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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2015; 09(03): 135-139
DOI: 10.1055/s-0037-1618932
Übersichtsarbeit
Schattauer GmbH

Bedeutung der Energiebilanz für das kardiometabolische Risiko

Impact of energy balance on cardiometabolic risk
A. Bosy-Westphal
1   Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
,
M. Lagerpusch
1   Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
,
M. J. Müller
2   Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel
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Publikationsverlauf

Publikationsdatum:
22. Dezember 2017 (online)

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Zusammenfassung

Eine chronisch positive Energiebilanz führt zu Veränderungen der Körperzusammensetzung und neuroendokriner Regelkreise, die zu einem erhöhten kardiometabolischen Risiko beitragen.

Veränderungen der Energiebilanz haben abhängig von Ausmaß und Dauer des Kaloriendefizits oder Überschusses eine Auswirkung auf die Partitionierung von Fett und Magermasse und den Stoffwechsel. Während der Gewichtsreduktion variieren die Abnahme von Fett- und Magermasse sowie die Partitionierung innerhalb der Fettmasse (z.B. werden das viszerale Fettgewebe und das Leberfett zu Beginn einer Gewichtsabnahme präferenziell mobilisiert).

Die Kenntnis der Determinanten von physiologischen Veränderungen der Körperzusammensetzung und der neuroendokrinen Regelkreise bei Gewichtszu- und -abnahme ermöglicht sowohl eine angemessene und zielgerichtete Therapieplanung als auch die Beurteilung des Therapieverlaufs von Patienten. Der Einfluss von Dynamik und Frequenz von Energiebilanzveränderungen auf die Körpergewichtsregulation und Risikofaktoren wie Insulinresistenz muss weiter untersucht werden, um Empfehlungen für innovative therapeutische Konzepte bei Adipositas ableiten zu können.

Summary

Cardiometabolic risk is caused by changes in body composition and neuroendocrine regulation that are consequences of a chronically positive energy balance.

The extent but also the duration and frequency of energy deficit or surplus determine partitioning of fat and lean mass and changes in metabolism with weight loss and weight gain. Visceral adipose tissue and liver fat are lost preferentially with modest weight loss, but the effect is attenuated with greater weight loss.

Prediction of physiologic changes in body composition and regulatory circuits with modulation of energy balance allows the development and monitoring of a personalized therapeutic weight loss strategy.

The impact of dynamics and frequency of changes in energy balance on body weight regulation and cardiometabolic risk requires further investigation before recommendations for clinical practice can be implemented.

Schlüsselwörter

Energiebilanz - Prädiabetes - kardiometabolisches Risiko

Keywords

Energy balance - prediabetes - cardiometabolic risk
 

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