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Obesity and energy balance: is the tail wagging the dog?

2876 Views 6 Replies 3 Participants Last post by  foxl
The scientific study of obesity has been dominated throughout the twentieth century by the concept of energy balance. This conceptual approach, based on fundamental thermodynamic principles, states that energy cannot be destroyed, and can only be gained, lost or stored by an organism. Its application in obesity research has emphasised excessive appetite (gluttony), or insufficient physical activity (sloth), as the primary determinants of excess weight gain, reflected in current guidelines for obesity prevention and treatment. This model cannot explain why weight accumulates persistently rather than reaching a plateau, and underplays the effect of variability in dietary constituents on energy and intermediary metabolism. An alternative model emphasises the capacity of fructose and fructose-derived sweeteners (sucrose, high-fructose corn syrup) to perturb cellular metabolism via modification of the adenosine monophosphate (AMP)/adenosine triphosphate (ATP) ratio, activation of AMPkinase and compensatory mechanisms, which favour adipose tissue accretion and increased appetite while depressing physical activity. This conceptual model implicates chronic hyperinsulinaemia in the presence of a paradoxical state of ‘cellular starvation’ as a key driver of the metabolic modifications inducing chronic weight gain. We combine evidence from in vitro and in vivo experiments to formulate a perspective on obesity aetiology that emphasises metabolic flexibility and dietary composition rather than energy balance. Using this model, we question the direction of causation of reported associations between obesity and sleep duration or childhood growth. Our perspective generates new hypotheses, which can be tested to improve our understanding of the current obesity epidemic, and to identify novel strategies for prevention or treatment.
continues... European Journal of Clinical Nutrition advance online publication, 20 July 2011
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Excellent report, Frank!

Still reading, but this would confirm my own experiences quite nicely. I find that my energy level goes down after my weight starts climbing, not before. And while my own pre-D diet was not the best, it was not all that bad!
17 pgs -- I printed a copy off for later consumption -- but I liked that it addressed children born in other countries and the rapid growth of contemporary Us kids ... at a glance, anyhow! Thank you so much!
Yes it will be quite a read -- still working though it myself -- but it shows early promise and I especially liked...
The aim of our review is not to claim that our revised model is correct or definitive, but rather to stimulate researchers to acknowledge that the direction of causation in obesity aetiology is less clear than is commonly assumed.Nothing that we propose in this article contradicts the laws of thermodynamics or the energy balance equation; rather,we follow others in questioning whether simplified interpretation of the energy balance equation can become misleading with regard to obesity causation. We suggest that if empirical work specifically addresses this dilemma,regardless of which model proves most compatible with data, the evidence base for obesity prevention is likely to improve.
...In other words, Open your minds people! :p
Beautiful, yes.

I'm also interested in the comparisons among children in different countries that Linda mentioned. Based on what I've seen in this Forum, both diabetes and obesity seem to operate differently according to the diet one was raised on.
You might also be interested in a recent BBC Horizon documentary The Nine Months That Made You...
although I'm not sure how you can get hold of a copy :eek:

Horizon explores the secrets of what makes a long, healthy and happy life. It turns out that a time you can't remember - the nine months you spend in the womb - could have more lasting effects on you today than your lifestyle or genes. It is one of the most powerful and provocative new ideas in human science, and it was pioneered by a British scientist, Professor David Barker. His theory has inspired a field of study that is revealing how our time in the womb could affect your health, personality, and even the lives of your children.
Okay, I made it through, this morning! I loved the entire thing, but noticed it centers on nutrition, rather than mentioning environmental promoters -- but perhaps that is part of why it is persuasive, to its intended audience, too. It was clearly an appeal to epidemiologists and researchers.

I was as I said before, especially fascinated by the section on prenatal and early-life factors, and how later-life impact the vulnerability caused by early-life factors (IUGR, formula vs breast-feeding, etc). These are things I definitely can use in educating my kids -- my youngest underwent that growth spurt after we got her, after spending 2.5 yrs living on mostly rice and noodles in China (I know they did their best for her), and I do worry for her health. Perhaps curtailing her intake of HFCS and sucrose (which was also an interesting aside) will help her. As it is, she craves sugar and goes for it -- not a good sign.
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