医学
胰岛素
胰岛素抵抗
糖尿病
内科学
血糖性
2型糖尿病
碳水化合物代谢
内分泌学
碳水化合物
超重
作者
David S. Ludwig,Louis J. Aronne,Arne Astrup,Rafael de Cabo,Lewis C. Cantley,Mark I. Friedman,Steven B. Heymsfield,James D. Johnson,Janet C. King,Ronald M. Krauss,Daniel E. Lieberman,Gary Taubes,Jeff S. Volek,Eric C. Westman,Walter C. Willett,William S. Yancy,Cara B. Ebbeling
摘要
According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. Conceptualizing obesity as a disorder of energy balance restates a principle of physics without considering the biological mechanisms that promote weight gain. An alternative paradigm, the carbohydrate-insulin model (CIM), proposes a reversal of causal direction. According to the CIM, increasing fat deposition in the body-resulting from the hormonal responses to a high-glycemic-load diet-drives positive energy balance. The CIM provides a conceptual framework with testable hypotheses for how various modifiable factors influence energy balance and fat storage. Rigorous research is needed to compare the validity of these 2 models, which have substantially different implications for obesity management, and to generate new models that best encompass the evidence.
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