Diet at obesity
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Obesity - excess adjournment of fat in organism develops in connection with violation of exchange.
The main regulators of fatty exchange in organism are the central nervous and endocrine systems. However the frustration of fatty exchange connected with diseases of the central nervous system or endocrine glands meet rather seldom. Much more often the wrong diet, namely the overconsumption of food exceeding power consumption is the reason of obesity.
Excess intake of nutrients in organism can be consequence of the increased appetite and depends on excitability of the food center. Discrepancy between power consumption and consumption of food can arise when power consumption is reduced, and appetite remains at the former level. This phenomenon is observed at the persons passing from physical activity to slow-moving way of life and also at the patients who are long on bed rest.
Tendency to obesity at elderly people can be explained with the fact that with age the metabolism goes down, muscular activity also becomes less, and appetite in the same degree does not decrease. However it must be kept in mind constitutional and hereditarily family predisposition to obesity. At women obesity meets more often as fatty cellulose at them is more developed, than at men. During the periods of pregnancy, lactation and climax of the woman are especially often inclined to obesity.
Obesity is harmfully reflected in functions of different bodies and systems of organism. Most often and more at obesity the cardiovascular system suffers. Obesity promotes earlier and faster development of atherosclerosis.
Obesity is result of joint influence of two factors - excessive food and violation of regulation of metabolism which supplement each other. At obesity are observed:
- increase of excitability of the food center - appetite does not correspond to power consumption
- the strengthened transition of carbohydrates to fat in fatty tissue
- increase of process of adjournment of fat in fatty tissue
- weakening of process of mobilization of fat of fatty depots
For increase in power consumption, considering condition of cardiovascular system, carry out physiotherapy exercises, walks, occupations by easy sport, the massage, cold shower and other actions strengthening mobilization of fat from fatty depots. The patient with endocrine frustration appoint the corresponding preparations.
However the main, most effective method of treatment at all forms of obesity is the dietotherapy. The main requirements imposed to dietotherapy at obesity consist in the following:
- caloric content of food has to be below power consumption
- it is necessary to limit carbohydrates as fat in fatty tissue is generally formed of them
- the frequent receptions of low-calorie food in large volumes eliminating feeling of hunger are recommended
- the flavoring substances increasing excitability of the food center and, thus, the strengthening appetites, and also the substances promoting digestion and absorption of food in intestines are excluded
Diet caloric content below power consumption is limited depending on obesity degree. It is accepted to use three diets:
1) the diet with moderate restriction of calories for 20% (2200-2400 kcal) is appointed at obesity of the I degree when body weight is 10-20% higher than normal;
2) the diet with restriction of calories for 40% (1750-1800 kcal) is appointed at obesity of the II degree when weight is 20-30% higher than normal;
3) the diet with sharp restriction of calories for 60% (1260-1300 kcal) is appointed at obesity of the III degree when body weight exceeds normal more than for 30%.
The patients having obesity need to provide the full-fledged proteinaceous diet including 100-120 g of proteins. From them not less than 50% have to be proteins of animal origin in the form of low-fat grades of meat, fish and bird, and also low-fat dairy products.
Influence of proteins on metabolism at obesity is expressed in the following:
- proteins of food protect losses of proteins of organism
- proteins possess specifically dynamic action - raise metabolism
- proteins are necessary for normal function of endocrine glands
- excess of proteins in food reduces water delay in organism
- the proteinaceous food creates feeling of saturation. However at excessive amount of proteins in food the part them turns into carbohydrates
Now in food corpulent moderately limit fats till 70-80 and even to 90 g, including vegetable fats not less than 25-30 g are given. Fats slow down the strengthened transition of carbohydrates to fat. Availability of fats in food eliminates feeling of hunger.
The fat choice is of great importance. Milk fat is necessary as vitamin A source. Besides, being emulsified, it is better acquired in intestines and easier is oxidized in liver.
Useful effect of vegetable fats is explained by the content in them of polyunsaturated fatty acids which easily are oxidized in organism and promote adjournment of fat in fatty tissue less. Polyunsaturated fatty acids possess lipotropic action, under their influence the fatty exchange, in particular exchange of lipids is normalized, and cholesterol in blood decreases.
Vegetable fats do not contain cholesterol.
In food corpulent sharply limit refractory meat fats as they in intestines are soaked up mainly in lymphatic ways and, getting to blood bed, increase the content of fat in blood that promotes adjournment of fat in fatty tissue. Besides, thanks to the high content of saturated fatty acids, these fats are oxidized in organism more difficultly and are laid in fatty depots. Thus, it is necessary to exclude fat grades of meat and fish, sausage, brains, calves and other snack from diet of these patients; these products along with fats contain also the increased amount of cholesterol.
At obesity carbohydrates are the main source of formation of fat in fatty tissue. Therefore in food corpulent restriction of carbohydrates - one of the main requirements of dietotherapy. However small amount of carbohydrates of 120-180-200 g is necessary for the prevention of acidosis. Sugar and different sweets sharply limit, and at strict diet exclude. At the same time considerably reduce the products containing large amounts of starch. Treat them: bread, flour products, any grain, bean and potatoes.
Vegetables, fruit and berries enter into diet in enough. These vegetable products contain a few carbohydrates, besides part of carbohydrates in the form of cellulose and pectin - the substances which are not digested in digestive tract. Only grapes which contain up to 20% of sugar - glucose are excluded. Vegetable cellulose increases the volume of food and gives feeling of saturation, besides, regulates function of intestines.
At obesity the content of vitamins B needs to pay attention to diet. Vitamin C activates oxidizing processes in organism therefore at obesity the food has to be especially rich with ascorbic acid. It is easily feasible as with fresh vegetables and fruit enough vitamin C is entered. Fat-soluble vitamins A and E are necessary for normal work of endocrine glands.
Liquid (to 1000-1300 ml), and also table salt is moderately limited because at obesity there is water quantity delay in hypodermic fatty cellulose. On high security table salt is excluded.
Exclude the flavoring substances stimulating appetite from diet: extractive substances, spices, spices, marinades, different snack. Alcoholic beverages and beer exclude as they also stimulate appetite, besides, have high caloric content.
At obesity the diet is of great importance - frequent receptions of low-calorie food eliminate feeling of hunger. Medical institutions appoint the corpulent patient diet No. 8 with caloric content in 1750 kcal, the content of proteins of 100-120 g, fats of 60 g, carbohydrates of 150-200 g. In recent years changes are made to this diet - the amount of proteins to 120-130 g and fats to 80-90 g is increased, and also carbohydrates to 100-120 g at preservation of the caloric content of 1750-1800 kcal are reduced. The obligatory requirement of dietotherapy at obesity - to provide the individual diet to each patient (taking into account its ideal weight) calculated on the special device (nomograf) that can be executed, adding or reducing amount of butter and bread to the main diet.
The diet 8a with caloric content 60% lower than norm contains 1260-1300 kcal, proteins of 90 g, fats of 50 g, carbohydrates of 100 g, she is appointed the patient with the III degree of obesity. Diet 8a defective on structure therefore it is recommended for limited time.
Against low-calorie diet the patient with obesity enter days of "food switching" or as it is accepted to designate them, "fasting days". They are divided by structure of products on:
1) carbohydrate - vegetable, fruit and fruit and vegetable, kompotny;
2) proteinaceous - milk, kefiric, cottage cheese, meat, combined - meat with vegetables;
3) fatty - sour cream. Fruit and vegetable diets are deprived of proteins and fats, are low-calorie, electrolyte-deficient, with sharp restriction of sodium, are rich with vitamin C, potassium, the alkaline bases and cellulose. Proteinaceous diets - are well transferred meat and cottage cheese days by patients. Proteins raise metabolism, have lipotropic effect. In meat days it is reasonable to add vegetables, it is also possible to use fish with vegetables.
The question of treatment of obesity was repeatedly brought up by hunger. In clinic of medical foods in the period of the management of clinic of professor F.K. Menshikov this method has undergone check. Treatment was carried out by the following technique: within 12-15 days of the patient daily drank 1,5-2 l of borzhom and did not receive any food.
During starvation patients felt well and lost the flesh of 7-13 kg. But at research serious violations in metabolism have been found:
1) negative nitrogenous balance - release of nitrogenous substances continued due to destruction of proteins of organism;
2) acidosis - acetone and other ketonic bodies indicated incomplete combustion of fats;
3) gipovitaminoz B1 which stuck to 20 more days after hunger. Thus, starvation is harmfully reflected in organism. After treatment by hunger patients quickly enough recovered part of the lost weight, even on limited diet.