The well publicized French paradox means that when in France one can eat and drink with abandon without fear of becoming obese. Red wine consumption has often been cited as the protective factor in this phenomenon. The good news is that there may well be a scientific basis for this happy situation. Pal et al. (2004) studied the impact of acute consumption of red wine polyphenolics in postmenopausal women. They found that red wine polyphenolics attenuate postprandial chylomicron and chylomicron remnant levels in plasma, possibly by delaying absorption of dietary fat.
Many of us are today living in an increasingly obesogenic environment. The combination of sedentary lifestyles and ever more affordable and varied diets makes the maintenance of a caloric balance more and more of a challenge. It is difficult to deny knowledge of the value of exercise, fruit, vegetables, wholegrain and caloric restriction. However, despite this, obesity gathers momentum as the greatest epidemic ever to befall man. Whilst some prefer the word 'epidemic' to be applied only to infectious diseases, the point is well made. It is clear then that we need help, help in the form of foods that encourage us to consume less calories, help in the form of medicines that alter our metabolism in the direction of a favourable energy balance, and help by way of education on the consequences of ignoring the advice.
From this it seems that the future of novel weight loss ingredients is assured. However, it is only assured if the developers of such ingredients concentrate on sound science and do not become tempted to rush to market before proof of effect is manifest.
Satiety is mediated by a complex balance of hormonal interactions and signals (de Graaf et al., 2004). We are a long way from being able to safely manipulate hormonal balance to achieve desirable body weight but investigations in this important area continue. Meanwhile the elucidation of the human genome has spawned the new science of nutrigenomics. Clearly some of us are more predisposed to obesity than others and part of the explanation is the regulation of gene expression by food components. The reader is referred to Clément (2005), Bell et al. (2005), Loos and Rankinen (2005) and Roche et al. (2005) for recent reviews on the subject.
Certainly within the next generation there is an expectation that we might manipulate gene expression through food choices in order to control body weight. Roy et al. (2004) studied the impact of HCA on gene expression in rats. They found several genes sensitive to HCA and in particular the genes responsible for abdominal leptin production were downregulated whilst plasma leptin was unaffected.
The pharmaceutical industry has long since recovered from the withdrawal of Fen-Phen (FDA 1997). A number of promising drugs are currently under development for the treatment of obesity. Bray and Greenway (1999) and Carpino and Hadcock (2003) have reviewed the approaches being taken.
So perhaps now the tapeworm can be allowed to rest in peace, or perhaps not? Tapeworms have been shown to impact lipid metabolism in mice in favour of lipolysis (Rath and Walkey, 1987). Maybe we can learn something useful from the physiology of and physiological response to the humble tapeworm.
The last word should go to an even older discipline. Yoga and meditation have long been proposed for the control of body weight, not because of the calories they burn but because of their impact on the psychology of food consumption. This cuts to the very heart of the issue. We do not just eat because we feel hungry but also in response to many complex psychological, social and environmental factors. A holistic approach is mandated.
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