Metabolic Syndrome and Obesity in Childhood and AdolescenceEditor(s): Kiess W. (Leipzig)
Wabitsch M. (Ulm)
Maffeis C. (Verona)
Sharma A.M. (Edmonton, Alta.)
Societal Aspects and Prevention
Metabolic Syndrome and the ‘Western Diet': Science and PoliticsLustig R.H.a, b
aDivision of Pediatric Endocrinology, Department of Pediatrics, UCSF Benioff Children's Hospital and the bPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco, Calif., USA
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Metabolic syndrome comprises a set of chronic diseases (hypertension, diabetes, dyslipidemia, and cardiovascular disease) that tend to cluster together. Although obesity is commonly thought to be the antecedent of metabolic syndrome, this syndrome also occurs in lean individuals, suggesting that obesity is a marker of metabolic syndrome rather than a cause. The cellular mechanisms of metabolic syndrome include mitochondrial overload, de novo lipogenesis, hepatic insulin resistance and hyperinsulinemia, reactive oxygen species formation, endoplasmic reticulum stress, and the unfolded protein response. Specific alterations of the Western Diet uniquely drive this process and are unrelated to calories. These alterations include too little fiber, omega-3 fatty acids, and micronutrients, and too many omega-6 fatty acids, trans-fats, branched-chain amino acids, ethanol, and fructose. The food industry invokes personal responsibility while denying any corporate responsibility and citing scientific, policy, and social arguments. However, their responses obfuscate the scientific truth in order to obviate their culpability.
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