Obesity and dietary fat

Seidell, J.C. 1998. Dietary fat and obesity an epidemiologic perspective. Am. J. Clin. Nutr. 67, 546S-550S. 

Primary increases of VLDL probably reflect a number of genetic determinants and are worsened by factors that increase the rate of VLDL secretion from liver, ie, obesity, alcohol, diabetes, and estrogens. A major indication for treatment is the presence of atherosclerosis in the patient or the patient s family. Treatment includes weight reduction, restriction of all types of dietary fat, and avoidance of alcohol. Fibrates or niacin usually produce further reduction in triglyceride levels if dietary measures are not sufficient. Marine omega fatty acids may also be of value. 

At this point, the first therapeutic steps should be nonpharmacologic. Mr. Applebod s obesity should be treated with caloric restriction and a carefully monitored program of exercise. A reduction of dietary fat and sodium would be advised in an effort to correct his hyperlipidemia and his hypertension, respectively. 

Interaction of Dietary Fat and Hepatic Lipase Gene Polymorphism on HDL-C.. 12 Interactions of Apolipoprotein E (APOE) Genotype with Obesity and Alcohol... 14 Interaction of Polyunsaturated Fatty Adds (PUFA) and APOAl G-A... 

Fava F, Gitau R, Griffin BA, Gibson GR, Tuohy KM, Lovegrove JA. The type and quantity of dietary fat and carbohydrate alter faecal microbiome and short-chain fatty acid excretion in a metabolic sjmdrome at-risk population. Int J Obesity. 2013 37(2) 216-223. 

The rising incidence of obesity has not paralleled sucrose consumption. The FDA Task Force concluded that sugars have no unique role in obesity and that dietary fat rather than carbohydrate is a significant contributor to this condition (62,67,68). However, sugar can promote weight gain in individuals with life-styles marked by excess caloric intake and insufficient exercise. 

In vivo, FXR is expressed in white adipose tissue (WAT) with levels decreased in the WAT of dietary (high fat) and genetic objob mice) models of obesity. ... 

Pharmacology Orlistat is a reversible lipase inhibitor for obesity management that acts by inhibiting the absorption of dietary fats. It exerts its therapeutic activity in the lumen of the stomach and small intestine. 

Orlistat, a semisynthetic derivative of lipstatin, is a potent and selective inhibitor of pancreatic lipases. It was designed to treat obesity. Orlistat prevents approximately 25% of dietary fat from being absorbed. Very little of the drug itself is absorbed. Its adverse effects are therefore restricted to those related to fat malabsorption, with potential losses of fat-soluble vitamins. It has a relatively small effect on body mass, but enough to realise in one study a 37% reduction in the incidence of type 2 diabetes. 

It has been suggested that brown adipose tissue may also function to convert excess dietary fat into heat and thereby to resist obesity.k m Mice lacking the gene for the mitochondrial uncoupling protein are cold-sensitive but not obese. However, other proteins, homologous to UCP1, have been discovered. They may partially compensate for the loss.m,h... 

It remains to be seen whether the observed advantageous health effects of milk or dairy consumption are affected by the level of fat within these food items. It had previously been hypothesized that saturated fat in milk would have unfavorable health effects, particularly in relation to cardiovascular health and obesity because of the observed links between dietary saturated fat and CVD. In the Hoorn study, however, low-fat dairy consumption was positively related, while high-fat dairy consumption... 

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