Die Energiebilanz charakterisiert Adipositas, sie erklärt sie aber nicht und sie ermöglicht keine Strategien für eine nachhaltige Behandlung

Zusammenfassung

Die Energiebilanz dient häufig zur Erklärung der Entstehung von Übergewicht sowie als Basis für konservative Therapiemaßnahmen. Dies impliziert, dass Übergewicht durch eine zu hohe Energieaufnahme und/oder einen Mangel an Bewegung erklärt ist und somit eine Verringerung der Energiezufuhr oder eine Erhöhung des Energieverbrauchs zu einem Energiedefizit und damit zu einer Gewichtsabnahme führen. Dieses vereinfachende Paradigma lässt jedoch die Regulation der Energiebilanz außer Acht und verkennt damit die eigentlichen Ursachen und Therapieoptionen von Übergewicht. Die Kontrolle der Energiebilanz ist ein dynamischer Prozess, bei dem Veränderungen in einer Komponente der Energiebilanz eine Kompensation in anderen Komponenten des Systems zur Folge haben. Darüber hinaus haben Kalorien aus verschiedenen Makronährstoffquellen oder zu unterschiedlichen Tageszeiten verzehrt metabolische Auswirkungen, die über ihren Wert als Brennstoff hinausgehen, zu einer Änderung der Partitionierung der Energie im Stoffwechsel führen und damit den Appetit steigern. Die Energiebilanz dient nicht einer Lösung des Adipositasproblems. Diese ergeben sich aus dem Verständnis der Determinanten und Interaktion von Lebensstilfaktoren wie Zuckerkonsum, Snacking-Behavior und körperlicher Aktivität im Hinblick auf adipogene Stoffwechselveränderungen.

Abstract

The energy balance paradigm is commonly used to explain the development of overweight and serves as a basis for conservative therapeutic measures. It is implied that obesity is explained by an excessive energy intake and/or a lack of exercise, and that a reduction in energy intake or an increase in energy consumption leads to an energy deficit and thus to weight loss. This simplistic paradigm, however, ignores the control of energy balance and thus fails to address the actual causes and treatment options for obesity. Control of energy balance is a dynamic process in which changes in one component of energy balance can trigger compensation in other components of the system. Furthermore, calories from different macronutrient sources or consumed at different times of the day have metabolic effects that go beyond their value as fuel and lead to a change in the partitioning of energy in the metabolism, thereby increasing appetite. The energy balance paradigm cannot provide solutions of the obesity issue which arise from understanding the determinants and interaction of lifestyle factors such as sugar consumption, snacking behavior, and physical activity with respect to adipogenic metabolic changes.

Schlüsselwörter

Energiebilanz - Partitionierung von Energie - Energieverbrauch - energy constraint model - Adaptive Thermogenese

Key words

Regulation of energy balance - energy partitioning - obesity

Publication History

Article published online:
04 December 2023

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