What Can We Recommend Today

Diet and exercise are the cornerstones of prevention and treatment of obesity and related disorders. Although dietary recommendations have been changing over the past few years, it is hoped that, as we learn more from both observational and interventional studies, our recommendations will continue to be refined and will hopefully prove to be more and more effective. It is also hoped that diagnostic and therapeutic methods will continue to improve significantly. New medications and new surgical methods are continually tested, developed, and applied. We present herein our current understanding of underlying scientific principles and current recommendations with the explicit understanding that medical approaches should not only be characterized by continuous quality improvements but need to also be individualized and guided by the responsible treating physician.

Each chapter in this book provides an authoritative review of the current status of research and knowledge in each one of the most important clusters of current work in the Nutrition and Metabolism field. Text and graphs of several chapters appeared in their original form in the textbook "Nutrition and Metabolism", C. Mantzoros (editor), published by the Aristides Daskalopoulos Foundation in Athens, Greece, 2007. Material from these chapters is reproduced herein with permission granted by the Aristides Daskalopoulos Foundation. The chapters in this book are relatively brief, analytical, based on scientific evidence, and are written in an accessible style. We all hope that putting together cutting-edge research and reviewing critically current knowledge in all these fields will result in a sum that will be greater than its individual components. We also hope that ongoing work will lead, in the not so distant future, to a better understanding of the problems we are facing and to a more efficient creation of novel solutions that would allow us to effectively combat and hopefully eliminate this epidemic of the twenty-first century.

2 Genes and Gene—Environment Interactions in the Pathogenesis of Obesity and the Metabolic Syndrome

Despina Sanoudou, Elizabeth Vafiadaki, and Christos S. Mantzoros

Key Points

  • In recent years, the prevalence of obesity has risen sharply, becoming a major public health problem, especially in western countries.
  • According to the World Health Organization (http://www.who.int) , an estimated 1 billion adults are overweight (body mass index > 25 kg/m2), and 300 million of these are considered clinically obese (body mass index > 30 kg/m2).
  • In part as a result of the rising prevalence of obesity, the incidence of the metabolic syndrome and type 2 diabetes are also reaching the levels of an epidemic.
  • Although our genetic make-up has not changed significantly over the last 50 years, our diet and lifestyle have. This has unveiled how genetic predisposition can affect our response to environmental factors such as nutrition and exercise.
  • In the present chapter we discuss how our genes, alone and in combination with the environment, can give rise to obesity, the metabolic syndrome and diabetes.

Key Words: Mutations, Polymorphisms, Chromosomal loci, Animal models

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