体重管理中的能量补偿:机制和意义

能量摄入和消耗之间不平衡是体重过度增加的主要原因。通过增加身体活动和/或限制饮食摄入来实现能量负平衡是诱导减肥的常用方法。但这些干预行为对体重减轻的幅度小于预期。减肥失败的原因很大程度上是因为身体会通过一套协调补偿机制,来抵抗增加身体活动和限制饮食摄入导致的能量不足。本文对这些特定的代偿现象、潜在驱动机制及其对减肥的实际影响进行综述。确定了几种能量补偿的来源,包括静息代谢率的降低、非运动活动产热的减少以及饮食动力的增加。目前支持能量补偿的实证仍然有限,需要更多的研究来阐明各种能量补偿来源对减肥结果的影响作用。由于运动的潜在补偿性和个体差异,通用的“一刀切”减肥运动处方并不广泛适用。根据目前研究现状,运动处方与体重控制建议应具有个性化,同时应将生理、行为和环境等限制因素对能量平衡调节的贡献考虑在内。

Energy Compensation in Weight Management: Mechanisms and Implications

An imbalance between energy intake and expenditure is the primary etiology for excess weight gain. Achieving a negative energy balance by increasing physical activity and/or by restricting dietary intake is a commonly used approach to induce weight loss. These behavioral interventions, however, have resulted in a smaller than expected weight loss. The lack of success often seen in weight loss has been largely attributed to a coordinated set of compensatory mechanisms the body uses to resist an energy deficit induced by exercise or dietary restriction. This review provides a contemporary overview of these specific compensatory phenomena, the underlying mechanisms that drive them, and their practical implications for weight loss. Several sources of energy compensation have been identified including a reduction in resting metabolic rate, a reduction in non-exercise activity thermogenesis, and an increase in eating drive. However, supporting evidence for energy compensation still remains limited, and more research is needed to clarify the role various sources of energy compensation play in affecting weight loss outcomes. Given the wide range of potential compensatory responses to exercise and the interindividual variability, generic and one-size-fits-all exercise prescriptions for weight loss may not be appropriate. Based on the current literature, it appears that exercise prescription and weight control advice should not only be tailored to suit the individual and but also be holistic that consider the contribution of physiological, behavioral, and environmental constrains to energy balance regulation.