期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 114, 期 6, 页码 1873-1885出版社
OXFORD UNIV PRESS
DOI: 10.1093/ajcn/nqab270
关键词
obesity; weight loss; dietary carbohydrate; energy balance; macronutrients; endocrinology; insulin; glucagon; incretins; scholarly discourse
资金
- Lilly
- Janssen
- Allurion
- Novo Nordisk
- Canadian Institutes of Health Research
The obesity pandemic may be not only caused by excessive consumption of high-energy foods and lack of exercise, but also related to biological mechanisms. The carbohydrate-insulin model proposes a new cognitive framework, emphasizing hormonal responses to a high glycemic load diet.
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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