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Contribution of macronutrients to obesity: implications for precision nutrition

Nature Reviews Endocrinology volume 16, pages 305–320 (2020)Cite this article

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Abstract

The specific metabolic contribution of consuming different energy-yielding macronutrients (namely, carbohydrates, protein and lipids) to obesity is a matter of active debate. In this Review, we summarize the current research concerning associations between the intake of different macronutrients and weight gain and adiposity. We discuss insights into possible differential mechanistic pathways where macronutrients might act on either appetite or adipogenesis to cause weight gain. We also explore the role of dietary macronutrient distribution on thermogenesis or energy expenditure for weight loss and maintenance. On the basis of the data discussed, we describe a novel way to manage excessive body weight; namely, prescribing personalized diets with different macronutrient compositions according to the individual’s genotype and/or enterotype. In this context, the interplay of macronutrient consumption with obesity incidence involves mechanisms that affect appetite, thermogenesis and metabolism, and the outcomes of these mechanisms are altered by an individual’s genotype and microbiota. Indeed, the interactions of the genetic make-up and/or microbiota features of a person with specific macronutrient intakes or dietary pattern consumption help to explain individualized responses to macronutrients and food patterns, which might represent key factors for comprehensive precision nutrition recommendations and personalized obesity management.

Key points

  • Body weight and adiposity rely on energy equilibrium driven by energy-yielding macronutrient intake and energy expenditure under strict neuroendocrine control.

  • Complex energy homeostasis interactions between carbohydrates, lipids and proteins (dietary quantity and quality) follow the interpretation of their separate roles on fuel metabolism.

  • The intake of simple sugars and some saturated fatty acids has adverse effects on body adiposity, while protein and fibre consumption seem to beneficially modulate satiety and energy metabolism-related processes.

  • Personal genetic background and gut microbiota features contribute to explaining some metabolic inter-individual differences to macronutrient consumption.

  • Advances in understanding metabolism pathways and hormonal control depending on macronutrient intake involved in energy utilization are needed for precision and public health nutrition.

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Fig. 1: Key metabolic mechanisms on body weight regulation.

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Acknowledgements

R.S.-C. acknowledges financial support from the Juan de la Cierva Programme — Training Grants of the Spanish State Research Agency of the Spanish Ministerio de Ciencia e Innovación y Ministerio de Universidades (FJC2018-038168-I). R.S.-C., S.N.-C. and J.A.M. were part of the EU project Food4Me supported by the European Commission under the Food, Agriculture, Fisheries and Biotechnology Theme of the 7th Framework Programme for Research and Technological Development (ID no. 265494). M.A.M.-G. acknowledges the support of the European Research Council, Advanced Research Grant, PREDIMED-PLUS (ERC-2013-ADG #340918).

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Authors and Affiliations

  1. Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, Spanish National Research Council, Madrid, Spain

    Rodrigo San-Cristobal & José Alfredo Martínez

  2. Centre for Nutrition Research, University of Navarra, Pamplona, Spain

    Santiago Navas-Carretero & José Alfredo Martínez

  3. CIBERobn, Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion, Madrid, Spain

    Santiago Navas-Carretero, Miguel Ángel Martínez-González & José Alfredo Martínez

  4. IdisNA, Navarra Institute for Health Research, Pamplona, Spain

    Santiago Navas-Carretero, Miguel Ángel Martínez-González & José Alfredo Martínez

  5. Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain

    Miguel Ángel Martínez-González

  6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Miguel Ángel Martínez-González

  7. Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA

    José María Ordovas

  8. Department of Cardiovascular Epidemiology and Population Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain

    José María Ordovas

  9. Nutritional Genomics of Cardiovascular Disease and Obesity Fundation IMDEA Food, Campus of International Excellence, Spanish National Research Council, Madrid, Spain

    José María Ordovas

Authors
  1. Rodrigo San-Cristobal
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  2. Santiago Navas-Carretero
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  3. Miguel Ángel Martínez-González
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  4. José María Ordovas
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  5. José Alfredo Martínez
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Contributions

All authors contributed to all aspects of the manuscript.

Corresponding author

Correspondence to Santiago Navas-Carretero.

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Competing interests

The authors declare no competing interests.

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Nature Reviews Endocrinology thanks the reviewers for their contribution to the peer review of this work.

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Supplementary information

Glossary

Ileal brake

The delay in gastric emptying and small intestinal transit induced by the presence of certain nutrient solutions or products in the ileum.

Weende approach

The calculation of carbohydrate from the known content of fat, protein and fibre of a food.

Nutrigenetics

The science that identifies and characterizes gene variants associated with differential response to nutrients and relates this variation to diverse disease states.

Exposome

Encompasses life-course environmental exposures (including lifestyle factors) from the prenatal period onwards, including the body’s response through different endogenous metabolic processes.

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San-Cristobal, R., Navas-Carretero, S., Martínez-González, M. et al. Contribution of macronutrients to obesity: implications for precision nutrition. Nat Rev Endocrinol 16, 305–320 (2020). https://doi.org/10.1038/s41574-020-0346-8

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