The role of nutrition in abdominal obesity

Recognition of the biological and health importance of abdominal fatness has stimulated researchers, clinicians and public health workers. Most work and 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 fatness. But these contributors themselves, when considered mechanistically, raise possibilities about other potentially important modulators of abdominal fatness, such as adipocyte differentiation and apoptosis, the kinetics of cell fat content, its hormonal and neural control, along with underlying genetic predisposition and expression. In turn, the ways in which environmental factors may influence fat distribution come into focus; these include nutritional factors, which may be as broad as the food cultural (given ethnic differences in abdominal fatness) or as located as specific food factors like those which are thermogenic (eg. capsaicin-like), hormone- like (notably the candidate phytoestrogens) or essential fatty acids which affect receptor 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 with early life events and/or physical activity and/or substance abuse having a determinant role in the development of abdominal fatness. To what extent, and how, it is now opportune to ask.