This paper sought to propose a new pathophysiological model that integrates several concepts to understand how to prevent the growing incidence of obesity and associated chronic metabolic disease. At the center of this model is the lack of physical activity, which is so prevalent in contemporary populations. The authors propose that a sedentary lifestyle triggers a stress response which induces physiological changes such as insulin resistance, hepatic lipogenesis, hyperglycemia, central adiposity and associated prothrombotic and proinflammatory states. It is well accepted that high levels of both physical activity and cardiorespiratory fitness are associated with lower mortality. Moreover, caloric restriction is also important in order to limit central adiposity and ectopic fat deposition. The authors suggest to target both physical activity and caloric intake in order to prevent chronic metabolic diseases instead of focussing only on weight reduction.
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