דו״ח מאומת

Obesity has emerged as a global epidemic, creating an increased burden of weight-related diseases and straining healthcare systems worldwide. While the fundamental principle of energy balance-caloric intake versus expenditure-remains central to weight regulation, real-world outcomes often deviate from simplistic predictions due to a multitude of physiological and environmental factors. Genetic predispositions, variations in basal metabolic rates, adaptive thermogenesis, physical activity, and nutrient losses via fecal and urinary excretion contribute to interindividual differences in energy homeostasis. Additionally, factors such as meal timing, macronutrient composition, gut microbiota dynamics, and diet-induced thermogenesis (DIT) further modulate energy utilization and metabolic efficiency. This Perspective explores key physiological determinants of the energy balance, while also highlighting the clinical significance of thrifty versus spendthrifty metabolic phenotypes. Key strategies for individualized weight management include precision calorimetry, circadian-aligned meal timing, the use of protein- and whole food diets to enhance DIT, and increases in non-exercise activity, as well as mild cold exposure and the use of thermogenic agents (e.g., capsaicin-like compounds) to stimulate brown adipose tissue activity. A comprehensive, personalized approach to obesity management that moves beyond restrictive caloric models is essential to achieving sustainable weight control and improving long-term metabolic health. Integrating these multifactorial insights into clinical practice will enhance obesity treatment strategies, fostering more effective and enduring interventions.…

PMID: 39997062

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.…

PMID: 16002825

Individuals can lose body weight and improve health status on a wide range of energy (calorie)-restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate, and Mediterranean approaches, in addition to commercial slimming programs, meal replacements, and newly popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve low-density lipoprotein cholesterol the most, while lower-carbohydrate diets may preferentially improve triglycerides and high-density lipoprotein cholesterol. However, differences between diets are marginal. Weight loss improves almost all obesity-related co-morbidities and metabolic markers, regardless of the macronutrient composition of the diet, but individuals do vary in preferences and ability to adhere to different diets. Optimizing adherence is the most important factor for weight loss success, and this is enhanced by regular professional contact and supportive behavioral change programs. Maintaining weight losses in the long term remains the biggest challenge, and is undermined by an "obesogenic" environment and biological adaptations that accompany weight loss.…

PMID: 28214525

Irritable Bowel Syndrome (IBS) is a functional disorder of the digestive system. Its global prevalence varies widely, estimated at up to 10%, due to differences in diagnostic criteria, cultural factors, and dietary patterns. Dietary interventions have emerged as first-line strategies for symptom management, with the low-FODMAP (fermentable oligo-, di-, and monosaccharide and polyol) diet demonstrating robust efficacy in reducing gastrointestinal symptoms by minimizing poorly absorbed, fermentable carbohydrates. However, concerns regarding the long-term nutritional adequacy, potential alterations in gut microbiota composition, and sustainability of the low-FODMAP diet have prompted the need for more integrative and nutritionally balanced dietary models. In contrast, the Mediterranean Diet (MD), rich in fruits, vegetables, legumes, whole grains, nuts, olive oil, and omega-3 fatty acids from fish, is widely recognized for its anti-inflammatory, cardiometabolic, and potential anticarcinogenic effects. Notably, adherence to the MD has been associated with favorable gut microbial profiles and reduced risk of colorectal and other gastrointestinal cancers. However, the high FODMAP content of many MD components limits its immediate compatibility with IBS dietary protocols. This review explores the evidence supporting the integration of MD principles into a low-FODMAP framework for the dietary management of IBS. Rather than proposing a new model, we synthesize existing literature, including recent clinical findings, and offer practical, evidence-informed guidance for tailoring a Mediterranean-style low-FODMAP diet that supports both symptom management and long-term nutritional health. Integrating MD principles into the low-FODMAP approach offers a promising strategy to enhance the nutritional quality, sustainability, and long-term efficacy of dietary management in IBS.…

PMID: 41011418