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如今，肥胖是对人类健康的一个巨大挑战，人们需要有效且低风险的膳食替代治疗。食用不可消化多糖（NDPs）被认为是一种很有前途的减肥方法。来自华南理工大学食品科学与工程学院、香港中文大学食品营养系和食品营养与健康学科创新引智基地（111基地）的研究人员在期刊eFood (ISSN: 2666-3066)上发表了题为“Behavior of Non-Digestible Polysaccharides in Gastrointestinal Tract: A Mechanistic Review of its Anti-Obesity Effect”的文章，综述了食用不可消化多糖（NDPs）在胃肠道内的行为研究进展，探讨了NDPs的减肥机制。
要点介绍
如今，肥胖作为一种脂肪储存过多或异常的流行病，已成为世界范围内严重的公共卫生问题，患病率逐年增长。根据世界卫生组织的数据，2016年，超过6.5亿人被诊断患有肥胖症，到2030年，将有10亿人受到影响。肥胖及其多种并发症，如高脂血症、2型糖尿病、某些癌症等，会导致患病者生活质量降低、死亡率增加，而且会带来巨额医疗费用负担。
由高能量摄入和低能量消耗引起的能量失衡是肥胖发生的根本原因，此外还有其他相关因素，包括遗传代谢、内分泌失调等。迄今为止，预防肥胖的策略主要包括抗肥胖药物、减肥手术、饮食和运动。其中，对抗肥胖的首选方法是坚持定期运动和低能量饮食，比如控制脂肪和糖的摄入量。此外，以前批准的抗肥胖药物，具有一定的副作用。通过胃分流术或胃束带手术减肥虽然比药物治疗更有效，但只有少数患者适合这种治疗方法。因此，近年来，人们一直在探索有效、易获得以及低风险的替代疗法。
作为一种天然产物，不可消化多糖（NDPs）在肥胖症研究中一直备受关注（图1）。它们广泛分布于植物、真菌和微生物中。越来越多的证据表明，它们可以通过调节脂质代谢、降低炎症水平、改善胰岛素抵抗等多种机制预防肥胖症的发生。生物利用度相对较低的NDPs在体内发挥抗肥胖作用的方式，如改变机体成分、改善代谢紊乱等，在很大程度上可能是基于其在胃肠道系统中的行为。本文综述了NDPs在胃肠道中的行为及其与胃肠道生理相关的潜在减肥机制，旨在为更好地理解NDPs对体重增加的控制提供一些重要的见解。
结果表明，与胃肠道内NDPs行为相关的减肥机制可能包括：（i）抑制脂肪吸收，（ii）改变肠道微生物群及其代谢产物，如短链脂肪酸，（iii）调节胆汁酸分布，（iv）调节食欲和饱腹感效应，保护肠道屏障。
图1. Graphical Abstract。
图2. 多糖与肥胖的研究趋势。数据来源于网站(http://apps.webofknowledge.com). 检索日期：2021年2月。
图3. NDPs在胃肠道过程中抑制肥胖的机制示意图。(1）NDPs调节脂肪吸收；(2） NDPs通过在肠道内发酵来改变肠道微生物群及其代谢产物；(3）NDPs通过提高胃肠饱腹感降低食物摄入量；(4）NDPs调节糖脂代谢；(5）NDPs保护肠道屏障，减轻代谢性内毒素血症。
研究结论：在这篇综述中，我们总结了NDPs在胃肠道中的行为，并着重介绍了NDPs的抗肥胖机制及其生理效应。结果表明，NDPs可以到达结肠并被结肠微生物利用。他们通过控制脂肪吸收、肠内发酵、调节胆汁酸分布、调节食欲和饱腹感以及通过恢复肠屏障改善代谢性内毒素血症等机制显示了对胃肠道内肥胖的治疗作用。
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原文信息
Y. Zhang, Q. Xie, L. You, P. C. Cheung, Z. Zhao， "Behavior of Non-Digestible Polysaccharides in Gastrointestinal Tract: A Mechanistic Review of its Anti-Obesity Effect", eFood, 2021, DOI: 10.2991/efood.k.210310.001.
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