Human obesity: an evolutionary approach to understanding our bulging waistline.

Abstract:

:The unique worldwide spread of the human species and the remarkably long post-reproductive survival show that our genome permits excellent adaptation to vastly different environments. Moreover, the main scourges of later age, namely malignant growths and atherosclerosis, appear in humans later than in shorter-living animals. In recent years, excess weight and obesity have become mass phenomena with a pronounced upward trend in all developed countries. However, despite the detrimental effects of being overweight, these populations live longer than ever, which in part may be explained by the availability of better medical treatment. The prevalence and predicted further spread of obesity can be understood in the light of evolution. In all animal species energy metabolism is asymmetric with energy accumulation ('thrifty genotype') being the necessary condition of survival during hard times. For humans, which are no different to other animals in this respect, this genetic programming was necessary for survival because during the course of history, including the recorded history in the more developed Middle East, Europe or China, there was never a long period of uninterrupted food abundance, whereas famines were regular and frequent. Therefore fat accumulation, when food was available, meant survival at times of shortage, while the possible detrimental effects of overindulgence in food and being overweight expressed in unrealistically old age were irrelevant. It is the central, mostly intra-abdominal fat (in both humans and animals) that is more medically important than the subcutaneous truncal fat, and the accumulation of both types of fat is conditioned by high food consumption; therefore it is a historic novelty for human populations. In contrast, lower-body fat in human females is unique in the animal kingdom: it is much less metabolically active, it is of much lower pathologic significance than central fat, and it is programmed to be mobilized mostly during pregnancy and lactation. In view of all this, norms of desired weight should be based on hard mortality and morbidity statistics and not on theoretical, esthetic or fashion considerations. By this criterion, the upper limit of desirable weight is likely to be body mass index (BMI) 27 or 28, but specified for different populations (sex, race, ethnic origin); moreover, with aging, the detrimental effects of obesity diminish and finally disappear. Risks of other pathologies related to obesity (e.g. diabetes, hypertension and coronary disease) are also population-specific. However, total fatness, measured by BMI, is insufficiently sensitive as a risk factor, and fat distribution (upper-body versus low-body type, as reflected by waist circumference and waist:hip ratio) plays at least as prominent a role. Therefore the detailed norms, not yet available, should take into account both general obesity and fat distribution and be specific for different populations. Since long-term weight loss in adults is rarely achievable, public health measures should be aggressively directed at the prevention of obesity from childhood.

journal_name

Diabetes Metab Res Rev

authors

Lev-Ran A

doi

10.1002/dmrr.230

keywords:

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

347-62

issue

5

eissn

1520-7552

issn

1520-7560

pii

10.1002/dmrr.230

journal_volume

17

pub_type

杂志文章,评审
  • Identification and functional analysis of a novel G310D variant in the insulin-like growth factor 1 receptor (IGF1R) gene associated with type 2 diabetes in American Indians.

    abstract:AIMS:Insulin-like growth factor 1 receptor (IGF1R) is involved in cell growth and glucose homeostasis. In the current study, the IGF1R locus was analysed as a candidate gene for type 2 diabetes (T2D) in American Indians. MATERIALS AND METHODS:Whole genome sequence data from 335 American Indians identified 3 novel miss...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2994

    authors: Muller YL,Skelton G,Piaggi P,Chen P,Nair A,Kobes S,Hsueh WC,Knowler WC,Hanson RL,Baier LJ,Bogardus C

    更新日期:2018-05-01 00:00:00

  • Heparanase prevents the development of type 1 diabetes in non-obese diabetic mice by regulating T-cell activation and cytokines production.

    abstract:BACKGROUND:Heparanase is an endo-beta-D-glucuronidase that cleaves heparan sulfate saccharide chains. The enzyme promotes cell adhesion, migration and invasion, and was shown to play a significant role in cancer metastasis and angiogenesis. METHODS:The present study focuses on the involvement of heparanase in autoimmu...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.868

    authors: Bitan M,Weiss L,Zeira M,Reich S,Pappo O,Vlodavsky I,Slavin S

    更新日期:2008-07-01 00:00:00

  • Autoantibodies against PFDN2 are associated with an increased risk of type 2 diabetes: A case-control study.

    abstract:BACKGROUND:The adaptive immune system is involved in type 2 diabetes mellitus (T2DM), indicating the presence of unidentified autoantibodies that might be useful biomarkers for emerging immunomodulatory therapy. A prior microarray study with a small number of participants suggested the association of novel autoantibodi...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2922

    authors: Chang DC,Piaggi P,Hanson RL,Knowler WC,Bogardus C,Krakoff J

    更新日期:2017-11-01 00:00:00

  • Self glucose monitoring and physical exercise in diabetes.

    abstract::Cardiorespiratory fitness, which is determined mainly by the level of physical activity, is inversely related to mortality in the general population as well as in subjects with diabetes, the incidence of which is also increased by low exercise capacity. Exercise is capable of promoting glucose utilization in normal su...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审

    doi:10.1002/dmrr.982

    authors: Pugliese G,Zanuso S,Alessi E,Simonelli P,Fallucca S,Fallucca F,Balducci S

    更新日期:2009-09-01 00:00:00

  • Widening awareness of hyperglycemia unawareness.

    abstract::Hyperglycemia unawareness is the term suggested to me (M. Muggeo, personal communication, 1997) to encompass very broadly all of the stages in diabetes mellitus from the onset of any degree of hyperglycemia until the diagnosis is actually made. Diabetes and its handmaiden, obesity, are growing in epidemic proportions ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 评论,社论

    doi:10.1002/1520-7560(200007/08)16:4<228::aid-dmrr125>

    authors: Roth J

    更新日期:2000-07-01 00:00:00

  • Vitamin D deficiency is associated with painful diabetic neuropathy.

    abstract:BACKGROUND:The aetiology of painful diabetic neuropathy is unclear. We have evaluated vitamin D levels in diabetic patients with and without painful neuropathy. METHODS:Forty-three patients with type 1 diabetes and painless (DPN) (n = 20) or painful (PDN) (n = 23) neuropathy and 14 non-diabetic healthy control subject...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.3361

    authors: Alam U,Petropoulos IN,Ponirakis G,Ferdousi M,Asghar O,Jeziorska M,Marshall A,Boulton AJM,Efron N,Malik RA

    更新日期:2021-01-01 00:00:00

  • Impact of diabetes mellitus on immature platelet fraction and its association with coronary artery disease.

    abstract:BACKGROUND:Higher prothrombotic status and alterations in platelet function and thrombopoiesis are associated with diabetes mellitus (DM). We assessed the impact of diabetes and glucose control on the immature platelet fraction (IPF) and their relationship with prevalence and extent of coronary artery disease (CAD). M...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.3290

    authors: Verdoia M,Nardin M,Rolla R,Pergolini P,Suryapranata H,Kedhi E,Carriero A,De Luca G,Novara Atherosclerosis Study Group (NAS).

    更新日期:2020-05-01 00:00:00

  • Essential phospholipids prevent islet damage induced by proinflammatory cytokines and hypoxic conditions.

    abstract:BACKGROUND:The pancreatic islet damage that occurs through an inflammatory response and hypoxia after infusion is a major hurdle in islet transplantation. Because essential phospholipids (EPL) have been shown to exhibit anti-inflammatory properties in liver disease, we analysed their protective effect on islets in infl...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2714

    authors: Shahbazov R,Kanak MA,Takita M,Kunnathodi F,Khan O,Borenstein N,Lawrence MC,Levy MF,Naziruddin B

    更新日期:2016-03-01 00:00:00

  • Identification of specific angiotensin-converting enzyme variants and haplotypes that confer risk and protection against type 2 diabetic nephropathy.

    abstract:BACKGROUND:Cross-sectional and family studies identified angiotensin-converting enzyme (ACE) gene as a risk factor for diabetic nephropathy (DN). The contribution of ACE gene variants to DN development and progression is controversial and varies among different ethnic/racial groups. METHODS:We investigated the associa...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.1006

    authors: Ezzidi I,Mtiraoui N,Kacem M,Chaieb M,Mahjoub T,Almawi WY

    更新日期:2009-11-01 00:00:00

  • Early transcriptional regulation by C-peptide in freshly isolated rat proximal tubular cells.

    abstract:BACKGROUND:Clinical studies have shown that proinsulin C-peptide exerts renoprotective effects in type 1 diabetes, although the underlying mechanisms are poorly understood. As C-peptide has been shown to induce several intracellular events and to localize to nuclei, we aimed to determine whether gene transcription is a...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.1220

    authors: Lindahl E,Nordquist L,Müller P,El Agha E,Friederich M,Dahlman-Wright K,Palm F,Jörnvall H

    更新日期:2011-10-01 00:00:00

  • The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus.

    abstract::Foot problems complicating diabetes are a source of major patient suffering and societal costs. Investing in evidence-based, internationally appropriate diabetic foot care guidance is likely among the most cost-effective forms of healthcare expenditure, provided it is goal-focused and properly implemented. The Interna...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2694

    authors: Bakker K,Apelqvist J,Lipsky BA,Van Netten JJ,International Working Group on the Diabetic Foot.

    更新日期:2016-01-01 00:00:00

  • Influence of diabetic metabolic state on fracture healing in spontaneously diabetic rats.

    abstract:BACKGROUND:Type 1 diabetes mellitus (DM) has been shown to alter the properties of bone and impair fracture healing in both humans and animals. The objective of this study was to examine changes in the histomorphometrical, histological and mechanical parameters of bone and remodeling during fracture healing, depending ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.537

    authors: Follak N,Klöting I,Merk H

    更新日期:2005-05-01 00:00:00

  • The metabolic demands of driving for drivers with type 1 diabetes mellitus.

    abstract:BACKGROUND:The active cognitive-motor demands of driving may have a significant metabolic demand that could contribute to the development of hypoglycemia. Conversely, symptoms caused by the stress of driving may be confused with hypoglycemia and lead to false alarms. This study examined the metabolic demand and the phy...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.306

    authors: Cox DJ,Gonder-Frederick LA,Kovatchev BP,Clarke WL

    更新日期:2002-09-01 00:00:00

  • Statins are associated with new onset type 2 diabetes mellitus (T2DM) in Medicare patients ≥65 years.

    abstract:BACKGROUND:To evaluate the association of statins and co-morbidities with new onset type 2 diabetes mellitus (T2DM) in patients 65 years and older. METHODS:This retrospective study used de-identified administrative healthcare claims and enrolment data from a Medicare Advantage Prescription Drug (MAPD) health plan offe...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.3310

    authors: Tangelloju S,Little BB,Esterhay RJ,Brock G,LaJoie S

    更新日期:2020-09-01 00:00:00

  • Thiazolidinedione therapy and breast cancer risk in diabetic women: A systematic review and meta-analysis.

    abstract::Rising experimental evidence suggests that thiazolidinediones (TZDs) exert a protective effect on breast cancer. However, studies concerning this issue were inconsistent and limited. Hence, we performed a meta-analysis with data from currently available studies to evaluate the effect of TZDs on breast cancer risk amon...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审

    doi:10.1002/dmrr.2961

    authors: Du R,Lin L,Cheng D,Xu Y,Xu M,Chen Y,Wang W,Bi Y,Li D,Lu J

    更新日期:2018-02-01 00:00:00

  • Calculating individualized glycaemic targets using an algorithm based on expert worldwide diabetologists: Implications in real-life clinical practice.

    abstract:BACKGROUND:The aim of this study was to assess the clinical implications of calculating an individualized HbA1c target using a recently published algorithm in a real-life clinical setting. METHODS:General practitioners (GPs) from the Spanish Society of Family Medicine Diabetes Expert Group were invited to participate ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2976

    authors: Alvarez-Guisasola F,Cebrián-Cuenca AM,Cos X,Ruiz-Quintero M,Millaruelo JM,Cahn A,Raz I,Orozco-Beltrán D,Spanish Society of Family Medicine Diabetes Group.

    更新日期:2018-03-01 00:00:00

  • Case series of a hybrid closed-loop system used in pregnancies in clinical practice.

    abstract:BACKGROUND:Hybrid closed-loop (HCL) therapy is rarely studied in pregnancy. We present three cases of women with type 1 diabetes who used the Medtronic 670G HCL system for most or all of gestation. METHODS:The Medtronic 670G system has a manual mode (no automated insulin delivery) and an auto mode (AM, HCL therapy). W...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.3248

    authors: Polsky S,Akturk HK

    更新日期:2020-03-01 00:00:00

  • Association of iron indices and type 2 diabetes: a meta-analysis of observational studies.

    abstract::The literature on the role of body iron status in the development of type 2 diabetes (T2D) in humans is inconsistent. We aimed to assess the association between iron indices and T2D by a meta-analysis of previously published studies. A systematic literature search was conducted in PubMed and EMBASE. Observational stud...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/dmrr.2506

    authors: Orban E,Schwab S,Thorand B,Huth C

    更新日期:2014-07-01 00:00:00

  • Axonal dysfunction prior to neuropathy onset in type 1 diabetes.

    abstract:BACKGROUND:The present study was undertaken to determine whether there were changes evident in axonal membrane function prior to the onset of neuropathy in patients with type 1 and type 2 diabetes. METHODS:From a cohort of 110 consecutive referrals, nerve excitability was investigated in 40 diabetic patients without c...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2360

    authors: Arnold R,Kwai N,Lin CS,Poynten AM,Kiernan MC,Krishnan AV

    更新日期:2013-01-01 00:00:00

  • A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable.

    abstract::Diabetic foot ulceration poses a heavy burden on the patient and the healthcare system, but prevention thereof receives little attention. For every euro spent on ulcer prevention, ten are spent on ulcer healing, and for every randomized controlled trial conducted on prevention, ten are conducted on healing. In this ar...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2738

    authors: Bus SA,van Netten JJ

    更新日期:2016-01-01 00:00:00

  • Prevalence of hyperglycaemia in singleton versus twin pregnancy.

    abstract:BACKGROUND:There is conflicting information regarding the risk of gestational diabetes mellitus in twin pregnancies. This study was conducted to determine whether the risk of gestational diabetes mellitus is higher in pregnant Japanese women with twin versus singleton pregnancy. METHODS:The prevalence of gestational d...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2586

    authors: Morikawa M,Yamada T,Akaishi R,Kojima T,Nishida R,Koyama T,Cho K,Minakami H

    更新日期:2015-02-01 00:00:00

  • Diabetic fatty liver disease is associated with specific changes in blood-borne markers.

    abstract:BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) can lead to cirrhosis and hepatocellular carcinoma and is strongly associated with obesity and insulin resistance. The aim of this study was to assess if plasma markers associated with NAFLD are increased in people with concomitant diabetes compared with those withou...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2269

    authors: Sharma S,Barrett F,Adamson J,Todd A,Megson IL,Zentler-Munro PL,MacRury SM

    更新日期:2012-05-01 00:00:00

  • Interpreting the results of the Semmes-Weinstein monofilament test: accounting for false-positive answers in the international consensus on the diabetic foot protocol by a new model.

    abstract:AIMS:The Semmes-Weinstein monofilament is the most widely used test to diagnose the loss of protective sensation. The commonly used protocol of the International Consensus on the Diabetic Foot includes a 'sham' application that allows for false-positive answers. We sought to study the heretofore unexamined significance...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.2465

    authors: Slater RA,Koren S,Ramot Y,Buchs A,Rapoport MJ

    更新日期:2014-01-01 00:00:00

  • Diabetes and microvascular pathophysiology: role of epidermal growth factor receptor tyrosine kinase.

    abstract::Type 2 diabetes is responsible for the increased prevalence of ischaemic heart disease, generally related to coronary artery disease, which is associated with increased morbidity and death in diabetic patients. Epidermal growth factor receptor (EGFR) tyrosine kinase, one of the many factors involved in cell growth and...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审

    doi:10.1002/dmrr.1050

    authors: Matrougui K

    更新日期:2010-01-01 00:00:00

  • Comparison of insulin lispro mix 25 with insulin lispro mix 50 as an insulin starter in Asian patients with type 2 diabetes: a phase 4, open-label, randomized trial (CLASSIFY study).

    abstract:BACKGROUND:Lispro Mix 25% insulin lispro/75% insulin lispro protamine (LM25) and Lispro Mix 50% insulin lispro/50% insulin lispro protamine (LM50) were compared as starter insulins in East Asian patients with type 2 diabetes. METHODS:Phase 4, open-label, randomized trial conducted in China, Japan, Korea, and Turkey. S...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1002/dmrr.2816

    authors: Watada H,Su Q,Li PF,Iwamoto N,Qian L,Yang WY

    更新日期:2017-01-01 00:00:00

  • Association between bone mineral density and type 1 diabetes mellitus: a meta-analysis of cross-sectional studies.

    abstract::A few studies have investigated the relationship between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) values. This meta-analysis was performed to explore differences between T1DM and healthy individuals in BMD values measured at five bone sites.We searched the database of PubMed for cross-sectional s...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/dmrr.2508

    authors: Pan H,Wu N,Yang T,He W

    更新日期:2014-10-01 00:00:00

  • Effect of antiretroviral agents on carbohydrate metabolism in HIV-1 infected pregnant women.

    abstract:BACKGROUND:Despite the correlation between the use of protease inhibitors (PI) and adverse metabolic glycemic events, no prospective study has examined these parameters in pregnant women who use these drugs. METHODS:A prospective study was conducted on 57 pregnant women to investigate the effect of antiretroviral drug...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.576

    authors: El Beitune P,Duarte G,Foss MC,Montenegro RM Jr,Spara P,Quintana SM,Figueiró-Filho EA,da Costa AG,Filho FM

    更新日期:2006-01-01 00:00:00

  • Thymic expression of insulin-related genes in an animal model of autoimmune type 1 diabetes.

    abstract:BACKGROUND:Insulin and multiple other autoantigens have been implicated in the pathogenesis of autoimmune type 1 diabetes, but the origin of immunological self-reactivity specifically oriented against insulin-secreting islet beta-cells remains obscure. The primary objective of the present study was to investigate the h...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.182

    authors: Kecha-Kamoun O,Achour I,Martens H,Collette J,Lefebvre PJ,Greiner DL,Geenen V

    更新日期:2001-03-01 00:00:00

  • Risk of type 1 diabetes in childhood and maternal age at delivery, interaction with ACP1 and sex.

    abstract:BACKGROUND:We have investigated the possible role of ACP1 (also known as cLMWPTP: cytosolic low molecular weight phosphotyrosine phosphatase), a highly polymorphic enzyme involved in signal transduction of T-cell receptor, insulin receptor and other growth factors in the relationship between maternal age at delivery an...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.521

    authors: Bottini N,Meloni GF,Lucarelli P,Amante A,Saccucci P,Gloria-Bottini F,Bottini E

    更新日期:2005-07-01 00:00:00

  • Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes.

    abstract:BACKGROUND:Environmental factors such as nutrition or exposure to infections play a substantial role in the pathogenesis of type 1 diabetes (T1D). We have previously shown that gluten-free, non-purified diet largely prevented diabetes in non-obese diabetic (NOD) mice. In this study we tested hypothesis that early intro...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章

    doi:10.1002/dmrr.748

    authors: Funda DP,Kaas A,Tlaskalová-Hogenová H,Buschard K

    更新日期:2008-01-01 00:00:00