daytime plasma insulin concentrations were not uniformly increased following a HF breakfast. We conclude that a single HF meal delays the postprandial peak in glucose concentrations, likely due to delayed gastric emptying. This will confound attempts to use insulinemia as a marker of insulin resistance. After 4–8 weeks of overeating a HF diet accompanied by 2–4 kg of fat gain, insulin sensitivity decreases by ∼10%. Although we could not demonstrate that baseline insulin resistance predicts visceral fat gain with overfeeding, normal-weight relatives of type 2 diabetes mellitus do tend to gain more weight and become more insulin resistant than those without a positive family history of type 2 diabetes mellitus. In summary, short-term weight gain from HF diets induces relatively mild metabolic disorders.
  • 机译 执行摘要
    • 作者:C D Gardner
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 1期
    摘要:
  • 机译 B淋巴细胞作为胰岛素抵抗的新兴介质
    摘要:Obesity is associated with chronic inflammation of various tissues including visceral adipose tissue (VAT), which contributes to insulin resistance. T cells and macrophages infiltrate VAT in obesity and orchestrate this inflammation. Recently, we made the surprising discovery that B cells are important contributors to this process. Thus, some B cells and the antibodies they produce can promote VAT-associated and systemic inflammation, leading to insulin resistance. This report will focus on the properties of these B cells, and how they contribute to insulin resistance through T-cell modulation and production of pathogenic autoantibodies. Understanding the mechanisms by which B cells contribute to insulin resistance should lead to new antibody-based diagnostics and B-cell modulating therapeutics to manage this increasingly prevalent disease.
  • 机译 肥胖的代谢异质性:脂肪组织的作用
    • 作者:T McLaughlin
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 1期
    摘要:Obesity is not synonymous with insulin resistance. Why some but not all individuals develop insulin resistance with weight excess is not clear, but a number of plausible hypotheses with ample support now exist. This article reviews regional fat distribution, inflammation, lipotoxicity/ectopic fat and impaired adipogenesis as leading theories as to why excess body weight has the potential to promote insulin resistance.
  • 机译 量身定做减肥的饮食方法
    • 作者:C D Gardner
    • 刊名:International Journal of Obesity Supplements
    • 2012年第Suppl 1期
    摘要:Although the ‘Low-Fat' diet was the predominant public health recommendation for weight loss and weight control for the past several decades, the obesity epidemic continued to grow during this time period. An alternative ‘low-carbohydrate' (Low-Carb) approach, although originally dismissed and even vilified, was comparatively tested in a series of studies over the past decade, and has been found in general to be as effective, if not more, as the Low-Fat approach for weight loss and for several related metabolic health measures. From a glass half full perspective, this suggests that there is more than one choice for a dietary approach to lose weight, and that Low-Fat and Low-Carb diets may be equally effective. From a glass half empty perspective, the average amount of weight lost on either of these two dietary approaches under the conditions studied, particularly when followed beyond 1 year, has been modest at best and negligible at worst, suggesting that the two approaches may be equally ineffective. One could resign themselves at this point to focusing on calories and energy intake restriction, regardless of macronutrient distributions. However, before throwing out the half-glass of water, it is worthwhile to consider that focusing on average results may mask important subgroup successes and failures. In all weight-loss studies, without exception, the range of individual differences in weight change within any particular diet groups is orders of magnitude greater than the average group differences between diet groups. Several studies have now reported that adults with greater insulin resistance are more successful with weight loss on a lower-carbohydrate diet compared with a lower-fat diet, whereas adults with greater insulin sensitivity are equally or more successful with weight loss on a lower-fat diet compared with a lower-carbohydrate diet. Other preliminary findings suggest that there may be some promise with matching individuals with certain genotypes to one type of diet over another for increasing weight-loss success. Future research to address the macronutrient intake component of the obesity epidemic should build on these recent insights and be directed toward effectively classifying individuals who can be differentially matched to alternate types of weight-loss diets that maximize weight-loss and weight-control success.

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