Obesity - a perspective based on the biochemical interrelationship of lipids and carbohydrates.

Many factors affect the onset of obesity including satiety control, reduced levels of physical exercise as well as hormonal and genetic parameters which influence the metabolic pathways leading to the net accumulation of triacylglycerol (TAG). The predominant fatty acid of human adipose tissue TAGs is oleic acid, reflecting primarily the composition of the diet but also the product of de novo lipogenesis. Consequently, both carbohydrates and lipids are potential sources of these stored fats. Many studies have been carried out using a variety of differing experimental protocols on healthy, obese or diabetic humans and animals in positive or neutral energy balance to establish the underlying molecular basis for obesity particularly in humans. This short review discusses the interdependence and control of the metabolism of lipids and carbohydrates as it relates to lipogenesis and proposes a unified hypothesis for obesity which brings together a number of different approaches focusing on (i) the interaction of dietary fat and carbohydrate, which typically represent approximately 80% of the daily caloric intake, and their role in the synthesis of TAGs, (ii) the biochemical pathways which control the amount of TAG produced by controlling the composition of their fatty acids via the action of stearoyl-CoA desaturase (SCD), (iii) the control of lipogenesis and SCD by dietary polyunsaturated fatty acid (PUFA) and (iv) the interaction of PUFAs with the transcription factors, peroxisome proliferator activated receptors (PPAR) alpha and gamma, which maintain the balance between oxidation and storage of lipids. The hypothesis focuses on the central role of stearoyl-CoA desaturase (SCD) and its inhibition by polyunsaturated fatty acids (PUFAs) acting via transcription factors based upon data obtained from both animal and human studies. From these observations it should be possible to determine the relevance of the hypothesis to humans and to speculate how these aspects of metabolism may impact the risk of developing related diseases such as coronary heart disease, Type 2 diabetes and certain forms of cancer.