Nature Reviews：膳食纤维与代谢（综述）
文章发布于：Nature Reviews Gastroenterology and Hepatology
2024-02-23
1
本综述全面探讨了肥胖背后的多种激素、神经和代谢机制，揭示了膳食纤维通过调节肠道菌群促进体重管理和改善代谢功能的潜力；
2
肥胖是一种复杂的慢性进行性疾病，其特征是超重以及肠道内分泌和神经激素信号通路失调，导致食欲和能量储存增加，而基于胃肠道的内分泌疗法是目前最有效的减重和改善代谢功能的途径；
3
肠道菌群通过多种自主神经和躯体神经内分泌途径与宿主相互作用来改变代谢，菌群代谢物（如短链脂肪酸、吲哚衍生物和胆汁酸）与肥胖和代谢失调的发病机制有关；
4
膳食纤维在化学和物理结构方面的异质性决定了其对胃肠道、肠道菌群和能量稳态的影响，增加膳食纤维的摄入有助于治疗肥胖和代谢综合征；
5
利用基线微生物群和临床特征可以预测个体对纤维补充的反应，了解肠道菌群及其基因通路如何与饮食成分相互作用有助于设计更有效的个性化治疗方法，提高膳食干预的成功率。
Obesity and metabolic syndrome represent a growing epidemic worldwide. Body weight is regulated through complex interactions between hormonal, neural and metabolic pathways and is influenced by numerous environmental factors. Imbalances between energy intake and expenditure can occur due to several factors, including alterations in eating behaviours, abnormal satiation and satiety, and low energy expenditure. The gut microbiota profoundly affects all aspects of energy homeostasis through diverse mechanisms involving effects on mucosal and systemic immune, hormonal and neural systems. The benefits of dietary fibre on metabolism and obesity have been demonstrated through mechanistic studies and clinical trials, but many questions remain as to how different fibres are best utilized in managing obesity. In this Review, we discuss the physiochemical properties of different fibres, current findings on how fibre and the gut microbiota interact to regulate body weight homeostasis, and knowledge gaps related to using dietary fibres as a complementary strategy. Precision medicine approaches that utilize baseline microbiota and clinical characteristics to predict individual responses to fibre supplementation represent a new paradigm with great potential to enhance weight management efficacy, but many challenges remain before these approaches can be fully implemented.
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