Fashionable and modern diets of
the Statistics knows everything... According to it, all-knowing, the population of economically developed countries of the planet not only grows old, but also grows stout, despite persistent desire of people to remain as long as possible young, harmonous and, of course, healthy.
I of doctors, and journalists emergence of the increasing number of stout persons disturbs in recent years. Extra kilos are called the reason of nearly all our diseases.
In my opinion, value of obesity in our life, in structure of the general incidence, in life expectancy of people is a little exaggerated.
Who is abroad, we will allow in the USA, Germany or Australia, pays attention that there are a lot of stout persons; and, nevertheless, it does not prevent them to live for 10 - 15 years longer, than there live Russians. And if to speak about a role of some illness in the general structure of incidence, then it is necessary to see first of all things objectively, from the point of view of the expert, but not from positions of the advertizing companies doing quite good business on various “miracle diets“ and tablets for fast weight loss.
If the person has several extra kilos of weight, but does not complain of anything and the illness does not disturb him, well and let enjoys life it what is. It is not necessary to inspire in it an inferiority complex. The reasons of trouble should be looked for not only in excess weight. Though, of course, obesity do not promote health at all and can become the reason of various diseases: a hypertensive illness, coronary heart disease, diabetes, etc.
In Clinic of medical foods of Institute of food of the Russian academy of medical sciences in 75 years of its existence there passed stationary and out-patient treatment thousands and thousands of patients with an excess weight and obesity.Working with
in clinic more than 40 years, being engaged in doctoring and scientific researches in the field of food, I came to a conclusion that at treatment of “obesity from an overeating“, or as we still speak, “obesity from laziness“, first of all the corresponding psychological spirit of the patient is necessary. The success of treatment depends mainly on you, and the doctor acts only as the kind adviser.
you increase the level of the physical activity: charging, exercise machines, run, swimming, work on a garden site - that to whom suits. It helps to replace fatty cellulose with muscular tissue.
Further you reduce the caloric content of your day diet to 1100 - 1500 kilocalories, generally reducing consumption of digestible carbohydrates (all this sweets together with sugar) and high-calorific animal fats (fat meat, butter), and also include in the menu more crude fruit and vegetables, completely excepting sharp snack not to increase appetite. You eat 4 - 5 times a day, but last time - not later than 2 hours to a dream. You should refuse for some time fried dishes and rich broths, but the slim figure costs this concession. Limit reception of table salt. Light-salted dishes are less tasty and appetizing, and besides salt detains liquid that promotes increase of weight.
the biggest test for which you should go are fasting days of times a week, they will shake slowly and gently your level of a metabolism and to transfer it to new rails. The head can sometimes begin to spin, but on it there is home “ambulance“ - sweet tea with a piece of black bread.can use
as unloading cottage cheese days - 400 grams of low-fat cottage cheese, apple - 1,5 kilograms of crude or baked unsweetened apples, cucumber or water-melon - on 1,5 kilograms of pulp of vegetables, kefiric - 1,5 liters of kefir, and also meat or fish - on 300 - 350 grams of boiled meat or fishes.
That`s all. If you are able to sustain it within a month, then without prejudice to health will dump 3 - 4 kilograms. I did not tell anything new, but it is the reliable and right way checked by time to a slim figure.I will Especially tell
about starvation. Across the field Bragg can apply a long complete starvation only in the conditions of a hospital (clinic) under supervision of skilled therapists and nutritionists. Even in our hospital to some patients who tried to follow such system it became bad, and to use it in house conditions without supervision of the doctor - the dangerous imagination. Quite another matter, when it is about one-day starvation. It is quite admissible on condition of good tolerance.
By the way, the aspiration to grow thin in that that became can turn into a dangerous stereotype and provoke development of such disease as anorexia of the neurotic at which the nervous system suffers at the person. If we interfere in an organism inner sanctum - its metabolism, then it should be done competently and carefully.
Alas, revolutionary experiments with the organism for achievement of a desired ideal (in our case - ideal weight) often come to an end in clinics of neurosises. And the young girls who saw enough of the Hollywood beauties and a top - models become the victims of this vicious practice most often.
the Aspiration to an ideal is capable to rouse people to any victims. But, apparently, an ideal - the most changeable thing on light. What was considered ideal in the 19th century can seem ugly today.
to Keep a slim figure and at the same time the full-fledged breakfast will help not to lose health. Meal well satisfies in the mornings hunger and allows to prevent a chronic overeating during the day. Some nutritionists advise (and it is quite fair) to make the morning menu of three groups of the products containing: carbohydrates (bread, fruit, porridges from this or that grain and cereals), protein (fish, eggs, milk, yogurt), is a little fat (butter, cheese with the lowered content of fat). If did not manage to eat houses, then, nutritionists advise, it is necessary to take a breakfast for work or to come into cafe.
the Classical dietotherapy is under construction on the following postulates of a balanced diet. The term “rational“ means “reasonable“ (from Latin ratio - reason):
- Compliance of caloric content of food to needs of the specific person for energy taking into account his energy consumption.
- a Certain, evidence-based ratio between the main feedstuffs - proteins, fats and carbohydrates.
- Observance of the mode of meal, uniform distribution of its volume and caloric content during the day that is necessary for prevention of excess weight.
the Special question - about food at advanced age. At the same time the food mode has to have an anti-sclerous focus.I Will remind
that the word “diet“ is designated by both a food allowance, and structure of food. One experts build this word to Latin dies (day), others consider that it comes from the Greek diaita meaning means of living, a manner to live, a way of life.Brockhaus and Efron`s Encyclopaedic dictionary reports
:“ The diet is meant as the food mode set for healthy and sick according to age, a constitution, a profession, climate, seasons etc.“ . This good definition. Really, healthy nutrition under control of the doctor - the most natural and harmless method of prevention and treatment of many illnesses. A diet in a broad sense this word - a basis of a healthy lifestyle. Each person has to have an idea of structure of food competently to choose a food allowance, using available products.
Making recommendations about balanced and medical foods, the attending physician uses this physiology of digestion, hygiene of food, experience of applied medicine. Our health, prevention of diseases, life expectancy in many respects depend on the healthy nutrition constructed on the basis of data of science on food. It is difficult to make an individual diet most, and at times it is impossible. Only the attending physician knowing a state of your health, results of the conducted researches, your weight, growth, energy expenditure, possible food allergy, shipping an organism of concrete food, your tastes and habits can itself or together with the nutritionist to make the correct, evidence-based individual recommendations about questions of food.
In literature concerning food is available many publications devoted to a role of separate feedstuffs (proteins, fats, carbohydrates) and their optimum ratio in a diet. In 1891 Alexander Danilevsky, professor of Imperial Kharkiv university, published work “Food and character“ in which emphasized a special role of protein of products of an animal origin.“ The choice of food is not indifferent for character and activity of a brain and muscles“. It gives the supervision demonstrating that the people eating mainly fish “temper much more softly also are less cruel, than those who give preference to meat“.
D. V. Kanshin, the author of the book “Encyclopedia of Food“ (1895), noted possible harm from surplus in a diet of animal protein (a lot of meat food) at gout.
the legend that in Ancient China the way of execution at which sentenced fed only with boiled meat was applied Exists. At the same time kidneys did not cope with removal from an organism of products of an exchange of proteins. Owing to organism poisoning with nitrogenous connections through one - two months the criminal perished.the amount of carbohydrates in a diet Is far not indifferent
for an organism. The outstanding nutritionist, the founder of Clinic of medical foods professor M. I. Pevzner (1872 - 1952) wrote in 1949:“ It is established that the diet, fat-rich, but poor in carbohydrates, causes dehydration (reduction of content of water) of an organism. Apparently, the fact that at some corpulent patients under the influence of a diet with normal amount of fat (to 100 grams a day) and with sharp restriction of carbohydrates, and also owing to dehydration of fabrics weight is gradually lost is explained by it. At some very corpulent patients such diet promoted loss of weight at good health of the patient“. M. I. Pevzner applied diets with the lowered amount of carbohydrates (carbohydrates - 125 - 150, proteins - to 100, fats - 100 - 120 grams) at treatment of the patients (obesity, rheumatism, allergic diseases) taking a course of dietary treatment in Clinic of medical foods.
the Diet of the doctor Robert Atkins (1930 - 2003) - the cardiologist, the nutritionist heading the medical center in New - York, more rigid in comparison with a low-carbohydrate diet of Pevzner. On Atkins`s diet we will stop in more detail for the reason that, in our opinion, its concept is very close to the concept of a so-called Kremlin diet. Basic provision of the theory of Atkins: carbohydrates stimulate insulin secretion that in turn promotes appetite increase. The author considers that, having limited consumption of carbohydrates to 20 grams and even to 10 grams a day, it is possible to achieve development of a good-quality ketoz at which the feeling of hunger and appetite decrease. Ketoz, according to Atkins, it is impossible to confuse to ketoacidosis (violation kislotno - alkaline balance from - for surplus of ketone bodies). At a good-quality ketoz the ketone bodies which are formed when splitting fat are excreted with urine, and sometimes and with the exhaled air. In it the reason of an unpleasant smell from a mouth at doctor Atkins`s patients. According to Atkins, weight loss is possible against consumption of rather large amount of fat and protein and rather high caloric content of a diet.
according to professor D. G. Bessesen, the director of clinic of endocrinology of Colorado University (2004), “fast decrease in body weight at the initial stage of a diet of Atkins is proved; it is caused, mainly, by mobilization of a glycogen from depot and faster development of feeling of saturation... It is impossible to exclude that in certain cases this diet is really optimum for decrease in body weight“. D. G. Bessesen explains fast, but short-term weight reduction (masses) of a body with moderate restriction of caloric content of a diet and the increased removal of water at an expenditure of stocks of a glycogen. In blood concentration atherogenous (promoting atherosclerosis) lipids decreases a little that it is possible to explain with restriction of caloric content of food and weight loss (decrease in body weight practically always improves a lipidic exchange). The amount of vitamins and mineral substances at an introduction phase of a diet of Atkins can be insufficient.
the long time is not so easy to keep to Atkins`s Diet. Let`s remind that at the same time exclude from a diet sugar, bread, potatoes, porridges, macaroni and many other products and dishes, habitual for Russians.
Should pay tribute to doctor Atkins who had the greatest experience of application of a low-carbohydrate diet. He writes that its diet is contraindicated at some diseases, including at diseases of kidneys. It is contraindicated to pregnant women and nursing mothers. Atkins writes: “First of all you need to visit the attending physician, to pass full medical examination and to make necessary tests... I want that you understood: careful medical examination before Atkins`s diet is extremely important...“
Why one of modern fashionable diets call “Kremlin“? First it was called a diet of the American astronauts. Rumors went that some of our “large“ public figures very much grew thin, sitting on it. And from an easy hand of “Komsomolskaya Pravda“ the diet received the present name - “Kremlin“.I Believe
that this diet has no relation to the Moscow Kremlin. There during meals use the recommendations of capital nutritionists checked decades in the conditions of Clinic of medical foods and the culinary art which carried by the best recipes in centuries. But it is not the name.“ Kremlin“ the diet, as well as a low-carbohydrate diet of Pevzner, as well as Atkins`s diet (there are in the world of dietology also other low-carbohydrate diets), represents the modified option of low-carbohydrate diets.
So if in a low-carbohydrate diet of Pevzner amount of carbohydrates in a daily diet reduce to 125 grams, in Atkins`s diet - to 20 grams, in the “Kremlin“ diet it is offered to reduce carbohydrates in a daily diet to 40 grams.we Will remind
that the need of the adult for carbohydrates considerably depends on nature of the performed work and physical activity and averages 400 - 500 grams a day. Thus, in diets “Kremlin“ and Atkins the amount of carbohydrates in a daily diet is reduced more than in 10 and even by 20 times! Whether it is indifferent for health of the person, for his metabolism? I believe what is not present.
the Dietitians using Atkins`s diet in the practice of doctoring - most “abrupt“ concerning reduction of carbohydrates, note side effects of this diet among which - the locks connected with a lack of cellulose of a diet, the unpleasant smell from a mouth connected with emergence of the increased number of ketone bodies in blood.
At more prolonged use of a diet of Atkins can assume a possibility of an exacerbation of such illnesses as gout (from - for surplus of the meat products rich with purina), diseases warmly - vascular system (from - for a significant amount of saturated fats in a diet).
Can agree with those American nutritionists who consider that the doctor has to report to the patient about possible side effects of a diet, and the patient has to confirm in writing a consent to treatment with a diet with sharply limited amount of carbohydrates in a diet. And it is even better - not to apply long Atkins`s diet.
In our opinion, options of diets with sharp restriction of carbohydrates it is possible to apply to fast weight reduction on medical indications or in connection with vital circumstances. The famous nutritionist, is a lot of years heading office of a metabolism in Clinic of medical foods and treated thousands of patients with an excess weight, the candidate of medical sciences Yu. Popova considers that similar diets “suit enough young people and almost healthy people who should lose quickly several extra kilos, for example, before a trip to holiday or after New Year`s holidays and feasts“. One - two weeks of such diet - quite sufficient withfate.
In our opinion, low-carbohydrate diets, including Atkins`s diet, the “Kremlin“ diet, have the right for existence. But it is worth to remember about an unilaterality of these diets. When the person begins to limit himself in one products (in this case containing carbohydrates) and to give preference to others (rich with fats and proteins), there can come adverse changes in a metabolism. Therefore similar diets cannot be used constantly, to do them by a food basis. But they are quite acceptable for short term.
the “Kremlin“ diet - compromise. In it it is less carbohydrates, than in a low-carbohydrate diet of Pevzner, but much more (twice!) than in Atkins`s diet. Before this diet receives a start in life, in practice of dietary doctoring, it is necessary to conduct clinical trials. Dietary treatment has to be carried out only on doctor`s orders and under its continuous supervision. Before a dietotherapy the doctor having the certificate of the nutritionist and that is very important the corresponding experience, collects the anamnesis, conducts careful clinical examination, laboratory researches (the general blood test, a biochemical blood test - such indicators as cholesterol, triglycerides, uric acid, sugar, the analysis of urine), an electrocardiogram, etc.
of the Diet with the low content of carbohydrates - not for all irrespective of as they are called - Pevzner`s diet, Atkins or “Kremlin“. These diets have indications and contraindications. It is possible to tell definitely that they are unacceptable for people of advanced age.would recommend to begin with
Ya treatment of excess weight or obesity with consultation at the dietitian.