The role of nutrition in abdominal obesity

Recognition of the biological and health importance of abdominal fatness ha s stimulated researchers, clinicians and public heath workers. Most work an d interest so far has focussed on how it might account for health outcomes, with increasing attention to its preferred measurement. Its aetiology and pathogenesis is thought to reflect gender, age and energy balance which, if positive, leads to increased total body fatness, including abdominal fatne ss. But these contributors themselves, when considered mechanistically, rai se possibilities about other potentially important modulators of abdominal fatness, such as adipocyte differentiation and apoptosis, the kinetics of c ell fat content, its hormonal and neural control, along with underlying gen etic predisposition and expression. In turn, the ways in which environmenta l factors may influence fat distribution come into focus; these include nut ritional factors, which may be as broad as the food cultural (given ethnic differences in abdominal fatness) or as located as specific food factors li ke those which are thermogenic (eg. capsaicin-like), hormone-like (notably the candidate phytoestrogens) or essential fatty acids which affect recepto r function (like omega-3 fatty acids). There is a prima facie case for food intake, aside from its energy value, in its own right, or in conjunction w ith early life events and/or physical activity and/or substance abuse havin g a determinant role in the development of abdominal fatness. To what exten t, and how, it is now opportune to ask. (C) 1998 Elsevier Science Inc.