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Macronutrient balances and obesity: the role of diet and physical activity

Published online by Cambridge University Press:  02 January 2007

Arne Astrup*
Affiliation:
Research Department of Human Nutrition, KVL, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark.
*
*Corresponding author: Email: ast@kvl.dk
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Abstract

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Observational cross-sectional and longitudinal studies suggest that a high fat diet and physical inactivity are independent risk factors for weight gain and obesity. Mechanistic and intervention studies support that fat possesses a lower satiating power than carbohydrate and protein, and a diet low in fat therefore decreases energy intake. The effect of dietary fat on energy balance is enhanced in susceptible subjects, particularly in sedentary individuals with a genetic predisposition to obesity who consume a high fat diet.

Dietary carbohydrate promotes its own oxidation by an insulin-mediated stimulation of glucose oxidation. In contrast, high fat meals do not increase fat oxidation acutely. A sedentary life-style and low physical fitness cause a low muscular fat oxidation capacity, and the consumption of a high fat diet by these individuals promotes fat storage in a synergistic fashion.

Ad libitum low fat diets cause weight loss proportional to pre-treatment body weight in a dose-dependent way, i.e. weight loss is correlated positively to the reduction in dietary fat content. Increased physical activity prevents relapse after weight loss and studies have shown that those who keep up a higher level of physical activity are more successful in maintaining the reduced body weight. In conclusion, important interactions exist between genetic make up, dietary fat and physical fitness, so that a low fitness level and susceptible genes reduce muscular fat oxidation capacity which may decrease the tolerance of dietary fat. Increasing daily physical activity and reducing dietary fat content may be more effective when combined than when separate in preventing weight gain and obesity.

Type
Research Article
Copyright
Copyright © CABI Publishing 1999

References

1Yu-Poth, S, Zhao, G, Etherton, T, Naglak, M, Jonnalagadda, S, Kris-Etherton, PM. Effects of the National Cholesterol Education Program's Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am. J. Clin. Nutr. 1999; 69: 632–46.CrossRefGoogle ScholarPubMed
2 Obesity: preventing and managing the global epidemic. Report of a WHO Consultation on Obesity, Geneva 3–5 June 1997. Geneva: WHO Publications, 1997.Google Scholar
3Astrup, A. The American paradox: the role of energy-dense fat-reduced food in the increasing prevalence of obesity. Curr. Opin. Clin. Nutr. Metab. Care. 1998; 1: 573–7.CrossRefGoogle ScholarPubMed
4Prentice, AM, Jebb, SA. Obesity in Britain: gluttony or sloth? Br. Med. J. 1995; 311: 437–9.CrossRefGoogle ScholarPubMed
5Flatt, JP, Ravussin, E, Acheson, KJ, Jequier, E. Effects of dietary fat on postprandial substrate oxidation and on carbohydrate and fat balances. J. Clin. Invest. 1985; 76: 1019–24.CrossRefGoogle ScholarPubMed
6Astrup, A, Flatt, JP. Metabolic determinants of body weight regulation. In: Bouchard, C, Bray, GA, eds. Regulation of Body Weight, Biological and Behavioral Mechanisms. Dahlem Workshop Report LS 57. Chichester John Wiley & Sons 1996, 193210.Google Scholar
7Zhang, Y, Proenca, R, Maffei, M, Barone, M, Leopold, L, Friedman, JM. Positional cloning of the obese mouse gene and its human homologue. Nature. 1994; 372: 425–32.CrossRefGoogle ScholarPubMed
8Astrup, A, Raben, A, Buemann, B, Toubro, S. Fat metabolism in the predisposition to obesity. Ann. NY Acad. Sci. 1997; 827: 427–33.CrossRefGoogle ScholarPubMed
9Blundell, JE, MacDiarmid, JI. Passive overconsumption. Fat intake and short-term energy balance. Ann. NY Acad. Sci. 1997; 827: 392407.CrossRefGoogle ScholarPubMed
10Stubbs, RJ, Harbron, CG, Murgatroyd, PR, Prentice, AM. Covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men eating ad libitum. Am. J. Clin. Nutr. 1995; 62: 316–29.CrossRefGoogle ScholarPubMed
11Stubbs, RJ, Ritz, P, Coward, WA, Prentice, AM. Covert manipulation of the dietary fat to carbohydrate ratio and energy density: effect on food intake and energy balance in free-living men, feeding ad libitum. Am. J. Clin. Nutr. 1995; 62: 330–7.CrossRefGoogle ScholarPubMed
12Tordoff, MG, Reed, DR. Sham-feeding sucrose or corn oil stimulates food intake in rats. Appetite. 1991; 17: 97103.CrossRefGoogle ScholarPubMed
13van Stratum, P, Lussenberg, RN, van Wezel, LA, Vergoesen, AJ, Cremer, HD. The effect of dietary carohydrate: fat ratio on energy intake by adult women. Am. J. Clin. Nutr. 1978; 31: 206–12.CrossRefGoogle Scholar
14Astrup, A, Toubro, S, Raben, A, Skov, R. The role of low fat diets and fat substitutes in body weight management: what have we learned from clinical studies? J. Am. Diet. Assoc. 1997; 97: S82–7.CrossRefGoogle ScholarPubMed
15Astrup, A. Dietary composition, substrate balances and body fat in subjects with a predisposition to obesity. Int. J. Obes. 1993; 17(suppl. 3): S32–6.Google ScholarPubMed
16Kant, AK, Graubard, BI, Schatzkin, A, Ballard-Barbash, R. Proportion of energy intake from fat and subsequent weight change in the NAHNES 1 Epidemiologic Follow-up Study. Am. J. Clin. Nutr. 1995; 61: 11–7.CrossRefGoogle Scholar
17Prentice, AM, Black, AE, Coward, WA, Davies, Hl, Goldberg, GR, Murgatroyd, PR, et al. High levels of energy expenditure in obese women. Br. Med. J. 1986; 292: 983–92.CrossRefGoogle ScholarPubMed
18Heitmann, BE, Lissner, L. Dietary underreporting by obese individuals—is it specific or non-specific? Br. Med. J. 1995; 311: 986–9.CrossRefGoogle ScholarPubMed
19Radimer, KL, Harvey, PWJ. Comparison of self-report of reduced fat and salt foods with sales and supply data. Eur. J. Clin. Nutr. 1998; 52: 380–2.CrossRefGoogle ScholarPubMed
20Paeratakul, S, Popkin, BM, Keyou, G, Adeir, LS, Stevens, J. Changes in diet and physical activity affect the body mass index of Chinese adults. Int. J. Obes. 1998; 22: 424–31.CrossRefGoogle ScholarPubMed
21Bray, GA, Popkin, BM. Dietary fat intake does affect obesity. Am. J. Clin. Nutr. 1998; 68: 1157–73.CrossRefGoogle ScholarPubMed
22Astrup, A, Ryan, L, Grunwald, G, Storgaard, M, Saris, W, Hill, JO. Ad libitum low-fat diets and body fatness: a meta-analysis of intervention studies. J. A. M. A. (submitted).Google Scholar
23Willet, WC. Is dietary fat a major determinant of body fat? Am. J. Clin. Nutr. 1998; 67: 556s–62s.CrossRefGoogle Scholar
24Katan, MB, Grundy, SM, Willett, WC. Beyond low-fat diets. N. Engl. J. Med. 1997; 337: 563–6.Google ScholarPubMed
25Rolls, BJ, Rowe, EA, Turner, RC. Persistent obesity in rats following a period of consumption of a mixed, high energy diet. J. Physiol. (London) 1980; 298: 415–27.CrossRefGoogle ScholarPubMed
26Hill, JO, Lin, D, Yakubu, F, Peters, JC. Development of dietary obesity in rats: influence of amount and composition of dietary fat. Int. J. Obes. 1992; 16: 321–33.Google ScholarPubMed
27Nagle, DL, McGrail, SH, Vitale, J, Woolf, EA, Dussault, BJ, DiRocco, L, Holmgren, L, Montegno, J, Bork, P, Hugzar, D, Fairchild-Huntress, V, Ge, P, Keiltz, J, Ebeling, C, Balbini, L, Gilchrist, J Burn, P, Carlson, GA, Moore, KJ. The mahogany protein is a receptor involved in suppression of obesity. Nature. 1999; 398: 148–52.CrossRefGoogle ScholarPubMed
28Heitmann, BL, Lissner, L, Sørensen, TIA, Bengtsson, C. Dietary fat intake and weight gain in women genetically predisposed to obesity. Am. J. Clin. Nutr. 1995; 61: 1213–7.CrossRefGoogle ScholarPubMed
29Toubro, S, Sørensen, TIA, Hindsberger, C, Christensen, NJ, Astrup, A. Twenty-four-hour respiratory quotient: the role of diet and familial resemblance. J. Clin. Endocrinol. Metab. 1998; 83: 2758–64.Google ScholarPubMed
30Ranneries, C, Bülow, J, Buemann, B, Christensen, NJ, Madsen, J, Astrup, A. Fat metabolism in formerly obese women: effect of exercise on substrate oxidation and adipose tissue lipolysis. Am. J. Physiol. (Endocrinol. Metab.) 1998; 274: 155–61.CrossRefGoogle Scholar
31Raben, A, Mygind, E, Astrup, A. Lower activity of oxidative key enzymes and smaller fiber areas in skeletal muscle of postobese women. Am. J. Physiol. 1998; 275: E487–94.Google ScholarPubMed
32Heini, AF, Weinsier, RL. Divergent trends in obesity and fat intake patterns: the American paradox. Am. J. Med. 1997; 102: 259–64CrossRefGoogle ScholarPubMed
33Astrup, A, Lundsgaard, C, Stock, MJ. Is obesity contagious? Int. J. Obes. 1998; 22: 375–6.CrossRefGoogle ScholarPubMed