Abstract
Okinawa has long been a world-famous area of longevity. Recently, however, an expansion of lifestyle-related metabolic and cardiovascular diseases (e.g. metabolic syndrome, diabetes mellitus, dyslipidemia and hypertension) in Okinawa has been linked with a substantial drop in life span (Okinawa Crisis). Despite a mild increase in exaggerated body fat mass, the risk for diabetes mellitus is known to elevate substantially. By nature, body weight homeostasis is critically regulated by the inter-tissue communications between brain and peripheral tissues. To survive starvation, the cold, and water/salt deficiencies, our physiologic systems have evolved in favor of fat storage and sodium retention, hence the global increase in obesity-diabetes-hypertension syndrome given today's caloric excess and sedentary lifestyle. Recent research has unveiled the molecular mechanisms of fuel homeostasis. For example, the adipocyte-derived hormone leptin strongly controls appetite and fuel homeostasis via the hypothalamus. However, clinical application of leptin for the treatment of obesity-diabetes syndrome has been hampered by the fact that leptin action is deteriorated on a high-fat, westernized diet. In this article, the update around the medicine of obesity and metabolic syndrome is reviewed with particular focus on the novel molecular and cellular mechanisms of preference for fatty foods.
