![conference banner](/images/conference-banner.jpeg)
摘要
代谢综合征是一种以肥胖为特征的频繁代谢疾病,胰岛素抵抗似乎是主要的病理生理改变。 治疗代谢综合征的目标是降低冠心病和2型糖尿病的风险。 改变生活方式的疗法结合了单独饮食或结合其他策略的具体建议。 在这篇综述中,我们讨论了以下主题:1)代谢综合征和肥胖症高发的重要性,以及2)着重于饮食脂肪摄入的生活方式改变在MS管理中的作用。
关键词: 肥胖,代谢综合症,胰岛素抵抗,糖尿病,饮食,生活方式。
[1]
Aguilar, M.; Bhuket, T.; Torres, S.; Liu, B.; Wong, R.J. Prevalence of the metabolic syndrome in the United States, 2003-2012. JAMA, 2015, 313(19), 1973-1974.
[http://dx.doi.org/10.1001/jama.2015.4260] [PMID: 25988468]
[http://dx.doi.org/10.1001/jama.2015.4260] [PMID: 25988468]
[2]
Heiss, G.; Snyder, M.L.; Teng, Y.; Schneiderman, N.; Llabre, M.M.; Cowie, C.; Carnethon, M.; Kaplan, R.; Giachello, A.; Gallo, L.; Loehr, L.; Avilés-Santa, L. Prevalence of metabolic syndrome among Hispanics/Latinos of diverse background: The Hispanic Community Health Study/Study of Latinos. Diabetes Care, 2014, 37(8), 2391-2399.
[http://dx.doi.org/10.2337/dc13-2505] [PMID: 25061141]
[http://dx.doi.org/10.2337/dc13-2505] [PMID: 25061141]
[3]
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 2002, 106(25), 3143-3421.
[http://dx.doi.org/10.1161/circ.106.25.3143] [PMID: 12485966]
[http://dx.doi.org/10.1161/circ.106.25.3143] [PMID: 12485966]
[4]
Ng, M.; Fleming, T.; Robinson, M.; Thomson, B.; Graetz, N.; Margono, C.; Mullany, E.C.; Biryukov, S.; Abbafati, C.; Abera, S.F.; Abraham, J.P.; Abu-Rmeileh, N.M.; Achoki, T.; AlBuhairan, F.S.; Alemu, Z.A.; Alfonso, R.; Ali, M.K.; Ali, R.; Guzman, N.A.; Ammar, W.; Anwari, P.; Banerjee, A.; Barquera, S.; Basu, S.; Bennett, D.A.; Bhutta, Z.; Blore, J.; Cabral, N.; Nonato, I.C.; Chang, J.C.; Chowdhury, R.; Courville, K.J.; Criqui, M.H.; Cundiff, D.K.; Dabhadkar, K.C.; Dandona, L.; Davis, A.; Dayama, A.; Dharmaratne, S.D.; Ding, E.L.; Durrani, A.M.; Esteghamati, A.; Farzadfar, F.; Fay, D.F.; Feigin, V.L.; Flaxman, A.; Forouzanfar, M.H.; Goto, A.; Green, M.A.; Gupta, R.; Hafezi-Nejad, N.; Hankey, G.J.; Harewood, H.C.; Havmoeller, R.; Hay, S.; Hernandez, L.; Husseini, A.; Idrisov, B.T.; Ikeda, N.; Islami, F.; Jahangir, E.; Jassal, S.K.; Jee, S.H.; Jeffreys, M.; Jonas, J.B.; Kabagambe, E.K.; Khalifa, S.E.; Kengne, A.P.; Khader, Y.S.; Khang, Y.H.; Kim, D.; Kimokoti, R.W.; Kinge, J.M.; Kokubo, Y.; Kosen, S.; Kwan, G.; Lai, T.; Leinsalu, M.; Li, Y.; Liang, X.; Liu, S.; Logroscino, G.; Lotufo, P.A.; Lu, Y.; Ma, J.; Mainoo, N.K.; Mensah, G.A.; Merriman, T.R.; Mokdad, A.H.; Moschandreas, J.; Naghavi, M.; Naheed, A.; Nand, D.; Narayan, K.M.; Nelson, E.L.; Neuhouser, M.L.; Nisar, M.I.; Ohkubo, T.; Oti, S.O.; Pedroza, A.; Prabhakaran, D.; Roy, N.; Sampson, U.; Seo, H.; Sepanlou, S.G.; Shibuya, K.; Shiri, R.; Shiue, I.; Singh, G.M.; Singh, J.A.; Skirbekk, V.; Stapelberg, N.J.; Sturua, L.; Sykes, B.L.; Tobias, M.; Tran, B.X.; Trasande, L.; Toyoshima, H.; van de Vijver, S.; Vasankari, T.J.; Veerman, J.L.; Velasquez-Melendez, G.; Vlassov, V.V.; Vollset, S.E.; Vos, T.; Wang, C.; Wang, X.; Weiderpass, E.; Werdecker, A.; Wright, J.L.; Yang, Y.C.; Yatsuya, H.; Yoon, J.; Yoon, S.J.; Zhao, Y.; Zhou, M.; Zhu, S.; Lopez, A.D.; Murray, C.J.; Gakidou, E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2014, 384(9945), 766-781.
[http://dx.doi.org/10.1016/S0140-6736(14)60460-8] [PMID: 24880830]
[http://dx.doi.org/10.1016/S0140-6736(14)60460-8] [PMID: 24880830]
[5]
Grams, J.; Garvey, W.T. Weight loss and the prevention and treatment of type 2 diabetes using lifestyle therapy, pharmacotherapy, and bariatric surgery: mechanisms of action. Curr. Obes. Rep., 2015, 4(2), 287-302.
[http://dx.doi.org/10.1007/s13679-015-0155-x] [PMID: 26627223]
[http://dx.doi.org/10.1007/s13679-015-0155-x] [PMID: 26627223]
[6]
Lean, M.E.J.; Brenchley, S.; Connor, H.; Elkeles Chairman, R.S.; Govindji, A.; Hartland, B.V.; Lord, K.; Southgate, D.A.T.; Thomas, B.J. Dietary recommendations for people with diabetes: an update for the 1990s. Nutrition subcommittee of the british diabetic association’s professional advisory committee. J. Hum. Nutr. Diet., 1991, 4(6), 393-412.
[http://dx.doi.org/10.1111/j.1365-277X.1991.tb00123.x]
[http://dx.doi.org/10.1111/j.1365-277X.1991.tb00123.x]
[7]
Janssen, I.; Fortier, A.; Hudson, R.; Ross, R. Effects of an energy-restrictive diet with or without exercise on abdominal fat, intermuscular fat, and metabolic risk factors in obese women. Diabetes Care, 2002, 25(3), 431-438.
[http://dx.doi.org/10.2337/diacare.25.3.431] [PMID: 11874926]
[http://dx.doi.org/10.2337/diacare.25.3.431] [PMID: 11874926]
[8]
Obesity management for the treatment of type 2 diabetes. Diabetes Care, 2016, 39(Suppl. 1), S47-S51.
[http://dx.doi.org/10.2337/dc16-S009] [PMID: 26696681]
[http://dx.doi.org/10.2337/dc16-S009] [PMID: 26696681]
[9]
Garvey, W.T.; Mechanick, J.I.; Brett, E.M.; Garber, A.J.; Hurley, D.L.; Jastreboff, A.M.; Nadolsky, K.; Pessah-Pollack, R.; Plodkowski, R. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Comprehensive Medical Care of Patients With Obesity - Executive Summary. Endocr. Pract., in press
[http://dx.doi.org/10.4158/EP161365.GL] [PMID: 27219496]
[http://dx.doi.org/10.4158/EP161365.GL] [PMID: 27219496]
[10]
Shaw, K.; Gennat, H.; O’Rourke, P.; Del Mar, C. Exercise for overweight or obesity. Cochrane Database Syst. Rev., 2006, 4(4)CD003817
[PMID: 17054187]
[PMID: 17054187]
[11]
Obesity: The Prevention, Identification, Assessment and
Management of Overweight and Obesity in Adults and
Children. Centre for Public Health Excellence at NICE
(UK), National Collaborating Centre for Primary Care
(UK). NICE Clinical Guidelines, No. 43. London In: National
Institute for Health and Clinical Excellence; UK, 2006.
[PMID: 22497033]
[PMID: 22497033]
[12]
Bowyer, C.; Trotter, K. Obesity treatment: future directions for the contribution of dietitians. J. Hum. Nutr. Diet., 1997, 10(2), 95-101.
[http://dx.doi.org/10.1046/j.1365-277X.1997.00045.x]
[http://dx.doi.org/10.1046/j.1365-277X.1997.00045.x]
[13]
Grace, C. A review of one-to-one dietetic obesity management in adults. J. Hum. Nutr. Diet., 2011, 24(1), 13-22.
[http://dx.doi.org/10.1111/j.1365-277X.2010.01137.x] [PMID: 21210871]
[http://dx.doi.org/10.1111/j.1365-277X.2010.01137.x] [PMID: 21210871]
[14]
Frost, G.; Masters, K.; King, C.; Kelly, M.; Hasan, U.; Heavens, P.; White, R.; Stanford, J. A new method of energy prescription to improve weight loss. J. Hum. Nutr. Diet., 1991, 20(3), 369-373.
[http://dx.doi.org/10.1111/j.1365-277X.1991.tb00120.x]
[http://dx.doi.org/10.1111/j.1365-277X.1991.tb00120.x]
[15]
Avenell, A.; Broom, J.; Brown, T.J.; Poobalan, A.; Aucott, L.; Stearns, S.C.; Smith, W.C.; Jung, R.T.; Campbell, M.K.; Grant, A.M. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol. Assess., 2004, 8(21), iii-iv, 1-182.
[http://dx.doi.org/10.3310/hta8210] [PMID: 15147610]
[http://dx.doi.org/10.3310/hta8210] [PMID: 15147610]
[16]
Scottish Intercollegiate Guidelines Network. Obesity in
Scotland: Integrating Prevention with Weight Management.
A National Clinical Guideline Recommended for Use in
Scotland by the Scottish Intercollegiate Guideline Network In: SIGN; Edinburgh,, 1996.
[17]
Heymsfield, S.B.; van Mierlo, C.A.; van der Knaap, H.C.; Heo, M.; Frier, H.I. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int. J. Obes. Relat. Metab. Disord., 2003, 27(5), 537-549.
[http://dx.doi.org/10.1038/sj.ijo.0802258] [PMID: 12704397]
[http://dx.doi.org/10.1038/sj.ijo.0802258] [PMID: 12704397]
[18]
Food and Agriculture Organization of the United Nations,
World Health Organization. Codex standard for formula
foods for use in very low energy diets for weight reduction. Available at: . http://www.fao.org/fao-who-codexaliment-arius/en/ [Accessed July 26, 216
[19]
Brand-Miller, J. Glycemic index and body weight. Am. J. Clin. Nutr., 2005, 81(3), 722-723.
[http://dx.doi.org/10.1093/ajcn/81.3.722] [PMID: 15755844]
[http://dx.doi.org/10.1093/ajcn/81.3.722] [PMID: 15755844]
[20]
Brand-Miller, J.C.; Holt, S.H.A.; Pawlak, D.B.; McMillan, J. Glycemic index and obesity. Am. J. Clin. Nutr., 2002, 76(1), 281S-285S.
[http://dx.doi.org/10.1093/ajcn/76.1.281S] [PMID: 12081852]
[http://dx.doi.org/10.1093/ajcn/76.1.281S] [PMID: 12081852]
[21]
McMillan-Price, J.; Brand-Miller, J. Low-glycaemic index diets and body weight regulation. Int. J. Obes., 2006, 2006(30), S40-S46.
[http://dx.doi.org/10.1038/sj.ijo.0803491]
[http://dx.doi.org/10.1038/sj.ijo.0803491]
[22]
Pawlak, D.B.; Bryson, J.M.; Denyer, G.S.; Brand-Miller, J.C. High glycemic index starch promotes hypersecretion of insulin and higher body fat in rats without affecting insulin sensitivity. J. Nutr., 2001, 131(1), 99-104.
[http://dx.doi.org/10.1093/jn/131.1.99] [PMID: 11208944]
[http://dx.doi.org/10.1093/jn/131.1.99] [PMID: 11208944]
[23]
Pawlak, D.B.; Kushner, J.A.; Ludwig, D.S. Effects of dietary glycaemic index on adiposity, glucose homoeostasis, and plasma lipids in animals. Lancet, 2004, 364(9436), 778-785.
[http://dx.doi.org/10.1016/S0140-6736(04)16937-7] [PMID: 15337404]
[http://dx.doi.org/10.1016/S0140-6736(04)16937-7] [PMID: 15337404]
[24]
Sloth, B.; Astrup, A. Low glycemic index diets and body weight. Int. J. Obes., 2006, 30, S47-S51.
[http://dx.doi.org/10.1038/sj.ijo.0803492]
[http://dx.doi.org/10.1038/sj.ijo.0803492]
[25]
Lean, M.E.J.; Lara, J. Is Atkins dead (again)? Nutr. Metab. Cardiovasc. Dis., 2004, 14(2), 61-65.
[http://dx.doi.org/10.1016/S0939-4753(04)80011-5] [PMID: 15242237]
[http://dx.doi.org/10.1016/S0939-4753(04)80011-5] [PMID: 15242237]
[26]
Harper, A.; Astrup, A. Can we advise our obese patients to follow the Atkins diet? Obes. Rev., 2004, 5(2), 93-94.
[http://dx.doi.org/10.1111/j.1467-789X.2004.00137.x] [PMID: 15086862]
[http://dx.doi.org/10.1111/j.1467-789X.2004.00137.x] [PMID: 15086862]
[27]
Freedman, M.R.; King, J.; Kennedy, E. Popular diets: a scientific review. Obes. Res., 2001, 9(Suppl. 1), 1S-40S.
[http://dx.doi.org/10.1038/oby.2001.113] [PMID: 11374180]
[http://dx.doi.org/10.1038/oby.2001.113] [PMID: 11374180]
[28]
Keys, A. Food items, specific nutrients, and “dietary” risk. Am. J. Clin. Nutr., 1986, 43(3), 477-479.
[http://dx.doi.org/10.1093/ajcn/43.3.477] [PMID: 3953486]
[http://dx.doi.org/10.1093/ajcn/43.3.477] [PMID: 3953486]
[29]
Sofi, F.; Abbate, R.; Gensini, G.F.; Casini, A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am. J. Clin. Nutr., 2010, 92(5), 1189-1196.
[http://dx.doi.org/10.3945/ajcn.2010.29673] [PMID: 20810976]
[http://dx.doi.org/10.3945/ajcn.2010.29673] [PMID: 20810976]
[30]
Kastorini, C.M.; Panagiotakos, D.B.; Chrysohoou, C.; Georgousopoulou, E.; Pitaraki, E.; Puddu, P.E.; Tousoulis, D.; Stefanadis, C.; Pitsavos, C. ATTICA Study Group. Metabolic syndrome, adherence to the Mediterranean diet and 10-year cardiovascular disease incidence: The ATTICA study. Atherosclerosis, 2016, 246, 87-93.
[http://dx.doi.org/10.1016/j.atherosclerosis.2015.12.025] [PMID: 26761772]
[http://dx.doi.org/10.1016/j.atherosclerosis.2015.12.025] [PMID: 26761772]
Article Metrics
![Wayfinder Image](/images/wayfinder.jpg)