Food intake and energy expenditure are sensed and processed by multiple brain centres to uphold energy homeostasis. Evidence from the past decade points to the brain vasculature as a new critical player in regulating energy balance that functions in close association with the local neuronal networks. Nutritional imbalances alter many properties of the neurovascular system (such as neurovascular coupling and blood–brain barrier permeability), thus suggesting a bidirectional link between the nutritional milieu and neurovascular health. Increasing numbers of people are consuming a Western diet (comprising ultra-processed food with high-fat and high-sugar content) and have a sedentary lifestyle, with these factors contributing to the current obesity epidemic. Emerging pharmacological interventions (for example, glucagon-like peptide 1 receptor agonists) successfully trigger weight loss. However, whether these approaches can reverse the detrimental effects of long-term exposure to the Western diet (such as neurovascular uncoupling, neuroinflammation and blood–brain barrier disruption) and maintain stable body weight in the long-term needs to be clarified in addition to possible adverse effects. Lifestyle interventions revert the nutritional trigger for obesity and positively affect our overall health, including the cardiovascular system. This Perspective examines how lifestyle interventions affect the neurovascular system and neuronal networks.

食物摄入和能量消耗由多个大脑中枢感知和处理，以维持能量稳态。过去十年的证据表明，脑血管系统是调节能量平衡的新关键参与者，该能量平衡与局部神经元网络密切相关。营养失衡改变了神经血管系统的许多特性（例如神经血管耦合和血脑屏障通透性），从而表明营养环境与神经血管健康之间存在双向联系。越来越多的人开始食用西餐（包括高脂肪和高糖含量的超加工食品）并过着久坐不动的生活方式，这些因素导致了当前的肥胖流行。新兴的药物干预（例如胰高血糖素样肽 1 受体激动剂）成功触发体重减轻。然而，除了可能的不利影响外，这些方法是否能够逆转长期暴露于西方饮食的有害影响（如神经血管解耦、神经炎症和血脑屏障破坏）并长期保持稳定的体重，还需要澄清。生活方式干预逆转了肥胖的营养触发因素，并对我们的整体健康（包括心血管系统）产生积极影响。本观点研究了生活方式干预如何影响神经血管系统和神经元网络。