NUTRITION OF CHILDREN WITH OBESITY

Common to obese children of various ages and degrees of obesity is the requirement that food be varied, with a sufficient amount of vitamins, do not contain hot seasonings, and be steamed, boiled or raw (salads); it reduces the amount of easily digestible carbohydrates, excludes sweets such as candy, cakes, cookies, as well as pasta, flour products and cereals, significantly limits the amount of bread, especially white and potatoes, reduces fats, especially lamb and pork, leaving the amount of protein at normal by age limits (meat, cottage cheese, fish).

Necessary conditions for a positive result of therapeutic nutrition for obese children are:

1. Strict adherence to diet and daily routine.

2. Normal volume of one feeding and daily amount of food.

3. Slow pace of eating.

4. Correct distribution of food calories throughout the day.

5. Regulation of the quantitative composition of food (sharp limitation of sweets and confectionery, cereals, bakery products, some limitation of refractory fats, maintaining a normal amount of protein).

6. Constant medical, parental and self-monitoring of the effectiveness of treatment (body weight gain curve).

7. Gradual transition of the patient to a diet appropriate to his age and degree of obesity.

With any degree of obesity, a child of any age first needs nutrition that corresponds to his physiological norms. Such nutrition will be restrictive, since most obese children still have an increased appetite and overeat.

If, with such nutrition, the child’s weight gain stops, we can talk about the positive effect of therapeutic nutrition and, after a certain period of adaptation, switch to a more strict diet. The purpose of this diet is the gradual reduction and elimination of excess body weight. The higher the degree of obesity, the longer the adaptation period.

SAMPLE WEEKLY MENU FOR OBSESS CHILDREN 10–14 YEARS OLD

MONDAY

First breakfast: low-fat cottage cheese, kefir, sugar, wheat bread.

Second breakfast: apples.

Lunch: rye bread, borscht with meat broth (half a portion), crumbly buckwheat porridge, boiled meat, butter, fresh cucumber, fruit.

Afternoon snack: milk.

Dinner: steamed fish, boiled beets, vegetable oil, rye bread.

At night: apple.

TUESDAY

First breakfast: egg, fresh cucumber, butter, tea with sugar, wheat bread.

Second breakfast: apples.

Lunch: fresh cabbage soup in meat broth, boiled potatoes, steamed fish, vegetable oil, fresh cucumber, dried fruit compote with sugar, rye bread.

Afternoon snack: kefir.

Dinner: stewed meat, green peas, butter.

At night: apples.

WEDNESDAY

First breakfast: wheat bread with cheese, coffee with milk and sugar.

Second breakfast: apples.

Lunch: pickle soup with meat broth (half portion), boiled zucchini, meat puree, tomatoes, vegetable oil, dried fruit compote, rye bread.

Afternoon snack: kefir.

Dinner: vinaigrette with sauerkraut, sausages.

At night: apples.

THURSDAY

First breakfast: ham sandwich, milk, wheat bread.

Second breakfast: vegetable salad with vegetable oil.

Lunch: vegetarian beetroot, semi-viscous buckwheat porridge, stewed meat, butter, tomatoes, fruit, rye bread.

Afternoon snack: kefir.

Dinner: boiled meat, 1/2 egg, boiled potatoes or mashed potatoes, green peas, fresh cucumber, vegetable oil.

At night: fruit.

FRIDAY

First breakfast: 1 egg, fresh cucumber, wheat bread, butter, tea with sugar.

Second breakfast: grated carrots.

Lunch: pea soup with meat broth, boiled potatoes, vegetable oil, steam fish, tomatoes, dried fruit compote, rye bread.

Afternoon snack: kefir.

Dinner: cabbage stewed in vegetable oil, sausages.

At night: fruit.

SATURDAY

First breakfast: full-fat cottage cheese, milk, wheat bread.

Second breakfast: apples.

Lunch: vegetarian borscht with sour cream, eggplant stuffed with meat, fruit, rye bread.

Afternoon snack: kefir.

Dinner: boiled fish, green peas, vegetable oil, rye bread.

At night: fruit.

SUNDAY

First breakfast: tomatoes, fresh cucumbers, sandwich with doctor's sausage and butter, coffee with milk and sugar.

Second breakfast: fruit.

Lunch: cauliflower soup with meat broth, boiled potatoes, steamed fish or steamed fish cutlets, vegetable oil, sauerkraut, dried fruit compote, rye bread.

Afternoon snack: milk.

Dinner: sauerkraut vinaigrette with vegetable oil, boiled meat.

At night: fruit.

DAILY SET OF FOOD PRODUCTS BY DAY OF THE WEEK IN THE NUTRITION REGIME OF OBSESS CHILDREN

MONDAY

Meat 150 g, fish 150 g, egg 1 piece, milk (kefir) 200 g, butter 15 g, vegetable oil 5 g, rye bread 75 g, wheat bread 50 g, cereal 30 g, potatoes 20 g, cabbage 150 g , other vegetables 400 g, fruits 300 g, sugar 10 g.

TUESDAY

Meat 150 g, fish 150 g, cottage cheese 75 g, milk (kefir) 400 g, butter 5 g, vegetable oil 10 g, sour cream 10 g, rye bread 50 g, wheat bread 50 g, potatoes 150 g, cabbage 150 g , other vegetables 230 g, fruits 200 g, dried fruits 20 g, sugar 20 g.

WEDNESDAY

Meat 150 g, cheese 50 g, milk (kefir) 250 g, vegetable oil 15 g, rye bread 50 g, wheat bread 50 g, potatoes 150 g, cabbage 50 g, other vegetables 400 g, fruits 200 g, dried fruits 20 g , sugar 20 g.

THURSDAY

Meat 50 g, fish 150 g, egg 1 piece, milk (kefir) 200 g, butter 5 g, vegetable oil 15 g, rye bread 50 g, wheat bread 50 g, cereal 25 g, potatoes 170 g, cabbage 150 g , other vegetables 350 g, fruits 100 g, dried fruits 20 g, sugar 20 g.

FRIDAY

Meat 200 g, fish 150 g, 1/2 egg, milk (kefir) 200 g, butter 15 g, vegetable oil 10 g, sour cream 10 g, rye bread 50 g, wheat bread 50 g, cereal 30 g, potatoes 75 g, other vegetables 400 g, fruits 300 g, sugar 10 g.

SATURDAY

Meat 150 g, cottage cheese 75 g, cheese 50 g, milk (kefir) 450 g, vegetable oil 10 g, sour cream 10 g, rye bread 50 g, wheat bread 50 g, potatoes 20 g, cabbage 150 g, other vegetables 300 g , fruit 300 g, sugar 10 g.

SUNDAY

Meat 150 g, fish 150 g, egg 1 piece, milk (kefir) 250 g, butter 5 g, vegetable oil 15 g, rye bread 50 g, wheat bread 50 g, potatoes 250 g, cabbage 175 g, other vegetables 150 g, fruits 200 g, dried fruits 20 g, sugar 20 g.

The calorie content of food (in%) during the day is divided as follows: first breakfast - 30, lunch - 40, afternoon snack - 10, first and second dinners - 20.

CHILDREN'S NUTRITION AND BASIC NUTRIENTS

The most important condition for nutrition is the correct combination of all nutrients in a person’s daily diet, moreover, they must be introduced in quantities that completely cover all the body’s expenses, both quantitatively and qualitatively.

In the human body, processes of oxidation (combination with oxygen) of various food substances - proteins, fats, carbohydrates - are continuously occurring, which are accompanied by the formation and release of heat. This heat is necessary for all life processes; it is spent on heating the inhaled air and maintaining body temperature. Thermal energy also ensures the activity of the muscular system. The more muscle movements a person performs, the more losses he produces, which require more food to cover.

The need for more food is expressed in heat units - calories. A calorie is the amount of heat required to heat 1 liter (large calorie) and 1 ml (small calorie) of water at a temperature of 15 degrees Celsius by one degree. Every gram of protein and every gram of carbohydrates of any food, when burned in the body (during oxidation), produces heat equal to 4 kcal, and when 1 g of fat is burned, 9 kcal is formed.

A child aged from 9 months to 1 year spends approximately 1000 kcal per day, from 1 year to 3 years - 1300-1600 kcal, and from 3 years to 1800-2000 kcal.

The daily energy expenditure of children within one age group depends on the physical development of the child, the state of his nervous system, climatic conditions, season of the year, intensity of movements, work, and general health.

The younger the body, the faster metabolic processes occur in it, which causes a greater need for energy. The source of energy is food, which is also a building material that is used to build organ cells and various systems, increases the child’s body’s resistance to adverse internal and external influences, and improves its performance. In order for a child to develop properly in different periods, the diet must contain all the basic nutrients: proteins, fats, carbohydrates, minerals, vitamins and water in optimal proportions.

PROTEINS AND THEIR ROLE IN METABOLISM

Proteins are of particular importance in children's nutrition. Without them, life, growth and development of the body are impossible. Proteins cannot be replaced by other nutrients, while they themselves can be used for energy purposes instead of fats and carbohydrates.

Proteins are found in all tissues and fluids of the body. They consist of a variety of amino acids. Some of the amino acids are formed in the body itself. They are called nonessential amino acids. Others enter the body only with food. These amino acids are called essential amino acids. For physiologically complete functioning of the body, the presence of all essential amino acids in food is necessary. Insufficient content of at least one essential amino acid in food leads to a decrease in the biological value of proteins and can cause protein deficiency, despite a sufficient amount of protein in the diet. Essential amino acids are found mainly in products of animal origin: milk, cottage cheese, meat, fish, eggs, as well as some vegetables, such as cabbage.

However, it would be wrong to think that a child’s body can do without proteins of plant origin, which are found in bread, cereals and vegetables, which mainly contain non-essential amino acids. Proteins from animal products in combination with proteins of plant origin provide the child’s body with the substances necessary for its growth and development.

In the diet of children in the first year of life, animal proteins should make up 75% of the total amount of protein in the daily diet, and in the diet of children from 2 to 7 years old - 65%.

The most important sources of protein are meat, fish, eggs, cheese, milk, bread, potatoes, beans, soybeans, and peas.

DAILY PROTEIN REQUIREMENT FOR A CHILD'S BODY

1-3 years – 45–55 g; 4–6 years – 60–70 g; 7–9 years – 75–85 g; 10–12 years – 90-100 g; 13–15 years old – 105–110.

Proteins in children's diets cannot be replaced by any other substances. Protein metabolism is closely related to other types of metabolism; it ensures the movement of fats, carbohydrates, salts, vitamins, hormones and other substances in the body.

ROLE OF FATS IN CHILDREN'S BODY

Children need fats not only as a source of energy. They are part of cell membranes, take part in metabolism, contribute to the development of immunity, are solvents for vitamins A, E, D and promote their absorption. By improving the taste of food, fats increase its nutritional value. They help the body retain heat and protect protein from combustion. Fats are found in many foods of animal and plant origin. Their biological value is different. Insufficient intake of fat into the body can lead to disruption of the central nervous system, changes in the skin, kidneys, vision organs, etc.

For a growing organism, essential polyunsaturated fatty acids are important, which are almost never formed in the body and must be supplied with food. Their content in animal products is low. They are found mainly in vegetable fats - sunflower, olive, corn. Therefore, vegetable fats must be included in baby food. The body needs animal fats, which are found in butter, milk, egg yolk and others.

Excess fat in the diet leads to metabolic disorders, deterioration, indigestion, and increased fat deposition in the subcutaneous tissue and other depots.

A CHILD'S DAILY NEED FOR FATS

1-3 years – 40–50 g; 4–6 years – 55–60 g; 7-9 years – 65–70 g; 10–12 years – 75–80 g; 13–15 years old – 85-100 g.

ROLE OF CARBOHYDRATES IN THE BODY

Carbohydrates are one of the main sources of energy. Each gram of carbohydrates provides 4 kcal of energy. The need for carbohydrates depends on the body's energy expenditure. One of the main representatives of carbohydrates is glucose. Complex carbohydrate compounds are involved in the construction of cell membranes and are the basis of the body's connective tissue (skin, mucous membranes). Simple and complex carbohydrates are found in beet, cane sugar, honey, berries, and fruits. They are absorbed by the body relatively quickly and quickly supply vital organs with glucose. In order to maintain blood sugar concentration at a constant level, it is necessary to consume complex carbohydrates with food, which are slowly absorbed in the intestines. They are found mainly in flour, cereals, potatoes and vegetables in the form of starch.

The correct ratio of quickly and slowly digestible carbohydrates in food ensures a uniform supply of sugars to the child’s body throughout the day.

Carbohydrates also include fiber, which is found in cereals, potatoes and vegetables. It practically does not undergo breakdown in the gastrointestinal tract, but plays an important role in the digestive processes - it promotes the secretion of digestive glands and regulates bowel movements.

An excess amount of carbohydrates in the diet disrupts the correct ratio of the main parts of food, which, in turn, leads to metabolic disorders, a decrease in the delay in protein consumption, water retention in the body, and the formation of an increased amount of fat, which, once deposited, almost does not participate in metabolic processes.

Sugar, honey, cereals, flour, vegetables (potatoes), fruits are rich in carbohydrates. The most easily digestible carbohydrates are those found in sugar, honey, fruits, and milk.

A CHILD'S DAILY NEED FOR CARBOHYDRATES

1-3 years – 170–180 g; 4–6 years – 200–250 g; 7–9 years – 270–300 g; 10–12 years – 320–350 g; 13–15 years – 350–400 g.

ROLE OF VITAMINS IN METABOLISM

For normal functioning of the body, it is necessary that the child’s diet include vitamins - substances that do not supply the body with energy, but are absolutely necessary to maintain life. They direct and accelerate metabolic processes. The body does not produce vitamins. They come either from the food they contain or in the form of synthetic drugs. Natural vitamins are healthier for the body than synthetic drugs.

The amount of vitamins consumed by a child must correspond to the needs of his body. Insufficient or excessive intake of vitamins is not indifferent to children and can cause serious diseases in them, called avitaminosis, hypo- or hypervitaminosis.

Vitamins are divided into two large groups: water-soluble and fat-soluble.

The group of fat-soluble vitamins includes vitamins A, D, E, and K.

Vitamin A affects the growth of the body and its resistance to infections. It is necessary to maintain normal vision, the condition of the skin and mucous membranes. Vitamin A is found in large quantities in fish oil, cream, butter, egg yolk, and liver. Some plant foods: carrots, lettuce, spinach, tomatoes, green peas, apricots, oranges contain carotene - provitamin A, which is converted into vitamin A in the body.

Vitamin D promotes bone formation and stimulates body growth. If there is a lack of vitamin D in food, the body's absorption of calcium and phosphorus is impaired, which leads to the development of rickets. The largest amount of vitamin D is found in fish oil, egg yolk, liver, and fish roe. Milk and butter contain small amounts of vitamin D.

Vitamin K is involved in tissue respiration and helps maintain normal blood clotting. Its deficiency can occur due to diseases of the digestive system or when taking various antibacterial drugs. Vitamin K is found mainly in tomatoes, green parts of plants, spinach, cabbage, and nettles.

The group of water-soluble vitamins includes vitamin C and B vitamins.

Vitamin C, or ascorbic acid, is actively involved in recovery processes, affects carbohydrate and protein metabolism, and increases the body's resistance to various infections. This vitamin is found in many fresh vegetables and fruits. The fruits richest in it are rose hips, black currants, chokeberries, sea buckthorn, gooseberries, citrus fruits, cabbage, potatoes, and leafy vegetables.

The group of B vitamins consists of water-soluble, independent vitamins that take part in metabolic processes in the body, the process of hematopoiesis, and growth stimulation. Vitamins of this group are found in brewer's and baker's yeast, buckwheat and oatmeal, rye bread, milk, meat, liver, egg yolk, and green parts of plants.

Vitamin E affects the activity of the endocrine glands, the metabolism of proteins and carbohydrates, and ensures intracellular metabolism. Vitamin E has a beneficial effect on the course of pregnancy and fetal development. Contained in corn grains, carrots, cabbage, green peas, eggs, meat and fish products, cow and olive oil.

There is a close relationship between the effects of individual vitamins. A lack of one vitamin in food leads to a disruption in the metabolism of other vitamins.

Only with proper nutrition do vitamins have the proper effect. A lack of vitamins in the body may depend on their low content in the diet, and on insufficient intake of other nutrients from food. For example, insufficient protein intake in children leads to vitamins being removed from the body.

Vitamins A, D, E, K are absorbed only when the food contains a sufficient amount of fat. The need for vitamin B1 increases with excess carbohydrate content in food.

A long-term lack of vitamins in the diet leads to vitamin deficiencies. But hypovitaminosis, the development of which is associated with a lack of vitamins in food, is more common. This is especially observed in the spring and winter months: children get tired faster, they experience weakness, apathy, lethargy, and they get sick more often.

MINERALS AND WATER

Children's food must contain minerals that are part of the cells and tissues of the body. They are necessary for the normal absorption of food, the formation of the skeleton, the production of hormones, proper hematopoiesis, the functioning of cells of the nervous system, the development and activity of endocrine glands, muscle and other tissues, etc. The main minerals necessary for children include calcium, potassium, sodium, phosphorus, magnesium, iron, copper.

Calcium is involved in the formation of the skeleton. Almost 90% of all calcium found in the body is found in bone tissue. Calcium is involved in the processes of blood clotting, cell membrane permeability, and nerve cell excitability. Calcium is found in many foods of animal and plant origin, but is not absorbed equally from them. In plant foods, calcium is contained in poorly soluble compounds that are poorly absorbed. Calcium is best absorbed from milk and dairy products, where it is combined with protein.

Phosphorus is actively involved in all basic metabolic processes. Phosphorus compounds with protein, fat, and nucleic acids are the most common components in the body. Like calcium, phosphorus takes part in the formation of the skeleton. It is included in a variety of food products. The largest amount is found in meat, egg yolk, fish, cheeses, oatmeal and buckwheat, legumes, and nuts.

Magnesium is involved in metabolism, together with calcium and phosphorus it participates in the formation of the skeleton, increases and improves intestinal activity, increases bile secretion, and participates in the transmission of nervous excitation. Magnesium is mainly found in wheat, rye, buckwheat, millet, barley, and oats.

Iron plays an important role in the body's recovery processes and is an integral part of hemoglobin. A sufficient supply of iron from food is very important for a child, since its reserves in the child’s body are limited. The greatest quantities of iron are found in meat, some offal, fish, fish products, egg yolk, legumes, oatmeal, buckwheat and pearl barley, green parts of plants and fruits.

Potassium and sodium play an important role in the processes of water-salt metabolism and take part in the regulation of acid-base balance. Potassium is necessary for the functioning of the muscles of the heart and intestines. Potatoes, carrots, cabbage, parsley, spinach, legumes, apricots, raisins, prunes and others are rich in potassium. Sodium is found in small amounts in animal products and is added in the form of table salt to food (from 3 to 8 g depending on the age of the children). Children need potassium more than sodium.

For the proper functioning of a child’s body, other mineral substances are also necessary, the so-called microelements - cobalt, zinc, iodine, fluorine, manganese, copper, etc.

Microelements enter the body of children with products of animal and plant origin. Sea foods are rich in iodine, cereals, yeast, legumes, and liver are rich in zinc; copper and cobalt are found in beef liver, kidneys, chicken egg yolk, and honey.

Water, which is part of every cell of the body, makes up from 58 to 75% of body weight. Proper development of a child is impossible without sufficient water content in his diet. The younger the child, the relatively greater his need for water. In the first year of life, children should receive daily 150 ml of fluid per 1 kg of body weight, from 1 year to 3 years - 100 ml, from 3 to 7 years - 80 ml, in older ones - 50 ml, which is 1-1 per day, respectively. 1.5-2 liters of water. This amount also includes the liquid contained in the diet. In the hot season, children need additional drinks - sweetened water, fruit and vegetable decoctions, rosehip decoction.

Both sharp restriction of salt and water and excessive consumption are equally harmful to a child’s body.

The child should receive all the nutritional components necessary for growth and development regularly throughout the year. In this case, the daily calorie requirement is as follows.

From 1 year to 3 years, a child’s daily energy requirement is 1400–1600 kcal; 4–6 years – 1600–1800; 7–9 years – 1800–2000; 10–12 years – 2000–2500; 13–15 years old – 2500–3000.

SCHEME FOR CALCULATING THE REQUIRED AMOUNT OF CALORIES

In order to calculate the required amount of calories, you need to remember that when 1 g of fat is “burned” in the body, 9.3 kcal is released, when carbohydrates are “burned” - 4.1 kcal, when proteins are “burned” - 4.1 kcal. For example, a 10-year-old child received 80 g of fat (80.0 x 9.3), 300 g of carbohydrates (300.0 x 4.1) and 100 g of protein (100.0 x 4.1) per day with food, which in total is 2384.0 kcal.

LIST OF RECOMMENDED PRODUCTS AND DISHES

Bread and flour products: rye and wheat bread made from wholemeal flour, protein-wheat bread. The amount of bread is reduced if body weight does not decrease. Bread contains the largest amount of carbohydrates of all allowed products in the daily diet (with the exception of sugar, which is strictly dosed), therefore, with systematic weighing, reducing or increasing the amount of bread in the diet while maintaining the same amount of other allowed products, you can reduce body weight or keep it constant level after weight loss. Protein bread contains 2 times less carbohydrates compared to regular bread.

Soups: vegetarian with vegetables, cereals, potatoes; 2-3 times a week in weak meat, fish or mushroom broth (no more than 1/2 plate); fruit; dairy - limited. Season with butter, sour cream, dill, parsley, citric acid, and onions after boiling and sautéing.

Meat and poultry dishes: lean beef, veal, meat and trimmed pork, rabbit, chicken, turkey, mainly boiled and jellied, dietary sausages, cut or chopped meat, beef jelly.

Fish dishes: low-fat varieties (pike perch, cod, pike, carp, bream, etc.) mainly boiled, jellied, stuffed. Sometimes you can eat baked or fried fish.

Milk and dairy products: low-fat milk and fermented milk products. Sour cream - in dishes. Low-fat cottage cheese with 9% fat content, natural and in the form of cheesecakes and puddings. Low-fat cheeses - limited.

Eggs: 1-2 pieces three times a week.

Dishes and side dishes from cereals, legumes and pasta: crumbly porridge from buckwheat, pearl barley, barley due to the reduction of bread.

Dishes and side dishes from vegetables and leafy greens: white cabbage, cauliflower, lettuce, radishes, cucumbers, zucchini, raw, boiled and baked tomatoes, pumpkin, turnips. Dishes from carrots, beets, rutabaga, potatoes.

Appetizers: raw vegetable salads, vinaigrettes, vegetable salads with boiled meat and fish, fish or meat aspic, lean ham.

Fruits, berries, sweets: sour and sweet and sour varieties of fruits and berries (apples, lemons, oranges, red currants, gooseberries, cranberries, etc.), jellies and mousses with sorbitol and xylitol.

Drinks: unsweetened compotes, tea with milk, tea, tomato juice, fruit and berry juices from sour varieties of berries and fruits, alkaline mineral water.

Sauces and spices: mild sauces based on vegetable broth, tomato puree.

Fats: butter and vegetable oil in dishes.

LIST OF EXCLUDED PRODUCTS AND DISHES

The following are excluded from the diet of obese children: products made from premium and 1st grade wheat flour, butter and puff pastry; milk, cereal, legume, pasta, potato soups; fatty meats, goose, duck, ham, sausages, smoked sausages, canned food; fatty fish, salted, smoked fish, canned fish in oil, caviar; fatty cottage cheese, sweet cheeses, cream, fermented baked milk, baked milk, fatty and salty cheeses; rice, semolina and oatmeal, pasta, legumes; fatty and spicy snacks; grapes, raisins, bananas, figs, dates, sugar, confectionery, jam, honey, ice cream, jelly, sweet varieties of other fruits; fatty and spicy sauces, mayonnaise, all spices; grape and other sweet juices, cocoa; meat and cooking fats; candies, chocolate and other sweets.

WHAT IS THE DANGEROUS OF OBESITY IN CHILDREN?

Obesity is a fairly common disease and occurs in almost 10% of children. It is known that most chronic diseases, including diseases of the cardiovascular system, develop in childhood. The higher the degree of obesity, the higher the mortality rate among overweight adults from cardiovascular disease. In children with a simple, uncomplicated phase of obesity, when there are no gross metabolic disorders, there are signs of changes in the cardiovascular system, and with the development of a complicated phase of obesity, changes in the cardiovascular system become persistent.

If we consider that metabolic disorders that accompany the complicated phase of obesity, such as increased blood cholesterol, blood sugar, concentrations of blood fats and fatty acids contribute to the development of atherosclerosis, then the danger of obesity becomes clear. Now more and more young people are becoming ill, including those who were overweight.

In obese children, functional changes in the gastrointestinal tract and biliary tract are just beginning to form, and in adults they are already fully felt.

The price to pay for obesity is diabetes. Many parents, brothers, sisters, grandparents and other relatives of children with diabetes were overweight.

Some parents of obese children, especially boys, often consult a doctor about the child’s delay in sexual development.

Obese patients often experience dysfunction of the musculoskeletal system. Symptoms such as flat feet, curvature of the lower extremities, damage to the spine and intervertebral cartilage, etc. are constant companions of such patients. They occur more often, the greater the degree of obesity.

In addition, obesity is a significant cosmetic defect that can cause mental changes in a child. Isolation, alienation, inexplicable mood swings, irritability are one of the common and serious symptoms of obesity. A child with a weak psyche may experience a breakdown, which is sometimes noted by doctors.

Thus, obesity in children can cause disruption of the cardiovascular system, gastrointestinal tract, musculoskeletal system, the development of diabetes mellitus, impaired puberty, and mental changes.

The main type of treatment for a disease in which obesity is the leading one is a physiologically balanced therapeutic diet, which must be used already in the early stages of the development of obesity (I–II degree), when it is still relatively easy to normalize some altered metabolic parameters by gradually changing the diet and rhythm of life.

PREVENTION OF OBESITY IN CHILDREN. REMINDER FOR PARENTS

Parents should know and remember the following:

1. The most successful treatment for obesity is its prevention. Without parental help, without the active participation of parents in the early detection of not only obese patients, but also children who have a family history of obesity, it is very difficult to combat and prevent obesity. Obesity will continue to increase, which means heart disease, vascular disease, etc.

2. Parents of obese children, whose families have a significant number of obese close relatives, should remember the need for early medical observation of children and consult with a doctor regarding the child’s nutrition, regimen, etc.

3. Children born weighing more than 4 kg are, as a rule, prone to developing obesity in the future, and some of them are more or less likely to develop diabetes mellitus at a more or less early stage.

4. Obesity is a prediabetic condition.

5. Do not overfeed children, especially under the age of 1 year. Constant mechanical stretching of the stomach by a greater volume of food than is normally required causes the formation and consolidation of the “increased appetite reflex,” which is one of the factors in the development and progression of obesity.

6. Avoid one-way carbohydrate feeding of children.

7. If a child develops a viral or infectious disease, it is necessary to consult a doctor. Infectious diseases are often complicated by damage to those parts of the brain that regulate metabolism.

8. Do not give children drugs that have strong side effects on metabolism.

9. Not only proper nutrition is necessary, but also a protective regime from unfavorable external influences that can cause hereditary metabolic defects. The child must be hardened in order to endure diseases as easily as possible, so that emergency circumstances of any disease for the body do not appear suddenly, causing a breakdown in its protective-adaptive reaction.

11. It is necessary to teach the child to eat properly (slow eating pace) and try to develop the correct time distribution of caloric content of food during the day.

RECIPES FOR COOKING INDIVIDUAL DISHES AT HOME

SALADS, SNACKS

FRESH TOMATO SALAD

Products: fresh tomatoes 100 g, vegetable oil 10 g.

Cut the prepared tomatoes into thin slices, lightly salt and pour vegetable oil over them.

FRESH CUCUMBER SALAD

Products: fresh cucumbers 100 g, sour cream 10 g.

Cut the prepared cucumbers into thin slices, lightly salt them and put sour cream in them. You can make a salad of tomatoes and cucumbers together.

WHITE CABBAGE SALAD WITH APPLES

Ingredients: cabbage 80 g, sour apples 50 g, sour cream 10 g.

Wash the cabbage, peel, remove the stalk, chop thinly, lightly salt, mix. After removing the core, chop the apples on a coarse grater. Combine cabbage, apples, sour cream and mix well.

SAUERCABBAGE SALAD

Ingredients: sauerkraut 120 g, vegetable oil 6 g, green onions 8 g.

Lightly squeeze the sauerkraut, finely chop the onion, add the onion and butter to the cabbage, mix well.

APPLE-TOMATO SALAD

Products: apples 50 g, tomatoes 40 g, parsley and dill 15 g, vegetable oil 12 g, salt.

Wash fruits and vegetables in running water, grate apples on a coarse grater, cut tomatoes into small slices, finely chop greens and mix everything carefully, adding vegetable oil and salt.

SALAD OF LETTUCE AND FRESH CUCUMBERS

Products: green salad 60 g, fresh cucumbers 30 g, parsley 10 g, sour cream 20 g, lemon juice.

Wash each lettuce leaf well, cut into not very small pieces with a sharp knife, add a cucumber cut into thin slices, divided into quarters, sprinkle with finely chopped parsley, salt, squeeze out lemon juice, mix everything well, pour in sour cream.

BEET SALAD

Products: beets 90 g, prunes 40 g, salt 3 g, sour cream 10 g.

Boil the beets, peel and grate on a coarse grater. Wash the prunes, cover with hot water for 10 minutes, remove the pits and finely chop. Mix the prepared beets and prunes thoroughly and pour in sour cream.

RAW VEGETABLE SALAD

Products: fresh cucumbers 40 g, tomatoes 40 g, carrots 20 g, green salad 40 g, green onions 15 g, sour cream 15 g.

Prepare vegetables. Cut the cucumbers and tomatoes into thin slices, grate the carrots on a coarse grater, thinly slice the onion and lettuce. Combine all the vegetables, add salt, add sour cream and mix carefully.

FISH JAY

Products: 200 g pike or pike perch, 3 g gelatin, 1/4 egg, 5 g carrots.

Cut the cleaned fish into pieces. Make a broth from fish waste and boil the fish in it. Then remove the fish, put the washed, soaked, swollen gelatin into the broth, stir well, strain through double gauze and pour the prepared jelly over the fish. Place the fish in a bowl or mold. Decorate the bottom of the mold with chopped hard-boiled eggs and carrots, and in a bowl you can use them to decorate the pieces of fish on top. You can use thin slices of lemon for decoration. They are poured with cooled, strained broth in which the fish was cooked, and allowed to harden. Then they put in pieces of fish, pour in enough broth to cover the entire fish, and let it harden.

If the fish is chilled in the mold, then when serving it, it is tipped onto a dish.

The broth can be made not from fish waste, but from a small amount of vegetables. In this case, you need to add more gelatin.

CHICKEN IN JELLY

Ingredients: 160 g chicken, 4 g gelatin, egg and herbs for decoration.

Boil the chicken, cut into 4 pieces, and cool it in the same broth in which it was cooked. Then separate the pulp from the bones and cut it into pieces. Strain the broth, add the dissolved gelatin and stir. Pour the seasoned broth over the chopped and placed meat in a dish, garnish with circles of hard-boiled eggs, herbs and let it harden.

FIRST MEAL

VEGETABLE BROTH

Products: carrots 110 g, white cabbage 110 g, cauliflower 110 g, rutabaga 110 g, turnip 110 g, parsley root 15 g, onion 25 g, water 1.3 l.

Place the peeled root vegetables in cold water and cook over low heat with the lid tightly closed until half cooked. Then add cabbage, onion and continue cooking until tender. Strain the finished broth and bring to a boil.

You can cook soups, sauces, and cereals using vegetable broth.

VEGETARIAN BORSHCH

Products: white cabbage 130 g, beets 155 g, potatoes 150 g, carrots 60 g, onions 35 g, fresh tomatoes 110 g or tomato sauce 20 g, parsley root 15 g, parsley and dill 30 g, butter 30 g, sour cream 50 g, water 1.5 l.

Boil vegetables until tender in a small amount of water. Boil the peeled beets in water until half cooked, grate them on a coarse grater and put them in the same water; add the rest of the chopped vegetables and cook until tender. Add the missing amount of liquid with hot water and bring to a boil. Before serving the borscht, add sour cream and finely chopped herbs.

MEAT BROTH WEAK

Products: bones 200 g, carrots 15 g, onions 20 g, parsley root 15 g, salt 8 g, water 1.2 l.

Wash the sugar beef bones thoroughly, chop them, cover with cold water and cook for 3 hours. Allow the foam to harden and remove it. After 2 hours from the start of boiling the broth, add onions, roots, and salt. Strain the finished broth.

HERCULE SOUP WITH MEAT BALLS

Products: Hercules cereal 40 g, carrots 50 g, beef meat 450 g, egg 1 piece, greens 25 g, broth 1.3 l.

Free the meat for meatballs from tendons and fat, pass through a meat grinder, add an egg to the minced meat, beat the mass well and prepare small meatballs from it.

Place the cereal, carrots from the broth, grated on a coarse grater, and meatballs into the prepared strained broth and cook until tender.

Before serving, add finely chopped parsley and dill to the soup.

RASSOLNIK WITH MEAT BROTH

Products: pearl barley 40 g, potatoes 200 g, carrots 60 g, onions 40 g, pickled cucumbers 80 g, sour cream 30 g, dill 25 g, broth 1.3 l.

Pour the cereal with a small amount of water and cook until half cooked. Chop carrots, onions, cucumbers and cook them in a small amount of broth for 30 minutes. Then combine the remaining broth, pearl barley along with the broth, broth with cucumbers, carrots and onions, add finely chopped potatoes and cook until tender.

Before serving, season the pickle with sour cream and finely chopped dill.

FRESH cabbage soup with meat broth

Ingredients: broth 1.3 l, fresh cabbage 250 g, potatoes 80 g, carrots 110 g, parsley and dill 25 g.

Grate the carrots on a coarse grater and put them into the broth, add potatoes, cabbage and cook until tender. Rub all the hot vegetables into the broth through a sieve and boil again.

Before serving, add sour cream and herbs to the cabbage soup.

BORSHCH COLD

Ingredients: 300 g of kefir or curdled milk, 120 g of beets, 100 g of cucumbers, 30 g of green onions, half a hard-boiled egg, 30 g of sour cream, 7 g of dill, 120 g of water.

Cut the cooked beets into small oblong pieces, peel the cucumbers and cut into thin slices or small cubes. Whisk the yogurt, adding a little salt to it so that there are no grains left in it, then add boiled beets or (in early spring) tops, which can be placed along with the broth, and cucumbers. Add boiled water and add finely chopped green onions and dill, grated with salt.

Before serving, place a hard-boiled egg, cut into 4 parts, on a plate and whiten with sour cream. Boiled potatoes can be served separately.

FRUIT SOUP

Ingredients: 100 g currants, 100 g apples, 100 g plums, 0.5 tablespoon starch, 2 tablespoons cream, sugar, some orange peels.

Wash the apples, cut them into pieces, wash the plums, remove the seeds, wash the currants, peel them. Boil the fruits by placing them in boiling water, rub through a sieve and boil. Brew starch diluted in cold water, pour into boiling soup, remove from heat, season with sugar, orange peels to taste, add a little sour cream.

VEGETABLE SOUP WITH MEAT

Ingredients: 300 g broth, 20 g butter, 30 g onions, 40 g carrots, 140 g cabbage, 80 g potatoes, 60 g tomatoes, 80 g meat, 30 g sour cream, parsley.

Finely chop the onion, fry it in oil, add sliced ​​carrots and simmer. Cut the cabbage and potatoes into small cubes and place in the boiling broth, along with the tomatoes cut into slices.

When serving, add cooked meat, sour cream and finely chopped parsley to the soup.

DRIED FRUIT SOUP

Ingredients: 110 g of dried fruits, 500 g of water, 15 g of pearl barley, a little sugar.

Wash dried fruits and soak in warm water. Then boil them in the same water, add a little sugar and leave for an hour in a well-closed pan.

Separately, cook the cereal in enough water so that it can cook freely. When the pearl barley is cooked, drain the water. Rinse the cereal with cold water and place in fruit soup.

BROTH WITH CAULIFLOWER

Ingredients: 150 g broth, 400 g cauliflower (one head), parsley.

Divide the cabbage into pieces, soak in cold water, rinse, put in boiling broth and cook for 15 minutes. Add chopped parsley to the prepared broth.

OKROSHKA

Ingredients: 1.5 liters of bread kvass, 250 g of boiled beef, 110 g of boiled ham, 2 green cucumbers, dill, salt, green onions, green onions, egg, 2 tablespoons of sour cream.

Cut the boiled beef and ham into small cubes. Egg white, hard-boiled egg, peeled cucumbers, cut green onions into small pieces, rub the yolk through a sieve. Then dilute this whole mass with bread kvass, add chopped boiled meat, chopped cucumbers, egg whites, onions and dill.

SECOND COURSES

BOILED EGGPLANT

Ingredients: 3 medium-sized eggplants, 2 tablespoons of crushed crackers, 1 teaspoon of butter, a little salt.

Wash the eggplants, peel them, cut them lengthwise into pieces, remove the grains. Boil water, add a little salt, put eggplants in boiling water and cook. When ready, drain and serve, sprinkled with toasted crushed breadcrumbs. Add a piece of butter to the eggplants.

BOILED ZUCCHURES

Ingredients: 0.5 kg of zucchini, 0.5 tablespoon of breadcrumbs.

Wash the zucchini, cut in half lengthwise, remove the seeds, cut into lengthwise pieces, cook, placing in lightly salted boiling water. When the zucchini is soft, drain and serve with breadcrumbs.

STEAM FISH CUTLETS

Products: low-fat fish (bream, pike perch, pike, carp, cod) 100 g, milk 30 g, loaf 20 g, butter 4 g, a little salt.

Pass fish fillet without skin and bones through a meat grinder, combine with a loaf soaked in milk, and mix well. Pass through the meat grinder again and mix thoroughly. Make cutlets from the resulting mass and steam them. Serve with melted butter.

BOILED FISH

Products: fish (cod, carp, sea bass, bream) 250 g, onion 10 g, butter 3 g, egg 1/4, parsley root 5 g, water 250 g.

Cut the prepared fish into small pieces. Place onion and parsley root in salted water and bring to a boil. Place pieces of fish into boiling water and bring to a boil over high heat, then cook the fish over low heat for another 30 minutes. Remove the finished fish from the broth, carefully examine each piece and remove the bones. For small children, divide the fish into small pieces, sprinkle with chopped egg and pour over melted butter.

Serve mashed potatoes as a side dish.

FISH STEWED WITH VEGETABLES

Ingredients: low-fat fish 200 g, carrots 15 g, onions 10 g, bay leaf 1 piece, butter 5 g.

Peel the carrots and onions, wash them, cut them into slices and cut each of them into 4 parts. Clean the fish from bones and skin, rinse in cold running water, cut into small pieces, combine them with vegetables, add 1 glass of hot water, bay leaf, place in a saucepan, cover with a lid and simmer for 35 minutes at first over high heat, and then As soon as the contents of the pan begin to boil - on low. The lid of the pan must be tightly closed. Season the finished fish with vegetables with butter.

CUTLETS WITH VEGETABLES

Ingredients: white cabbage 150 g, onion 6 g, butter 5 g, wheat flour 4 g, milk 50 g, egg 1/8, wheat crackers 3 g.

Finely chop and boil the cabbage in milk until half cooked, cool slightly, add sautéed onions, flour, salt, mix everything well. Make cutlets from the mixture, roll them in breadcrumbs, fry in oil. After frying the cutlets on both sides over medium heat, add 4 tablespoons of water, cover the frying pan with a lid and simmer over low heat until cooked.

STEWED PLUMS

Products: plums 120 g, water 50 g.

Wash fresh plums, remove seeds, put in a saucepan, add water, close the lid tightly and simmer over low heat in their own juice; no sugar needed.

MEAT MEATBALLS

Products: beef meat 150 g, wheat bread 20 g, butter 5 g, carrots 15 g, onions 5 g, cauliflower 25 g, parsley root 2 g, meat broth 120 g.

Chop the vegetables, pour in the broth and simmer over low heat until half cooked. While the vegetables are stewing, cook the meat. Pass the meat pulp together with bread soaked in water through a meat grinder. Add a tablespoon of warm water and melted butter to the prepared minced meat and mix everything well. Make small meatballs from the resulting mass and lower them into the broth with vegetables for 15–20 minutes. After cooking, the meatballs can be used as a side dish.

BEEF STROGANOV FROM BOILED MEAT

Ingredients: 200 g beef, 10 g butter, 30 g sour cream, 60 g carrots.

Cool the boiled lean beef and cut into oblong thin slices. Place in a frying pan, add water and, adding the carrots, boiled and mashed through a sieve, simmer for 10 minutes. Then add sour cream, butter and heat.

BOILED BEEF

Products: beef or veal meat 150 g, vegetable broth 70 g, butter 4 g, sour cream 4 g.

Wash, peel, rinse, cut the vegetables prepared for vegetable broth, pour boiling water over them, add salt and cook. Wash the meat, put it in boiling vegetable broth and cook until soft. Cut the finished meat into thin pieces and pour in sour cream sauce.

PREPARING SOUR CREAM SAUCE

Ingredients: 50 g sour cream, 10 g flour, a little salt.

Dry the flour in a frying pan, add sour cream and, stirring, bring to a boil. Add a little salt.

STEAM CHICKEN BITS

Ingredients: 300 g chicken, 25 g stale bread, 25 g milk or water, 15 g butter.

Pass the chicken meat removed from the bones through a meat grinder, add the bread soaked in milk or water, mix again, add a little butter, mix well and cut the meatballs. Steam.

MEAT PUREE

Ingredients: 200 g beef, sour cream sauce.

Cook lean meat without tendons and films, pass through a meat grinder, add a little sour cream sauce, mix well and serve with vegetable puree.

VEAL STEW

Ingredients: 500 g veal, 1/2 tablespoon melted butter, 50 g sour cream, 1 carrot, 1 parsley root, broth, a little salt.

Cut the washed, drained veal into pieces, sprinkle them with flour, fry them in oil, put them in a saucepan, fill them halfway with broth, add chopped carrots and parsley and simmer. When the meat becomes soft, add salt and sour cream.

VEGETABLE STEW

Products: potatoes 35 g, carrots 30 g, tomatoes 30 g, cauliflower 60 g, parsley 5 g, onions 8 g, butter 6 g, sour cream 6 g, broth or water 120 g.

Finely chop the peeled root vegetables, add a small amount of broth or water, close the lid tightly and simmer over low heat until half cooked. Add chopped potatoes, tomatoes, onions, cabbage to the root vegetables, add salt and continue to simmer until done. Shortly before the end of stewing, add sour cream and butter to the vegetables. Before serving, sprinkle the stew with finely chopped parsley.

BOILED BEET

Ingredients: 300 g beets, lemon juice, 1 teaspoon butter.

Wash the beets thoroughly, add hot water, cook, drain, cool, peel, quickly rinse, grate or cut into thin slices. Pour in a small amount of water, boil, add salt and lemon juice. Place a piece of butter on a plate.

POWDERED BUCKWHEAT PORridge

Ingredients: buckwheat 50 g, water 100 g, butter 3 g.

Pour the cereal into the water, stir, close the lid tightly and put on medium heat. When the cereal has absorbed all the water, place the pan with the porridge on low heat for 20 minutes. Add oil to the prepared porridge and stir.

COOK AND APPLE PUDDING

Ingredients: cottage cheese 50 g, apples 50 g, egg 1/4 piece, sugar 6 g, wheat crackers 4 g, butter 4 g.

Rub the cottage cheese through a sieve, add finely grated apples, sugar, and yolk. Beat the egg white and add it to the mixture, stirring from bottom to top. Place the prepared mass in a mold, greased with butter and sprinkled with breadcrumbs, and cook the pudding in a water bath for 35 minutes. Instead of apples, you can use black currants.

MASHED POTATOES

Ingredients: 150 g potatoes, 50 g milk, 1 teaspoon butter, parsley.

Wash the potatoes, peel them, rinse, and cook in lightly salted boiling water. When the potatoes become soft, remove them from the heat, drain, mash, add milk, butter, stir, serve, sprinkle with finely chopped parsley.

VITAMIN DRINKS DRINK FROM BLACK OR RED CURRANTS

Products: berries 300 g, sugar 85 g, water 1 l.

Sort the berries, rinse in running water, mash with a wooden spoon, squeeze out the juice through two layers of gauze and put in a cool place. Place the berry squeezes into a saucepan, add water, cover with a lid and boil over low heat for 20 minutes from the moment it boils. When the drink has cooled, strain it, add a little sugar, squeezed juice, stir and put in a cold place.

ROSE HIP BREW

Products: dried rose hips 50 g, water 300 g.

Peel dried rosehips from hairs, rinse with cold water, chop, put in an enamel pan, add hot water, boil for 10 minutes under a closed lid. Remove from heat and leave for 4 hours. Strain the infusion.

CARROT JUICE

Ingredients: 1 kg of carrots, a little sugar.

Wash the carrots, peel, rinse, grate on a fine grater, squeeze out the juice, add a little sugar. Sugar may not be added.

DRIED FRUITS COMPOTE

Products: dried fruits 120 g, water 1 l.

Carefully sort the dried fruits, put them in a sieve or colander and wash them in running water. Cut pears and large apples into pieces. Place the prepared fruits in cold water and cook over low heat until all the fruits are soft. For flavor, you can add orange or lemon peel.

Obesity is a chronic disease that is difficult to treat. Body weight exceeding 20% ​​of normal values ​​is already considered obese. Excess weight is not only an aesthetic problem. This is a huge danger for the whole body, which leads to diseases of the heart, liver, endocrine system, etc. For a disease such as 2nd degree obesity, diet is the main treatment.

Both adults and children are susceptible to obesity. The development of this disease is usually preceded by various types of problems.

The causes of obesity are:

• genetics;
• sedentary lifestyle;
• hormonal disorders;
• chronic diseases;
• mental disorders;
• unhealthy diet, etc.

The presence of similar problems, even if there is no obesity at the moment, may lead to the formation of excess weight, which can subsequently turn into obesity. In this case, it is recommended to follow a proper diet.

The problem of obesity has a special place in medicine. Treatment is often complicated by the fact that an overweight person also has a number of other diseases (cardiovascular, endocrine, diabetes, etc.). Patients are often prescribed medication, surgery, and physical activity. But the main treatment is diet therapy. You cannot prescribe a therapeutic diet for yourself. This can lead to unpleasant consequences if a person has other diseases along with obesity (for example, with stage 2 hypertension). Only an experienced doctor or nutritionist will be able to correctly create a diet so as not to harm the patient.

Principles of healthy eating for obesity

Proper nutrition will protect against obesity and other dangerous diseases (photo: xvatit.com)

When adhering to the rules of nutrition for obesity of the 2nd degree, you need to know the basic rules that are the same for all overweight people.

• Reduce the intervals between meals, but the portions should be small. This way you avoid feeling hungry during the day, which prevents you from overeating.
• Avoid fasting. Fasting is dangerous because a person may experience breakdowns, which lead to overeating and rapid weight gain.
• It is necessary to compare energy consumption with the calorie content of food. Rule 1 for obesity - fewer calories.
• Food products must contain vitamins, minerals and fiber.
• Foods with fast carbohydrates are allowed to be eaten only in the morning.
• In the first half of the day, eat more nutritious foods, and leave light foods for the second half.

Diet No. 8 for obesity

Obese people need to consume no more than 1900 calories per day (photo: okeydoc.ru)

Therapeutic diet No. 8 was developed especially for obese people.

Diet goals:

• weight loss;
• normalization of water-salt balance;
• regulation of lipid metabolism.

It is advisable to adhere to diet No. 8 under the supervision of a doctor

What are the principles of therapeutic nutrition in diet No. 8:

• limiting or completely eliminating the use of salt and spices that cause appetite;
• You are allowed to salt the finished dish directly on your plate;
• increase protein intake to 100 g per day;
• reduce the amount of fat to 80 g per day, of which 40 g are vegetable fats;
• reduce the amount of carbohydrates to 200 g per day;
• the number of calories per day should not exceed 1900 kcal;
• increase your intake of fiber foods;
• eat only boiled, stewed and baked foods;
• Fried foods, as well as chopped or pureed foods, are prohibited;
• fractional meals (up to 6 times a day);
• Sugar is excluded (sweeteners are allowed).

In particularly severe stages of obesity, which are treated in a hospital, the daily caloric intake may decrease from 800 to 1200 kcal

Table of allowed and prohibited foods for diet No. 8:

Allowed to use	Prohibited to use
Bread made from rye, wheat or whole grain flour	Bakery products made from premium wheat flour
Soups made from vegetable broths with added cereals	Dishes made from yeast, puff pastry, shortbread dough
First courses with light meat broths (beetroot soup, cabbage soup, borscht)	Pasta
Soups with diluted fish broth	Rice, semolina
Lean meat meatball soup	Beans
Lean meat and fish	Fatty meat and fish, lard, lard
Chicken eggs	Pickles, canned foods
Milk and dairy products low in fat	Sausages
Butter	Grapes, bananas, dates, figs and sweet dried fruits
Vegetable oil	Juice, kvass from the store
Loose porridges (buckwheat, pearl barley, barley)	Candies, cookies, ice cream,
Green vegetables	Chocolate
Fruit and berry jellies and compotes	Honey
Low-fat sauces (white or tomato)	Mayonnaise, horseradish, mustard, fatty and hot sauces
Green tea, black	Alcohol
Rose hip decoction	Semi-finished products
Chicory, coffee with milk	Fast food

Fasting days - when is it best to use them?

Apple fasting days are useful for people with insufficient physical activity (photo: magia-stroinosti.ru)

Fasting days are days when the daily diet is determined by the consumption of a number of specific foods. For example, meat fasting day, kefir, watermelon, apple, etc.

It is useful to arrange fasting days for obesity, diabetes, pancreatitis and other diseases.

• arrange 1-2 fasting days a week;
• do not eat heavily before going to bed;
• eat a couple of dried apricots or prunes at night as a mild laxative;
• The fasting day should take place in a calm, stress-free atmosphere.

Types of fasting days for obesity:

• Apple. During the day, eat 1.5 kg of unsweetened apples (divide the amount into 5-6 meals). Apples can be peeled and grated. You can also bake it with cinnamon.
• Cucumber. Divide 1.5 kg of cucumbers into 5 portions. At lunch and for the first dinner, add one soft-boiled egg to the cucumber.
• Buckwheat. On this day you need to eat one glass of steamed cereal without salt, oil and sauce every 2-3 hours. In this case, you need to drink up to two liters of clean water without gas per day.

You can also have meat meals (280-350 g of boiled meat with a vegetable side dish, divided into 5-6 portions). Curd (500-600 g of low-fat cottage cheese per day plus 2-3 glasses of coffee or tea without sugar). Combine fasting days with physical activity.

Diet for obesity of the 2nd degree. Menu for the week

Obese people need to give up fast food, sweets, processed foods and other junk foods (photo: caloriesburning.net)

In case of obesity of the 2nd degree, there is an excess of body weight by 30-50% of the norm. Weight accumulates slowly but steadily. In this case, a therapeutic diet and physical activity are prescribed. Only in combination is it possible to achieve results in case of 2nd degree obesity.

The diet for a patient with 2nd degree obesity (as well as nutrition for hypertension) is practically no different from the diet of patients with 1st degree.

Nutrition principles:

• distribution of nutrients - 60% proteins, 25% vegetable fats, 4-8g salt per day;
• drink no more than 1-2 liters of water per day;
• It is preferable to eat vegetables and fruits raw;
• Main courses should be stewed, baked, boiled or steamed;
• Divide the diet into 5-6 meals.

Diet for obesity of the 2nd degree and menu for the week:

Monday
Breakfast 1	Boiled hake 100 g. Boiled potatoes 50 g. Fresh cabbage salad 60 g. Coffee without sugar 200 ml.
Breakfast 2	Low-fat kefir 250 ml.
Dinner	Potato soup without meat 200 g. Boiled chicken 100 g. Fresh cucumbers 100 g. Brew without sugar 200 ml.
Afternoon snack	Berries or apples 200 g. Rose hip decoction 200 ml.
Dinner 1	Soft-boiled egg. Boiled lean beef and green peas 100 g.
Dinner 2	Dietary kefir 250 ml.
Tuesday
Breakfast 1	Steamed fish cutlets 200 g. Soft-boiled chicken egg. Coffee without sugar 200 ml.
Breakfast 2	Skim milk 200 ml.
Dinner	Vegetable soup with pearl barley 230 g. Boiled beef stroganoff with beets 260 g. Sauerkraut salad 60 g. Brew without sugar 200 ml.
Afternoon snack	Berries or apples 200 g.
Dinner 1	Boiled lean beef 50 g. Soft-boiled egg.
Dinner 2	Curdled milk 250 ml.
Wednesday
Breakfast 1	Jellied fish 310 g. Soft-boiled chicken eggs 2 pcs.
Breakfast 2	Apples 100 g. Kefir 250 ml.
Dinner	Vegetable soup 300 g. Stew with meat and vegetables 250 g. Brew without sugar 200 ml.
Afternoon snack	Apples 200 g.
Dinner 1	Soft-boiled egg.
Dinner 2	Yogurt or low-fat kefir 250 ml.
Thursday
Breakfast 1	Boiled beef 100 g. Low-fat kefir 250 ml.
Breakfast 2	Soft-boiled egg 1 pc. Apples 100 g. Coffee without sugar 200 ml.
Dinner	Lenten borscht 250 g. Boiled beef stroganoff 170 g. Boiled potatoes 80 g. Brew without sugar 200 ml.
Afternoon snack	Apples 200 g.
Dinner 1	Boiled chicken and green peas 100 g.
Dinner 2	Curdled milk 200 ml.
Friday
Breakfast 1	Any boiled meat 100 g. Low-fat kefir 250 ml.
Breakfast 2	Steamed carrot soufflé 130 g. Apples 150 g. Coffee without sugar 200 ml.
Dinner	Lenten cabbage soup 250 g. Boiled hake 150 g. Boiled potatoes 75 g. Brew without sugar 200 ml.
Afternoon snack	Apples 200 g.
Dinner 1	Boiled meat of your choice 100 g. Tea with milk without sugar 200 ml.
Dinner 2	Low-fat kefir 200 ml.
Saturday (fasting day)
Sunday
Breakfast 1	Vinaigrette 150 g. Low-fat cottage cheese 100 g. Tea without sugar 200 ml.
Breakfast 2	Apples 200 g.
Dinner	Lenten borscht with sour cream 200 g. Boiled meat of your choice 150 g. Stewed cabbage 100 g. Brew without sugar 200 ml.
Afternoon snack	Cottage cheese with milk 150 g.
Dinner 1	Any boiled fish 150 g. Vegetable stew 200 g. Tea with lemon without sugar 200 ml.
Dinner 2	Low-fat kefir 200 ml. Rye bread 20 g.

Obesity and children

Poor nutrition can trigger the development of obesity in children (photo: 31tv.ru)

Obesity in children is complicated by the fact that the body during this period needs an increased amount of vitamins, minerals, macro- and microelements. Treatment of obesity in childhood is also carried out through diet.

Principles of constructing dietary nutrition for an obese child:

• exclude or limit easily digestible carbohydrates;
• lamb, beef, pork fat and margarine are excluded;
• limit or eliminate the consumption of buns, sweets, cookies and other sweets;
• focus on vegetables, fruits and berries;
• Freshly prepared juices are good for children: tomato, beet, carrot, cabbage;
• meat, fish, milk, cottage cheese and other fermented milk products should be present in the diet in the amount recommended by age;
• prepare vegetarian first courses;
• it is allowed to prepare soup in diluted broth from meat or fish no more than twice a week;
• prepare cutlets and meatballs from lean meat or steamed fish;
• minimize or eliminate the consumption of potatoes;
• teach your child to eat slowly, chewing food thoroughly, then the feeling of fullness will last longer.

Obesity of the 2nd degree and above is a problem. It's not easy to get rid of it. But if you strictly follow nutritional standards, listen to your doctor’s advice, play sports and be active, you won’t have to wait long for results.

The causes of obesity and methods of treating the disease are described in the video below with Elena Malysheva, Doctor of Medical Sciences.

General rules

Obesity is defined as excess fat accumulation resulting from consuming calories that exceed a person's energy expenditure. High intake of carbohydrates and fats plays an important role in its development. The main criterion for diagnosing this condition is the body mass index, which, if it is from 25 to 40 kg/m2, is regarded as obesity of 1-2 degrees, and if it is more than 40 kg/m2, then obesity of extreme 4 degrees occurs. Is this already a disease or so-called morbid obesity.

It is accompanied by neurohumoral and metabolic disorders, as well as changes in organ function. The problem is important because many diseases are associated with obesity: metabolic syndrome, diabetes, hypertension, dyslipidemia, osteoarthritis, night apnea And polycystic ovary syndrome. Even a slight excess of weight (just 10%) already leads to an increase in mortality by 20%, increasing the risk of cardiovascular disease and diabetes. Thus, it can be considered as a socially significant disease.

Treating this disease is a difficult task and first of all you need to find out the cause. The formation of excess weight is often associated with eating disorders, which are psychological in nature. For example, in patients suffering from bulimia nervosa. Bulimia is a psychosomatic disorder manifested in uncontrolled food consumption. The second name for this disorder is ravenous hunger. Attacks of overeating are provoked by external influences and the disease can occur in the form of:

• paroxysmal absorption of food as a result of a strong appetite;
• constant consumption of large amounts of food;
• night food, when attacks occur at night.

Most often, the patient tries to get rid of the food he has eaten by vomiting or using enemas and laxatives. Bulimia with cravings for high-carbohydrate foods may occur when depression. In women, during the luteal phase, taste preferences change (a craving for sweets appears), appetite increases and a transient bulimia.

Patients in whom decreased satiety is accompanied by anxiety-depressive disorders and bulimia are prescribed antidepressants. Therapy with appetite regulators is also effective ( Sibutramine, Dietress).

A diet for obesity is always prescribed regardless of the cause that caused it. It is based on the principles of a balanced diet - it contains a sufficient amount of protein, vitamins and microelements. At the same time, the diet limits the amount of fat (from animals), salt (up to 3-5 g), easily digestible carbohydrates and free liquid (this depends on the degree of obesity), on average 1-1.2 liters. Any foods that stimulate the appetite are also limited.

It uses low-calorie products: lean fish, seafood, dietary meat, low-fat cottage cheese, milk, eggs, which contain essential amino acids And vitamins. Non-digestible fiber and complex carbohydrates are represented by vegetables, fruits, cereals and grains. The patient obtains unsaturated fatty acids through the consumption of vegetable oils.

Proper distribution of calories throughout the day is important. This is due to the fact that in the first half of the day fat breakdown processes predominate, and after 18 hours liposynthesis accelerates (especially at night). Taking this into account, breakfast should be the most high-calorie, so it can include complex and simple carbohydrates and protein. Lunch is less high in calories. For dinner, which should be very light, you can eat lean meat/fish with a vegetable side dish. Or cottage cheese with kefir. After dinner you can only drink water or kefir.

The composition of foods, as well as proteins, fats and carbohydrates, varies depending on the degree of obesity, but the basic principles of nutrition are similar:

• Inclusion of vegetables and fruits - sources of fiber and complex carbohydrates. You need to consume them daily, spreading them over all meals, since fiber slows down the absorption of carbohydrates and fats and the process of converting carbohydrates into fats. They also inhibit post-meal glucose rise and spike. insulin which promotes fat deposition.
• Mandatory consumption of complex carbohydrates (whole grain bread, muesli, cereals, cereals).
• Introduce protein through lean meats, fish, eggs and dairy products.
• Healthy fats in the diet are represented by vegetable oils.
• Exclusion of simple carbohydrates (sugar, honey, baked goods, etc.). The need for sweets must be met with berries and fruits.
• Avoiding alcohol, flavor enhancers, and processed foods. Nuts, popcorn, seeds and chips, which are often used for snacking, are quite high in calories. These unaccounted calories take a toll on your weight. When visiting during feasts, you need to choose less calorie dishes.
• Proper cooking (stewing, boiling, baking). Any fried foods are excluded.
• The last meal is no later than 2 hours before going to bed.

Diet therapy also provides for the correct diet and the implementation of certain rules:

• Five (or more) meals a day. Fractional meals in small portions, including snacks, prevent the development of a strong feeling of hunger and prevent breakdown and withdrawal from the diet. Patients often have a perverted diet - they eat rarely, consume little food in the morning, and large portions late in the evening. Large meals increase the volume of the stomach and enhance the absorption of carbohydrates and fats.
• Correct distribution of calories: for breakfast - 30% of daily calories, for lunch - up to 40%, dinner - 10%, 10% is also allocated for snacks.
• Mandatory drinking regimen, if there are no contraindications - 1.5-2 l/day.
• Avoid eating on the go - chips, pies, sandwiches, crackers.
• For all degrees of obesity, a subcalorie diet is prescribed (contains significantly fewer calories than the diet of a healthy person). The degree of calorie restriction depends on the degree of obesity and the patient's condition.

For 1st degree obesity

1st degree obesity characterized by a body mass index from 30.0 to 34. Patients at this stage do not consider themselves sick, they have no complaints from other organs, but sometimes they may experience weakness and increased fatigue. However, already at this stage you need to start fighting extra pounds, otherwise you may develop hyperinsulinemia, hypo ovarian function and menstrual irregularities.

Simple carbohydrates and sugar should be eliminated completely, replacing them with sweeteners. The norm for bread consumption is 150 g. The daily calorie content is no more than 1500 kcal. Reducing calories to this level allows you to lose 8% of weight in six months. For moderate obesity, even reducing it by 500 kcal compared to normal calorie content is sufficient.

Excluded:

• sweet and puff pastries;
• fatty fish, caviar and canned food;
• fatty meats and sausages;
• salted and pickled vegetables;
• full-fat milk, sour cream, cream, full-fat cottage cheese;
• pasta.

At 2 degrees of obesity there is an excess weight of 30-40% more than normal and a BMI of 35-39.9.

The diet of patients at these two stages is similar. It is based on complex carbohydrates that have a low GI: whole grains, many vegetables and fruits. All of these foods are rich in dietary fiber. Vegetables or fruits should be included in the diet five times a day. You should eat fish at least twice a week. It must be remembered that fasting is contraindicated, as it can lead to depression. As prescribed by your doctor, you may be prescribed a diet with a lower calorie content for a short time, which will be discussed below.

At obesity 3rd degree BMI exceeds 40. At grade 3, there is already a pronounced weight gain, which causes psychophysical discomfort in the patient, leads to the appearance of concomitant diseases (musculoskeletal, cardiovascular systems) and sexual disorders. The patient's health is deteriorating, there is constant dyspnea, pain in the heart area, weakness, decreased performance. Complications of impaired metabolism are diabetes, pancreatitis, hypertonic disease, kidney stones.

The diet involves large calorie restrictions. Reducing calories is achieved by cutting down “fast” carbohydrates and fats. The daily diet consists of up to 80 g of protein, 60 g of fat and 100 g of carbohydrates. Daily calorie content is no more than 1300 kilocalories. Sometimes it is recommended to reduce it to 1000 kcal or more - 650-850 kcal. These are the so-called reduced diets. Such nutrition can be prescribed for a short time (maximum 3 months), and the patient himself must be under the supervision of a doctor.

It is unacceptable to use (even occasionally):

• confectionery, sweets;
• any sweet drinks;
• ice cream;
• sweet fruits (bananas, grapes) and dried fruits;
• sugar, honey, baking (sugar is replaced xylitol, sorbitol, sweetener);
• foods that increase appetite (spicy sauces, smoked foods and seasonings).

It is better to exclude starchy vegetables from the diet completely. These include: potatoes, rutabaga, carrots, corn, pumpkin, Jerusalem artichoke, beets, mature beans and peas, squash, zucchini, parsnip and parsley root, radish, radish. However, this can be difficult to do in everyday life, so you need to use them as rarely as possible. Of course, potatoes, as the most highly starchy vegetable, are completely excluded from the diet.

The rate of fluid intake varies from person to person, usually no more than 1-1.2 liters per day. Salt intake is also significantly limited (3 g per day). In this regard, pickles and canned foods are contraindicated. The consumption of white bread, pasta, sago, white rice, and semolina is significantly limited.

The food menu may contain:

• vegetables: green peas, all types of onions, cucumber, kohlrabi, eggplant, all types of cabbage, broccoli, Brussels sprouts, Chinese cabbage, cucumbers, celery, seaweed, green salads, sorrel (rarely if uric acid levels are elevated), tops vegetables, chard, dill, sweet peppers, parsley, mushrooms, chicory, spinach, garlic;
• dietary varieties of bread (bran, grain, coarse);
• buckwheat and oatmeal, added to soup;
• unripe legumes (green beans, green peas);
• pears, apples, citrus fruits, kiwi, pineapples, plums.

When creating a diet menu for grade 3 obesity, you need to take into account not only prohibited foods, but also not exceed the volume of single servings and the number of foods allowed per day:

• fermented milk drinks 300 ml;
• low-fat cottage cheese 100 g;
• butter 5-10 g;
• one egg;
• fruit 200 g;
• allowed vegetables 200-300 g.

The diet ensures slow weight loss. You shouldn't try to lose weight quickly. The diet must be followed under the supervision of a specialist, and drug correction of metabolism and an effect on increased appetite are possible. Physical activity is required, the level of which will also be determined by a specialist taking into account concomitant pathology, but all patients, without exception, are recommended to walk for 45 minutes daily.

Obesity And diabetes very connected. The risk of diabetes mellitus with third degree obesity will increase 10 times. If a person leads a sedentary lifestyle and consumes mainly carbohydrate foods, more glucose is needed to process glucose. insulin. The pancreas works overtime, which over time depletes it and leads to the development of diabetes.

Carrot, beet and tomato juice, without preservatives and additives, and celery juice are considered healthy

Nutrition for obesity and diabetes is based on significant restriction of carbohydrates. This also applies to sweet fruits. The permissible amount depends on the degree of carbohydrate metabolism disorder. If you have diabetes, choose fruits with a low glycemic index (GI less than 55 is considered low). Such fruits include: grapefruits, lingonberries, cherry plums, apples, apricots, cranberries, plums, cherries, peaches, sea buckthorn, currants, gooseberries. The permissible daily intake of these fruits is 200 g.

Patients should maintain a healthy intestinal microflora, since the quality of digestion and the absorption of substances depend on this. The quality of microflora improves with a sufficient amount of fiber and consumption of fermented foods (sauerkraut and other pickled vegetables, beet kvass, kombucha, pickled fruits).

Authorized Products

• Lean fish, mussels, shrimp, squid and other low-calorie seafood, which are prepared by boiling or baking.
• Lean meat (beef, rabbit, chicken and turkey) is prepared in the same way.
• Cereals - brown rice, buckwheat, basmati rice, oatmeal. Porridge is boiled in water and the serving is 2 times smaller than usual. The frequency of porridge consumption decreases with grades 2 and 3 of the disease.
• Vegetable soups, cabbage soup, borscht, cooked in water, vegetable broth or secondary meat broth.
• Legumes with a low glycemic index can be included in the diet several times a week: green beans, soybeans, green and red lentils. Mature legumes should be limited.
• Egg whites.
• Grain bread and yeast-free bread with bran.
• Cashews and peanuts, which have a GI of 15, can sometimes be enjoyed as an addition to salads.
• Vegetables and fruits in general 500 g per day. In addition to fruits, you can eat dried apricots and prunes, which have a GI of 40, bran, sesame and flax seeds as a source of fiber.
• Preferred vegetables include: green peas, all types of onions, cucumber, kohlrabi, eggplant, all types of cabbage, broccoli, Brussels sprouts, Chinese cabbage, cucumbers, celery, seaweed, zucchini, green salads, radishes, radishes, turnips, sorrel ( rare if the level is elevated uric acid), vegetable tops, chard, dill, sweet peppers, parsley, mushrooms, chicory, spinach, garlic. Boiled carrots, potatoes and pumpkin have a high glycemic index and should be excluded. But you can eat raw carrots and beets.
• Low-fat cottage cheese and dairy products, this also applies to hard cheeses. To dress salads, you can use natural yogurt using 2 tablespoons. Its calorie content is several times lower than the same amount of vegetable oil.
• To dress salads, you need to use unrefined vegetable oils (olive, sesame or flaxseed, corn), but in the amount of 1 tbsp. l. Per day, given the very high calorie content.
• Weak tea with fructose, herbal teas, green tea, table water, rosehip infusion, vegetable juices with lower calorie content and unsweetened fruit juices (orange, pomegranate, apple).

Table of permitted products

	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
Vegetables and greens
greenery	2,6	0,4	5,2	36
eggplant	1,2	0,1	4,5	24
zucchini	0,6	0,3	4,6	24
cabbage	1,8	0,1	4,7	27
broccoli	3,0	0,4	5,2	28
boiled cauliflower	1,8	0,3	4,0	29
bulb onions	1,4	0,0	10,4	41
carrot	1,3	0,1	6,9	32
cucumbers	0,8	0,1	2,8	15
salad pepper	1,3	0,0	5,3	27
radish	1,2	0,1	3,4	19
white radish	1,4	0,0	4,1	21
red radish	1,2	0,1	3,4	20
black radish	1,9	0,2	6,7	35
salad	1,2	0,3	1,3	12
beet	1,5	0,1	8,8	40
soybeans	34,9	17,3	17,3	381
asparagus	1,9	0,1	3,1	20
tomatoes	0,6	0,2	4,2	20
Jerusalem artichoke	2,1	0,1	12,8	61
pumpkin	1,3	0,3	7,7	28
garlic	6,5	0,5	29,9	143
lentils	24,0	1,5	42,7	284
sorrel	1,5	0,3	2,9	19
Fruits
avocado	2,0	20,0	7,4	208
oranges	0,9	0,2	8,1	36
pomegranate	0,9	0,0	13,9	52
grapefruit	0,7	0,2	6,5	29
pears	0,4	0,3	10,9	42
kiwi	1,0	0,6	10,3	48
lemons	0,9	0,1	3,0	16
mango	0,5	0,3	11,5	67
tangerines	0,8	0,2	7,5	33
nectarine	0,9	0,2	11,8	48
peaches	0,9	0,1	11,3	46
apples	0,4	0,4	9,8	47
Berries
gooseberry	0,7	0,2	12,0	43
Red currants	0,6	0,2	7,7	43
black currant	1,0	0,4	7,3	44
Mushrooms
mushrooms	3,5	2,0	2,5	30
Nuts and dried fruits
sesame	19,4	48,7	12,2	565
flax seeds	18,3	42,2	28,9	534
fenugreek seeds	23,0	6,4	58,3	323
Cereals and porridges
buckwheat (kernel)	12,6	3,3	62,1	313
oat groats	12,3	6,1	59,5	342
cereals	11,9	7,2	69,3	366
millet cereal	11,5	3,3	69,3	348
Dairy
skim milk	2,0	0,1	4,8	31
natural yogurt 2%	4,3	2,0	6,2	60
Cheeses and cottage cheese
cottage cheese 0.6% (low fat)	18,0	0,6	1,8	88
curd tofu	8,1	4,2	0,6	73
Meat products
beef	18,9	19,4	0,0	187
rabbit	21,0	8,0	0,0	156
Bird
chicken fillet	23,1	1,2	0,0	110
turkey	19,2	0,7	0,0	84
Fish and seafood
fish	18,5	4,9	0,0	136
squid	21,2	2,8	2,0	122
mussels	9,1	1,5	0,0	50
seaweed	0,8	5,1	0,0	49
Oils and fats
linseed oil	0,0	99,8	0,0	898
olive oil	0,0	99,8	0,0	898
sunflower oil	0,0	99,9	0,0	899
Non-alcoholic drinks
green tea	0,0	0,0	0,0	-

Fully or partially limited products

First of all, food for overweight should not contain:

• Products with a high glycemic index.
• Fast food (fried pies, French fries, chips, etc.), which is not only a high-calorie product, but also contains a dangerous dose carcinogens, since the oil for its preparation is used several dozen times.
• Fatty pork, duck, goose, trans fats, animal fats, smoked meats, canned food in oil, sausages, palm and coconut oil.
• Fried foods due to their high calorie content. The calorie content of these products increases by 1.3 times.
• Fatty dairy products.
• White rice, pasta, semolina, dough products.
• Baking from any dough.
• Confectionery, ice cream.
• Limit salt.

Table of prohibited products

	Proteins, g	Fats, g	Carbohydrates, g	Calories, kcal
Vegetables and greens
beans	6,0	0,1	8,5	57
beans	7,8	0,5	21,5	123
Fruits
bananas	1,5	0,2	21,8	95
Berries
grape	0,6	0,2	16,8	65
Nuts and dried fruits
nuts	15,0	40,0	20,0	500
raisin	2,9	0,6	66,0	264
cashew	25,7	54,1	13,2	643
sunflower seeds	20,7	52,9	3,4	578
Cereals and porridges
semolina	10,3	1,0	73,3	328
white rice	6,7	0,7	78,9	344
Flour and pasta
pasta	10,4	1,1	69,7	337
Confectionery
jam	0,3	0,2	63,0	263
jam	0,3	0,1	56,0	238
candies	4,3	19,8	67,5	453
pastry cream	0,2	26,0	16,5	300
cookie	7,5	11,8	74,9	417
Ice cream
ice cream	3,7	6,9	22,1	189
Cakes
cake	4,4	23,4	45,2	407
Chocolate
chocolate	5,4	35,3	56,5	544
Raw materials and seasonings
mustard	5,7	6,4	22,0	162
mayonnaise	2,4	67,0	3,9	627
honey	0,8	0,0	81,5	329
Dairy
milk 3.6%	2,8	3,6	4,7	62
milk 4.5%	3,1	4,5	4,7	72
cream	2,8	20,0	3,7	205
sour cream 25% (classic)	2,6	25,0	2,5	248
Cheeses and cottage cheese
cheese	24,1	29,5	0,3	363
cottage cheese 11%	16,0	11,0	1,0	170
cottage cheese 18% (fat)	14,0	18,0	2,8	232
Meat products
pork	16,0	21,6	0,0	259
pork liver	18,8	3,6	0,0	108
pork kidneys	13,0	3,1	0,0	80
pork fat	1,4	92,8	0,0	841
salo	2,4	89,0	0,0	797
beef liver	17,4	3,1	0,0	98
beef kidneys	12,5	1,8	0,0	66
beef brains	9,5	9,5	0,0	124
Sausages
smoked sausage	16,2	44,6	0,0	466
smoked sausage	9,9	63,2	0,3	608
sausages	10,1	31,6	1,9	332
sausages	12,3	25,3	0,0	277
Bird
smoked chicken	27,5	8,2	0,0	184
duck	16,5	61,2	0,0	346
smoked duck	19,0	28,4	0,0	337
goose	16,1	33,3	0,0	364
Fish and seafood
smoked fish	26,8	9,9	0,0	196
salted fish	19,2	2,0	0,0	190
Red caviar	32,0	15,0	0,0	263
black caviar	28,0	9,7	0,0	203
canned fish	17,5	2,0	0,0	88
cod (liver in oil)	4,2	65,7	1,2	613
Oils and fats
butter	0,5	82,5	0,8	748
animal fat	0,0	99,7	0,0	897
cooking fat	0,0	99,7	0,0	897
Non-alcoholic drinks
instant coffee dry	15,0	3,5	0,0	94
black tea	20,0	5,1	6,9	152

* data is per 100 g of product

Menu (Power Mode)

Do not try to sharply limit all foods at once. During the adaptation period, you need to reduce portions by 2 times and eliminate flour, sweet products and sugar, as well as reduce the amount of bread. Even such restrictions will produce results. After 1-2 weeks, gradually reduce the frequency of eating cereals, replacing them with vegetable side dishes.

If your diet is varied and you think through all the dishes that you can use when you feel hungry, this will help you avoid breakdowns. This could be low-fat cottage cheese, stewed zucchini, green peas, a small portion of lentils, bran bread, bran with kefir and berries, apples or grapefruits.

For children

Nutritional (constitutional-exogenous) obesity in children is characterized by uniform accumulation of adipose tissue. This form occurs in 90% under the age of one year. With age, a slight degree of excess weight occurs. During puberty, girls gain even more weight. The number of fat cells in a child depends on the genetic factor, and the size of fat cells is already influenced by the nutritional factor. Excessive nutrition during the critical puberty period leads to an increase in their size.

The difficulties in organizing nutrition for children suffering from this pathology lie in the fact that, on the one hand, the child’s body must receive vitamins, macro- and microelements, a sufficient amount of proteins. On the other hand, children prone to weight gain should be limited in their diet. This should happen through carbohydrates (mostly easily digestible) and fats.

You should offer buns, candies, cookies, jam and other sweets as rarely as possible. Potato dishes, pasta and dough dishes (dumplings, dumplings, pancakes, pancakes) should be included in the menu very rarely. Lamb, pork, beef fats and margarine should be excluded. Vegetables and unsweetened fruits should prevail in the diet.

Of course, it turns out that with such restrictions, nutrition becomes hypocaloric, and a decrease in calorie content causes the consumption of fat from the depot. In the early stages of the disease, metabolism is normalized more easily and quickly and weight is reduced. Typically, caloric intake is reduced by 200-600 kcal. You should not sharply limit or quickly reduce caloric intake. This may cause weakness in the child and headache.

The diet for obese children includes:

• Meals 6 times a day and in small portions. Breaks between meals of 2.5-3 hours suppress the feeling of hunger and reduce appetite, so the child will not eat a large amount of food at the next meal.
• Dinner is no later than 19:00 and should be light.
• High calorie foods should be given in the first half of the day. Breakfast and lunch can consist of meat and fish dishes, and dinner can consist of vegetable and dairy dishes.
• Eating slowly and chewing thoroughly. At the same time, the feeling of fullness comes faster, and the child will not overeat.

Children's dietary food should include the age-specific norm of protein obtained from cottage cheese, yogurt, meat, fish, kefir, and milk. Three-year-old children should eat 80 g of meat per day, preschoolers - 100 g, from 7-12 years old up to 150 g of meat. Cottage cheese should be present in the diet daily in an amount of 50-80 g. Dairy products in an amount of 400-600 ml.

Vegetable juices are useful because they are lower in calories: tomato, beet, carrot, cabbage or a mixture of juices. Soups should be cooked vegetarian, and once a week in weak meat broth. To diversify a child’s diet, steamed meatballs, cutlets, dumplings and meatballs are prepared from fish and meat.

Dietary meals for obese children and the technology for their preparation can be found in reference books on therapeutic nutrition. Of course, not many children like vegetables, but perhaps from the list of dishes you will be able to choose the most suitable for your child.

You can prepare vegetable stew, eggplant sauté, carrots with béchamel sauce, cabbage casserole, cabbage, carrot, beet or zucchini cutlets, cabbage schnitzel, boiled fish with zucchini and low-fat sour cream, fish cutlets with vegetable garnish, cottage cheese with herbs, omelette with green beans or zucchini (tomatoes). For dessert, you can offer cranberry or lemon jelly with xylitol.

Older children are prescribed fasting days once a week with a caloric food content of 600-800 kcal. These can be standard fasting diets: dairy, apple, cottage cheese, kefir. Treatment with hunger is contraindicated, since catabolic processes intensify in the child’s body, and this can inhibit growth and disrupt the maturation of the body.

The child’s physical activity is also an important therapeutic factor. Physical activity significantly increases metabolic rate and accelerates weight loss.

Advantages and disadvantages

Reviews and results

This healthy diet should be constantly followed by the sick. Small deviations from the diet are possible. However, with eating disorders, weight loss may slow down. The reviews note positive aspects: weight decreases, swelling disappears and constipation. By following it, you can significantly improve your health. In cases of severe obesity, nutrition should be adjusted by an endocrinologist and nutritionist. It may take 1-1.5 months to lose weight, but it is important that losing weight does not turn into torture, and that the achieved weight does not increase again.

• “... I can say that for very fat people who are used to eating a lot of high-calorie foods, it is very difficult to follow a diet. So it is with me. I’ve been doing it for four months now - the process is going well, but it’s difficult for me. Low-calorie meals make you feel hungry after 1.5 hours and you have to eat again. All sorts of supplements such as MCC, Stroynitin, Garcinia. When the endocrinologist prescribed Meridia, she felt better and was able to take breaks for 3-3.5 hours, began to eat less and the weight shifted. I eat fish, vegetables, turkey, cottage cheese, eat porridge 3 times a week, and drink kefir. Result in 4 months minus 8 kg. The doctor says that the result is good and it is impossible to lose weight faster. With such a diet, he recommended taking vitamins, since irritability periodically sets in and there is often a bad mood”;
• “... The weight loss process became more effective when I began to pay attention to the glycemic index of foods. The doctor recommended it to me because I had an elevated level of insulin in my blood. I should have been examined a long time ago, because I’ve been on diets for a long time and often, but it’s of little use. Moreover, the weight returns after 1-1.5 months. The nutritionist outlined the diet and said that you need to eat this way all the time due to carbohydrate metabolism disorders. Calorie intake should be kept at 1200 kcal and eat low-calorie foods (non-starchy vegetables, eggs, meat, fish, chicken, low-fat cottage cheese and milk, cereals). In 2 months, walking 3 km daily, I lost 5 kg. The result is good, but I think that later the weight loss will slow down”;
• “... I’ve been on a diet for 2 months, I can’t stand the lack of sweets and starchy foods well. For fat women, it is important not to use them. I try not to commit any violations, but I do it all with anguish and stress. Even fruits and berries don't help. The doctor recommended taking Liprin and calming herbs. It really helped, as my appetite decreased and my cravings for sweets went away. I finish the package and then go to the appointment. I believe that if you are overweight, you cannot do without special medications. I eat chicken breast, fish, various salads. In the summer this can be done without problems, but in the winter you will have to buy frozen vegetable mixtures and prepare a stew. In winter, grapefruits and oranges will help out. I use mushrooms everywhere - in omelettes, warm salads, soups and borscht.”

Diet price

Food is relatively inexpensive if you don’t eat seafood every day. A large number of vegetables and fruits in the diet in winter can slightly increase the cost of food. It can reach 1600-1700 rubles. in Week.

NOTE! The information about diets on the site is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision about their use. Before using the diet, be sure to consult a dietitian.

There are not so many effective and safe drugs to combat excess weight. The bulk of what the Internet offers us in this regard either does not have the properties described in the manufacturer’s instructions, or may be effective, but cause some harm to health. Both are dangerous. The use of “dummies” makes a person become disillusioned with treatment and give up, and dangerous drugs make a person treat new pathologies caused by taking these miracle drugs.

Effective treatment is unlikely to be possible if the patient’s emotional and mental state leaves much to be desired, which is often observed when working with people who are significantly overweight. Therefore, psychotherapy sessions are often used along with other therapeutic measures.

Diet for obesity 2nd degree

Since obesity is a consequence of unhealthy eating behavior, no treatment will be effective without its correction. Let's put it another way, many nutritionists agree that diet for stage 2 obesity is the main method of combating the disease and is equated to medical procedures.

There is simply no universal diet that would help everyone lose extra pounds equally effectively. Sometimes you have to try several diets until you settle on the one that gives the greatest weight loss. The choice of diet should be based on the nutritional characteristics of stage 2 obesity.

The main points that you need to rely on when choosing an effective diet are the following requirements:

• The food should be simple but with sufficient nutritional value. The patient’s body should not suffer from a lack of vitamins, microelements, essential amino acids, etc.
• A large amount of fiber in foods and dishes will help cleanse the intestines and speed up the process of weight loss.
• Low calorie food, as a necessary condition for weight loss, is a common condition for all diets.
• The patient’s diet should not contain sweet carbonated drinks (they are replaced with mineral water and natural compotes of fruits and berries), honey and sweets, ice cream, high-calorie desserts, fatty meats and fish, sausages and smoked meats, canned food, pickles, hot seasonings and sauces , alcoholic drinks.
• It is necessary to minimize the consumption of sugar and salt, oil and fats (giving preference to vegetable oils), dough products (especially puff pastry, yeast and shortbread), fried and hearty dishes. Dairy products should be very low in fat, ideally low-fat. Fruits are low in sugar. It is better to take gray or black bread and preferably with bran.
• Portions should be significantly smaller than usual, and the frequency of meals should be increased to 6 times a day.
• Fresh vegetables and non-sweetened fruits rich in fiber, green leafy vegetables and root vegetables rich in vitamins and microelements, low-fat dairy products, and green tea are healthy.
• Fasting days. They are required to cleanse the body of harmful wastes and toxins that interfere with weight loss. On this day, the patient should eat only certain foods. The best option is apple and cottage cheese day (but the cottage cheese should be low-fat). You can also sit on vegetables for a day, with the exception of potatoes.

The daily diet should contain much fewer calories than before, and nevertheless the figure should not be lower than 1200 kcal.

Here is an approximate diet menu for stage 2 obesity, not forgetting that the frequency of meals increases and portions are reduced by half compared to usual:

1 breakfast:

• boiled meat, sauerkraut (not pickled!),
• coffee (with milk, but without sugar, sweetener - xylitol).

2 breakfast:

• skim cheese,
• green tea without sugar.

Dinner:

• borscht in vegetable broth without meat,
• boiled chicken meat, boiled or baked vegetables,
• compote of unsweetened fruits and berries.

Afternoon snack:

• large apple (fresh or baked)

1 dinner:

• boiled or baked potatoes,
• lean fish (boiled, baked or steamed)

2 dinner (light snack at night)

• A glass of kefir with zero fat content.

Nutrition for stage 2 obesity, despite its fairly low calorie content, should still be varied. Instead of borscht, you can eat soup or vegetable stew, instead of baked potatoes, make a carrot casserole or a salad of boiled beets and low-fat sour cream, etc.

You need to eat more unsweetened fruits and raw vegetables (if possible), include in your diet a small amount of fiber-rich cereals (oatmeal, rice, buckwheat), eggs, and low-fat dairy products.

The main thing with stage 2 obesity is the desire to lose weight. This means you will have to be patient, teaching yourself to eat little by little and only healthy food.

Physical activity for stage 2 obesity

The diet itself, no matter how effective it may be, is unlikely to give a positive result if a patient with degree 2 obesity does not pay due attention to physical activity. Moreover, in this situation, not only special exercises play an important role, but also ordinary daily walks, swimming, hiking, cycling and even active work in the country.

As for physical exercises for stage 2 obesity, you can choose them yourself. Still, we are not talking about correcting individual parts of the body, but about losing weight as a whole, which means that any physical activity will be useful. But you can also entrust the matter to a specialist who will select a set of exercises that will help you get rid of extra pounds as quickly as possible, and not allow self-pity to overpower common sense and the desire to be healthy.

In addition, for grade 2 obesity, as with any disease, it is better to select exercise therapy taking into account the patient’s age and state of health, since moderate and severe obesity is often already accompanied by the development of various diseases. Only a doctor can choose effective exercises taking into account the characteristics of the body. In this case, you will have to exercise from 3 to 5 times a week and at least half an hour a day.

Walking, water procedures, elements of gymnastics are the best start to the day for overweight people. Physical activity during the day and visits to gyms and fitness clubs, where an experienced instructor will also provide all possible assistance in the fight against excess weight, will help reinforce their effect.

For obese children, parents should serve as role models for physical activity. Only they can interest the child to move actively, organizing walks in the fresh air, hiking, active recreation near the water, involving him in outdoor games and work.

Drug therapy for obesity

Doctors prescribe medications for grade 2 obesity with reluctance and only in cases where diet and physical activity do not give a visible positive result, and excess weight threatens the development of dangerous health pathologies.

Drug treatment for obesity is somewhat trial and error. There are simply no drugs in the world that are equally effective for all patients to help get rid of extra pounds. And here it is the specialist’s task to select exactly those medications that will give the best result.

There are 2 groups of drugs that help effectively fight excess weight:

• Anorectics are drugs that affect the human brain, in particular the satiety center located in the hypothalamus. They dull the feeling of hunger, reduce appetite, making it easier to tolerate food restrictions suggested by the diet. In our country, drugs based on sibutramine are common: Reduxin, Lindaxa, Meridia, Slimia, Goldline; drugs based on amfepramone (Fepranon) and phenylpropanolamine (Dietrin) are less commonly prescribed.
• Fat and carbohydrate blockers. These medications interfere with the absorption of fats and carbohydrates, responsible for weight gain, in the intestines. And although their effectiveness has been proven even with a normal diet, in case of obesity of the 2nd degree they will give a decent result only in combination with diet and physical activity. The most popular medications are those based on orlistat: the drug of the same name “Orlistat”, “Xenical”, “Orsoten”, “Listata”, etc., as well as dietary supplements such as “Chitosan”, “Reduxin-Lite”, etc.

Effective medications for stage 2 obesity

One of the most popular drugs from the group of anorectics used for obesity are Reduxin capsules. They are prescribed if BMI exceeds 30 kg/m2, which is observed in grade 2 obesity.

Reduxin

It is considered a combination drug, since its effect is due not to one, but to two main components - sibutramine and monocrystalline cellulose. The first affects the receptors responsible for satiety and appetite, and cellulose, due to its pronounced sorption and some detoxification properties, effectively cleanses the body, and the intestines in particular, from harmful microorganisms and their metabolic products, waste, toxins, allergens and other unnecessary substances, promoting rapid weight loss.

"Reduxin" is a serious drug that affects the brain. Prescribing it to yourself is a big health risk, because like every similar drug, Reduxin, in addition to individual intolerance to the drug, has many other contraindications for use. These include multiple heart diseases, circulatory disorders in the brain, excess thyroid hormones, severe kidney or liver pathologies, and angle-closure glaucoma.

This medicine is not prescribed to men for prostate adenoma. It is also prohibited to take the drug for such a rare disease as pheochromocytoma.

The drug should not be prescribed to pregnant women or those who are breastfeeding. It is also contraindicated in patients under 18 years of age, as well as in elderly people aged 65 years and older.

"Reduxin" is not prescribed to persons who have a pathological dependence, either medicinal, drug or alcoholic.

Taking the drug should not be combined with therapy with other centrally acting drugs used for weight correction, taking MAO inhibitors (at least 14 days must pass after the end of their therapy), drugs that affect the psyche and central nervous system, drugs for the correction of sleep disorders based on tryptophan.

Therapy with Reduxin should be carried out under the supervision of a medical specialist after a thorough examination of the patient. This is a necessary requirement, since the drug has several other contraindications related to the cause of weight gain. So the medicine is not prescribed if there are organic causes of obesity associated with internal pathologies, and not with banal overeating (the same hypothyroidism).

It would be inappropriate, and even dangerous, to take the drug for such severe eating pathologies as anorexia nervosa or bulimia, mental disorders, motor tics (Tourette's syndrome).

In this case, treatment should begin with a dosage of 10 mg (the optimal daily dose if well tolerated, which can be halved if necessary). Ideally, the determination of the required dose in the treatment of stage 2 obesity should be determined by the doctor, but not by the patient himself.

Taking the drug should be combined with diet and physical activity, as well as constant monitoring of changes in body weight. If during a month of drug therapy the patient’s weight has decreased by less than 5%, they switch to treatment with a drug with a higher dosage (15 mg).

A three-month course of therapy with Reduxin is indicative, during which the patient’s body weight should decrease by at least 5%. If this is not observed, it is more advisable to look for other methods of combating excess weight.

The duration of the therapeutic course is determined by the doctor, based on the results obtained and the patient’s health condition, but in any case it should not exceed 2 years.

Taking the drug may be accompanied by multiple side effects, which are often observed during the first month of treatment with Reduxin and are not dangerous or irreversible. You may experience dry mucous membranes, headaches, drowsiness, and itching of the skin. Some patients complain of nausea and lack of appetite, constipation, apathy or restlessness, numbness of the limbs, cramps, and swelling. Heart patients experience increased heart rate and increased heart rate and blood pressure. Increased risk of bleeding. Women complain of pain during menstruation. Some note the development of a flu-like syndrome.

All unwanted symptoms should be reported to your doctor. In this case, it is necessary to regularly (once every 2 weeks) measure blood pressure and heart rate. If taking the drug causes an increase in blood pressure, it must be discontinued.

Since only anoretic drugs based on sibutramine have become widespread in our country, all of the above can be applied to the drugs Lindaxa, Goldline, Meridia, and others with a similar composition.

Another thing is drugs that block the absorption of fats and carbohydrates. Here there is already a diversity in both composition and mechanisms of action.

Here you can highlight drugs that prevent the absorption of fats and carbohydrate blockers. The first group includes drugs based on orlistat (Orlistat, Xenical, Orsoten, etc.), as well as most dietary supplements (the same popular Chitosan, dietary supplement Reduxin Light). Among the drugs of the second group, it is worth highlighting the hypoglycemic drug "Glucobay" based on acobase, drugs based on metformin ("Glucophage", "Gliformin", "Siofor", etc.), the hypolipidemic drug "Lipobay" with the active ingredient cerivastatin, an enterosorbent used for treatment of 2nd degree obesity even in children, "Polyphepan".

Xenical

It is one of the most commonly prescribed drugs that limit fat absorption. Its action is based on blocking the production of the digestive enzyme lipase, which is responsible for the digestion of dietary fats (their breakdown and absorption in the gastrointestinal tract). Thus, fats are excreted from the body in practically unchanged form.

Xenical is not absorbed into the blood, but acts directly in the gastrointestinal tract.

Contraindications to the use of the drug are: cholestasis (or stagnation of bile, deficiency of its flow into the duodenum), chronic malabsorption syndrome, when nutrients and vitamins from food are absorbed in insufficient quantities, and, of course, individual intolerance to the drug. With epilepsy, an increase in the frequency of convulsive seizures is possible.

Directions for use and dosage. It is recommended to take the drug during meals or no later than an hour after it. A single dose of the drug is 120 mg of orlistat (1 capsule). The frequency of administration depends on the number of meals per day, since the drug must be taken with each main meal. It is recommended to limit the consumption of foods containing significant amounts of fats, proteins and carbohydrates to 3 times a day. In this case, taking the drug is limited to 3 capsules per day.

If for some reason the patient does not eat within the allotted time, taking the drug at this time is considered optional. The same can be said about eating low-calorie foods with minimal fat and carbohydrates.

There is no point in consuming more than 3 capsules per day as this treatment does not provide better results.

The drug is used with great caution for the treatment of grade 2 obesity in children under 12 years of age and patients with liver and kidney dysfunction.

Despite the small number of contraindications, the drug nevertheless has a significant number of side effects. The most common symptoms are: bloating, changes in the appearance of stool (oily stool) and stool frequency (more frequent urge to defecate, fecal incontinence), discomfort (pain of varying intensity, feeling of heaviness) in the abdomen, headaches. Women complain about disruptions in the menstrual cycle.

Less common are nonspecific symptoms such as respiratory and urinary tract infections, inflammation of the gum mucosa, damage to the integrity of teeth, fatigue and anxiety. Allergic reactions of varying severity are common (rash, swelling of the throat mucosa, bronchospasm, anaphylactic reactions). In rare cases, the development of pathologies such as pancreatitis, hepatitis, diverticulitis, and nephropathy is observed.

Reduxin Light

A dietary supplement for combating excess weight based on conjugated linoleic acid and vitamin E. It also blocks the absorption of fats, due to which, with effective diet therapy and sufficient physical activity, weight loss is achieved.

Despite the fact that this drug is not a complete medicine, it has its contraindications for use. These are chronic cardiac pathologies, periods of pregnancy and lactation, age under 18 years, hypersensitivity to dietary supplement components.

The therapeutic course lasts from 1 to 2 months. Moreover, such courses must be taken at least 3 times a year with an interval between courses of at least 1 month.

Side effects of the drug are not described in the instructions for it. Nevertheless, there is confirmed information indicating a connection between dietary supplements and the development of pathologies such as diabetes mellitus, cholelithiasis and urolithiasis, and hypervitaminosis.

Glucobay

A drug that blocks the absorption of carbohydrates. Acarbose in the drug blocks the production of alpha-glucosidase in the pancreas, which is responsible for the breakdown of sugar into glucose and fructose. This causes complex sugars to lose their ability to be absorbed in the intestines and enter the bloodstream. This action is effective both for diabetes mellitus and for the treatment of excess weight, in particular degree 2 obesity.

Take Glucobay in a daily dosage of 300 mg. The frequency of administration is 3 times a day. It is better to take the tablet immediately before meals or chew it with food.

If the effect is insufficient after 1-2 months of therapy, the dosage can be increased to 600 mg per day.

Contraindications to the use of the drug are chronic pathologies of the gastrointestinal tract with impaired absorption of nutrients, pathologies leading to flatulence, kidney failure, periods of pregnancy and lactation, age under 18 years, hypersensitivity to the drug.

Side effects include: bloating and abdominal pain, decreased bowel movements, nausea, intestinal obstructions, occasionally swelling, allergic reactions in the form of skin rashes.

Drugs called enterosorbents, which bind and remove harmful substances and toxins from the intestines, helping to quickly lose weight, also help in the treatment of many pathologies, including stage 2 obesity.

Polyphepan

A drug from a family of intestinal sorbents that are effective for lipid metabolism disorders, including obesity. It is available in the form of powder, tablets or granules for internal use.

The main contraindication to the use of the sorbent is hypersensitivity to the drug. However, it is undesirable to use it in case of exacerbation of gastric and duodenal ulcers, intestinal atony and gastritis occurring against the background of low acidity of gastric juice.

The daily dose for the drug in powder and granules is calculated based on the ratio: 0.5-1 grams per kilogram of weight per day. The daily dose is divided into 3-4 doses.

The duration of treatment can range from 3 to 14 days at the discretion of the doctor.

Taking the drug in rare cases may be accompanied by constipation and allergic reactions.

Other treatments for stage 2 obesity

Drug therapy for obesity will not be successful unless it is supported by a special low-calorie diet and physical fitness. But even in this case, the struggle with excess weight will continue for more than one day.

Treatment of obesity of the 2nd degree is a long process and requires willpower and a positive attitude from the patient. Often patients, not seeing results in the next couple of months, give up and become depressed. To avoid such situations, it is advisable to supplement obesity therapy with sessions of psychological assistance and the prescription of antidepressants.

In psychotherapeutic classes and hypnosis sessions, patients are taught not only to think critically about their problem, but also to develop correct eating habits, self-control while eating, the ability to resist their desires and the environment during feasts, the ability to deal with stress without resorting to food, etc. .d.

Physiotherapeutic treatment of obesity also shows good results, which, according to experts, ranks second among other methods of treating obesity of degrees 1, 2 and 3. The goal of physiotherapy is to correct the functioning of the endocrine system, normalize metabolism, and stimulate the body’s internal forces to fight pathology.

We have already mentioned the benefits of exercise therapy as one of the methods of physiotherapy above. It is also worth noting such a point as bicycle ergometer tests, which are necessary due to the fact that the body’s reserve forces decline with the increasing degree of obesity.

Massage is an excellent addition to physical therapy, helping to increase tone and relieve fatigue. Sweating procedures also have a good effect (in the absence of cardiovascular pathologies). Examples of such procedures are light, steam and mud baths, wet wraps, paraffin baths, hot procedures (for example, bathhouse, sauna).

It is also important to carry out hydro- and balneo-procedures in this regard. For example, contrast baths with a course of 15-18 procedures carried out daily, sulfide, carbon dioxide, radon, sea, iodine-bromine baths. Various showers have also become widespread in cases of obesity of the 2nd degree: Charcot's shower (from 10 to 16 procedures with a water temperature of 30-35 degrees and a jet pressure of 1.5 to 3 atmospheres, procedure duration 3-7 minutes), underwater shower-massage, fan shower, etc.

A wide variety of physiotherapeutic procedures contributes to effective weight loss in obesity. Unfortunately, not all of them are available in medical institutions, therefore, with stage 2 obesity, patients are often sent to specialized sanatoriums equipped with a variety of equipment for various physiotherapeutic procedures. For example, for climatotherapy (aero-, helio-, thalassotherapy), hyperbaric oxygenation, oxygen foam. In parallel with this, mineral water is taken, which reduces the resorption of dietary fats (Essentuki 4 or 20, Narzan, Borjomi, etc.).

Traditional treatment of obesity 2nd degree

Drug treatment of any disease is fraught with the development of various side effects, which are often more dangerous than the disease itself. Therefore, many patients are looking for an alternative to such treatment in traditional medicine recipes. And there is something in this, especially when it comes to the treatment of stage 2 obesity, which in itself is not as dangerous to health as anorectic drugs used to reduce appetite.

But you can also reduce your appetite with the help of traditional medicines. A decoction of corn silk perfectly reduces appetite. To prepare the medicinal composition, take 10 g of raw material and pour a glass of boiling water, then boil for half an hour and leave to cool. The strained broth is taken 4 times a day before meals, 3 tbsp. spoons.

Oat decoction (whole grain, not flakes) also helps fight excess weight. To prepare it, 2 tbsp. spoons of grain are boiled in a liter of water in the evening until tender. Leave to infuse until morning, then filter and drink half a glass three times a day.

To combat excess weight, ginger tea with honey is also effective, which is best prepared on the basis of natural green tea, adding an infusion of ginger root to it.

Another tasty and healthy drink is chamomile tea with lemon (use half a lemon for 1 glass of tea).

Fasting days with fruit and vegetable juices will also help you fight weight; lemon juice is also effective for weight loss.

In many cases, herbal treatment can perfectly replace drug treatment for stage 2 obesity. Chamomile, lemon balm, mallow, senna, nettle and other herbs will be effective.

Homeopathy for obesity

Homeopathy is considered one of the relatively safe methods of treating stage 2 obesity. And here we already find a wide selection of drugs that help fight both the underlying disease and its consequences.

In case of nutritional obesity due to overeating and consumption of high-calorie foods, the drugs Nux vomica, Ignacy, Acidum phosphoricum and Anacardium will be effective.

If there are disorders of fat metabolism, a homeopathic doctor may prescribe remedies such as Thuja, Pulsatilla, Fucus or Graphitis.

In addition to the main homeopathic medicines, drainage agents are prescribed to help enhance the effect of the former and speed up the result. Such drugs include Lycopodium, Taraxacum, Solidago, Carduus marianus.

Treatment with homeopathic remedies also takes into account concomitant diseases. Thus, for cardiac pathologies, Arnica or Lachesis can be prescribed, for gastrointestinal diseases - Calcium carbonicum, for diseases of the respiratory system - Ipecac or Kalium iodate, etc.

Good reviews from doctors and patients about specific drugs, such as “Grace” (5 granules 3 times a day half an hour before meals) and “Dietol compositum” (8 granules 5 times a day half an hour before meals or an hour after it) . But these medications must also be prescribed by a homeopathic doctor, who takes into account not only the existing diseases, but also the characteristics of the patient’s body.

• Therapeutic diet for obesity
• Diet 8 for obesity
• Diet for obesity 1st degree
• Diet for obesity 2nd degree
• Diet for obesity 3rd degree
• Diet for obesity 4 degrees
• Diet for fatty liver
• Children's diet for obesity
• Three best fasting days

What is obesity?

Obesity is a disease characterized by excessive fat deposition and, as a result, excessive development of adipose tissue. The main factor influencing weight gain is the discrepancy between the intake of calories into the human body and their expenditure. There are also other reasons for the occurrence of this dangerous disease, namely: endocrine disorders, hereditary constitutional predisposition, some physiological conditions (pregnancy, lactation, menopause), professional activity.

Today, over a billion people in the world are overweight and in one of the 4 stages of obesity. In Russia, 50% of women and 30% of men suffer from this, in Germany - every second resident, in Britain and North America - every third, in the USA - every fifth. Excess weight is determined quite simply and the Quetelet index is used for this. It is calculated by dividing a person's mass by the square of his height in meters (weight in kg/height in m2).

Weight is considered normal when the index is: for women – 19-24, for men – 20-25, an indicator above this indicates excess fat deposits. At stage I of obesity, the actual body weight exceeds the ideal by no more than 15-29%, at stage II - 30-49%, at stage III - 50-100%, at stage IV - more than 100%.

Therapeutic diet for obesity

Many special diets for obesity have been developed to treat overweight patients. All of them are based on the principle of reducing the energy value of the diet due to easily digestible fats and carbohydrates with a normal protein content. Foods that stimulate the appetite, table salt (up to 3g) and liquid (up to 1.0-1.2l) are limited. Small meals, 5-6 times a day. To provide the patient with a feeling of fullness, food must contain a lot of indigestible carbohydrates (fiber), and it should be served boiled, stewed or baked. Animal fats are replaced with vegetable oils.

Energy value of therapeutic diet options:

Products that can be consumed without restrictions:

Cabbage (all types)

Cucumbers, tomatoes

Lettuce, greens

Zucchini, eggplant

• Green beans

  Radish, radish, turnip

  Green peas (young)

  Spinach, sorrel

  Tea, coffee without sugar and cream

  Mineral water

  Lean meat (white chicken, turkey, veal, beef)

Vegetables can be consumed raw, boiled, baked, or steamed.

The use of fats (butter, mayonnaise, sour cream) in the preparation of vegetable dishes is not allowed

Foods to eat in moderation:

Milk and dairy products (low-fat)

Cheeses less than 30% fat

Cottage cheese less than 5% fat

Potatoes (no more than 6 tbsp per serving)

Corn

Mature legumes (peas, beans, lentils) (no more than 6 tbsp per serving)

Cereals (no more than 6 tbsp per serving)

Pasta (no more than 6 tbsp per serving)

Bread and bakery products (not rich; coarse bread is preferable, 1 k.)

Fruits (except bananas, dates and grapes)

! “Moderate amount” means half of your usual serving.

Products that need to be excluded or limited as much as possible:

Butter

Vegetable oil (1 tbsp/day)

Sour cream, cream

Cheeses with more than 30% fat content

Cottage cheese more than 5% fat

• Fatty meat (pork, lamb, chicken legs)

  Smoked meats

  Sausages, frankfurters, wieners

  Bird skin

  Canned meat, fish and vegetable in oil

  Nuts, seeds

  Sugar, honey

  Jams

  Candies, chocolate

  From fruits: bananas, dates, grapes

  Pastries, cakes and other confectionery products

  Cookies, pastry products

  Ice cream

  Sweet drinks (Coca-Cola, Fanta)

  Alcoholic drinks

Cooking methods such as frying should be avoided.

Try to use cookware that allows you to cook food without adding fat (steamer).

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Diet 8 for obesity

This diet is used for varying degrees of obesity to reduce a person’s weight and restore impaired water-salt and lipid metabolism. It uses only low-calorie foods. For example, seafood contains large amounts of organic iodine and essential amino acids. Protein foods - low-fat cottage cheese, cod and vegetable oil - ideally combine amino acids, vitamins and a sufficient amount of unsaturated fatty acids.

Food
Bread and flour products	Wheat bread, black and with bran. Allowable consumption is up to 150g per day.
	Mainly vegetable or fruit, from unsweetened fruits. It is allowed to consume vegetable soups with weak meat broth 2-3 times a week. The amount of soup is up to 250g per day.
	It is advisable to use buckwheat, oatmeal and barley cereals in the form of crumbly porridges.
	Low-fat types of fish (pike perch, cod) up to 150-200g per day, boiled or baked. Seafood.
Meat and poultry	Lean meats, chicken, turkey, rabbit up to 150g per day, boiled, stewed or baked.
	1-2 eggs per day, hard-boiled, egg white omelettes.
	Any dishes made from raw, boiled, stewed and baked vegetables. Potatoes are consumed limitedly, up to 200g per day.
Dairy	Cottage cheese, milk and low-fat fermented milk products. Sour cream is only added to dishes.
Fruits and berries	Fruits of sweet and sour varieties, boiled and raw. Jelly, mousses and compotes with xylitol and sorbitol.
	Green tea, coffee with milk, vegetable and fruit (unsweetened) juices, rose hip decoction.
Sauces and spices	Sauces based on weak vegetable and meat broths with dill and parsley. Spices: vanillin, cinnamon, turmeric.
	Vegetable oil in dishes, butter - in limited quantities.

Diet for obesity 1st degree

A person at this stage does not yet consider extra pounds a disease; he usually does not have any complaints. For this category of people, the norm is high physical and mental stress. Only a part of them may complain of general weakness and increased fatigue.

If you do not start getting rid of excess fat deposits during this period, then in the future this can lead to the development of diabetes mellitus and hyperinsulinemia, ovarian hypofunction (in women), and menstrual irregularities. To avoid such complications, active movement during the day and a balanced diet are recommended. It should consist of 60% proteins (including those of animal origin), 25% vegetable fats, 5-8 g of salt and up to 1.2 liters of liquid daily.

Sugar is completely excluded, except that you can use its substitutes. All dishes are prepared without salt; they are added separately. You should eat food at least 6 times a day, little by little.

1st breakfast: low-fat cottage cheese (100g), stewed carrots (200g), coffee with milk without sugar (200g).

2nd breakfast: apple or fresh cabbage salad without salt with a spoon of sour cream (170g).

Dinner: vegetable borscht (200g), stewed cabbage (150g), boiled meat (90g), dried fruit compote without sugar (200g).

Afternoon snack: low-fat cottage cheese (100g), rosehip decoction (200g).

Dinner: boiled fish, for example, pike perch (100g), vegetable stew (125g), green tea (200g).

For the night: low-fat kefir (150g).

The permissible amount of bread for the whole day is 150g.

Diet for obesity 2nd degree

This period is characterized by a slow but sure gain of extra pounds. It is difficult to lose weight, but there is a guarantee that the lost kilograms will not return in the future with an active lifestyle. Treatment of this type of disease requires an integrated approach, combining moderate physical activity and thoughtful nutrition.

Diets at stages 1 and 2 of obesity are similar to each other, therefore, here too, the patient’s daily diet should contain 60% proteins, 25% vegetable fats, 4-8 g of salt and up to 1.2 liters of liquid. All products are consumed raw (vegetables and fruits), boiled, stewed and baked. The daily food intake is divided into 6 small portions.

Prohibited for use:

sweet and puff pastries, cookies,

salted and pickled vegetables, legumes,

fatty meats and sausages,

fatty fish, caviar and canned food,

baked milk and sweet fermented milk products, full-fat cottage cheese,

pasta, milk soups with pasta,

sweet juices, kvass, cocoa, lemonade,

hot and fatty sauces, mayonnaise, hot spices.

Diet for obesity 3rd degree

This stage is characterized by the stability of fat deposits and in order to lose weight a person will need complex therapy. In some advanced cases, surgery cannot be avoided. The well-being of patients sharply worsens, shortness of breath appears at the slightest physical exertion and even at rest, pain in the heart area, headaches, weakness, drowsiness, and decreased performance.

As complications, atherosclerosis, heart and joint diseases, liver and biliary tract diseases, diabetes mellitus, hypertension, pancreatitis, and kidney stones develop. Treatment of patients is best carried out inpatiently, under the supervision of doctors and with one fasting day per week. The daily diet should include up to 80 g of proteins (70% of them of animal origin), 60 g of fats (30% of them of plant origin), 100 g of carbohydrates. The total calorie content of products should not exceed 1300 kilocalories.

Approximate diet for one day:

1st breakfast: boiled meat (90g), vegetable salad with vegetable oil (150g), coffee with milk without sugar (200g).

2nd breakfast: apple (about 100g).

Dinner: vegetarian borscht (200g), stewed cabbage (150g), boiled fish (100g), sugar-free apple compote (200g).

Afternoon snack: low-fat milk (180g).

Dinner: baked meatloaf stuffed with egg (90g), green tea (200g).

For the night: low-fat kefir (150g).

Diet for obesity 4 degrees

Patients who are 100% overweight usually require constant care. They have difficulty moving, cannot climb stairs, wash themselves in the bathroom or travel on public transport. Every step is difficult for them. Such patients have a whole bunch of serious diseases associated with excessive body weight: atherosclerosis, hypertension, diabetes mellitus, pancreatitis, Pickwickian syndrome - respiratory failure.

Obesity at stage 4 requires a comprehensive approach: a special diet and, quite possibly, surgical intervention. Treatment in a hospital, under the supervision of a doctor, is advisable.

Diet for fatty liver

Fatty liver is otherwise called fatty hepatosis, steatohepatosis or fatty degeneration. All these medical terms mean the same thing, namely, the pathological degeneration of liver cells into adipose tissue. Fatty degeneration cannot be called a fatal disease and up to a certain stage it is a reversible process. But if the disease is severely neglected, then a more disastrous result is inevitable - hepatitis or cirrhosis of the liver.

A diet for liver hepatosis involves limiting the consumption of animal fats and easily digestible carbohydrates, increasing protein intake and completely avoiding flour and pasta products, sugar and alcohol. In addition, traditional medicine offers a number of herbal remedies that help rid the liver of excess fat. They are represented by decoctions and infusions of immortelle, milk thistle, rose hips, etc.

Children's diet for obesity

Physicians have recently been particularly concerned about excess fat deposits in children. In Italy, 36% of preschoolers and adolescents suffer from this, in Greece - 31%, in Spain - 27%, in the USA - 26%, in Russia - about 30%. In order not to overfeed children and save them from extra pounds, you just need to follow some recommendations:

Feed babies and teenagers at the same time, 6 times a day, little by little. The first breakfast can be at 8 a.m., and the last light meal no later than 8 p.m.

breaks between meals of 3 hours help reduce appetite and get rid of hunger,

It is advisable to offer high-calorie dishes to preschoolers and schoolchildren in the first half of the day, when they are more active. It is advisable to prepare meat and fish dishes for breakfast and lunch, and vegetable and dairy foods in the late afternoon.

Diet for a child with obesity

A growing child's body must be provided with all useful substances, including vitamins, macro and microelements, and mineral salts. However, the menu of children prone to gaining extra pounds should include limited carbohydrates, especially easily digestible ones. Lamb, beef and pork fats, as well as margarine, should be completely excluded from consumption. Sweet buns, sweets, jam and cookies should be included in the diet of children and teenagers as little as possible. But vegetables in any form and unsweetened fruits and berries are very welcome.

Juices such as tomato, beetroot, cabbage, and carrot are also beneficial for children. They must be prepared only from fresh vegetables. In addition, each child should receive the age-appropriate amount of cottage cheese, meat, fish, milk and other dairy products. For two and three year olds, 80g of meat per day is enough, for preschoolers the norm will be 100g of meat, for schoolchildren 7-12 years old - 150g of meat. The amount of cottage cheese for both preschoolers and teenagers is the same - at least 50g per day. It is recommended to give milk to preschool children 500-600 ml per day, schoolchildren - 400 ml.

Soups are cooked mainly vegetarian; no more than twice a week they can be cooked in diluted meat or fish broth. Steamed meatballs, meatballs and cutlets are prepared from boiled fish and meat. But potatoes, which contain a large percentage of starch, should be included in the menu as rarely as possible. It is also important to teach your child to eat slowly, in this case the feeling of fullness occurs faster and the baby will not overeat.

The three best fasting days - how to lose excess weight

Today, we will analyze the nutrition for obesity menu for every day, compose it in as much detail as possible, varied and, no less important, from affordable and budget products, without any feijoa, foie gras and “unicorn meat”.

Hello, my dear readers! Svetlana Morozova is with you. As you know, I am very careful about nutrition. And I know from myself that sometimes it can be difficult and time-consuming to write out everything, select products for the week, distribute nutrients so that the result is balanced and varied. And if a special diet is required, then it takes a lot of time and effort to choose a truly adequate, complete option on the Internet among a great variety of advice. Therefore, today I want to help everyone who is faced with this search problem.

The path to healthy weight loss

So, you've decided to lose weight. And the best way is dietary nutrition. For obesity, doctors always prescribe

Why him?

• It puts lipid metabolism in order, the disruption of which causes fat to accumulate.
• , activates fat burning processes.
• Makes work easier.
• Improves digestion, relieves stress on the pancreas and intestines.

How are the following results achieved:

1. Mode . The human body is the most precise mechanism in the Universe. And for this mechanism to work like a clock, you need to set it to the correct mode. That is, eating at the same time, the same number of meals every day, taking into account biological rhythms: breakfast is best absorbed if it is eaten within an hour of waking up. And dinner - no later than 3 hours before bedtime. At the same time, we eat 6 times, the portions are small. And every day the same caloric intake. By the way, about calories:
2. Calories. Yes, sadly, you will have to count calories. Level 1 obesity allows up to 1800 kcal daily. For the second, up to 1500 kcal. The distribution of calories should be as follows: the most high-calorie foods occur in the first half of the day. Eat breakfast yourself, share lunch with a friend, and give dinner to your enemy. This is roughly what we will do.
3. Salt . Ideally, therapeutic nutrition requires that food be not salted at all. If you can do that, great. If not at all, then you need to limit salt to 3-5g per day.
4. Water. We control the liquid consumed, 1.5 -2 l. Water is a fat solvent, but if you are prone to swelling, it is better to stick to the lower limit. on will decrease .
5. Proteins fats carbohydrates . The amount of proteins is the same, we reduce the fat content by limiting animal fats, replacing them with vegetable ones. And from carbohydrates we remove simple ones, easily digestible– sugar, flour.
6. The main food is vegetables. These are our vitamins and fiber. It plays the role of a kind of filter because it is not absorbed. As it passes through, it absorbs toxins and excess fat, and digestion works better.

Menu for every day of the week

Monday .

1. Breakfast: oatmeal porridge (200g), bran bread sandwich with cheese, coffee without sugar with milk. 500 kcal
2. Snack : cucumber (about 200g). 30 kcal
3. Dinner: vegetable puree soup (250g), boiled meat (90g), buckwheat (150g), sugar-free compote, a piece of black bread. 510 kcal
4. Afternoon snack: cheesecakes made from low-fat cottage cheese (200g), green tea without sugar. 220kcal
5. Dinner : a piece of baked fish (100g) such as salmon, cod, with stewed vegetables (150g) as a side dish. 250 kcal
6. For the night: a glass of low-fat kefir. 110 kcal

Total: 1620 kcal.

Tuesday .

1. Breakfast: omelet of 2 eggs with milk (250g), a handful of nuts (50g), a couple of dry cookies, green tea without sugar. 700 kcal
2. Snack : apple (about 200g). 100 kcal
3. Dinner : Lenten cabbage soup (250g), boiled meatballs (100g), tomato and cucumber salad (150g), rosehip broth, a piece of black bread. 480 kcal
4. Afternoon snack: cabbage salad with carrots, olive oil dressing (200g). 180 kcal
5. Dinner : vinaigrette with sunflower oil (250g). 200 kcal
6. For the night: glass of yogurt 120 kcal

Total: 1780 kcal

Wednesday

1. Breakfast: millet porridge with milk (200g), beet and apple salad with sour cream (150g), coffee without sugar with milk. 530 kcal
2. Snack: orange (about 200g) 100 kcal
3. Dinner: lean borscht (250g), stewed fish with vegetables (250g), a slice of bran bread, green tea with lemon. 520 kcal
4. Afternoon snack: cottage cheese casserole with sour cream (200g). 220 kcal
5. Dinner: boiled chicken breast (100g), stewed cabbage (150g) 250 kcal
6. For the night: a glass of fermented baked milk. 120 kcal

Total: 1740 kcal

Thursday .

1. Breakfast : oatmeal with milk (200g), 1 boiled egg, chicory drink. 480 kcal
2. Snack : peach (200g) 130 kcal
3. Dinner : sorrel cabbage soup (250g), chicken cutlets (100g), Greek salad (150g), a piece of bran bread, dried fruit compote without sugar. 550 kcal
4. Afternoon snack: a handful of berries (200g). 100 kcal
5. Dinner : macaroni and cheese (200g), bell pepper, tomato, cucumber salad (100g) 300 kcal
6. Before bedtime : a glass of low-fat kefir. 110 kcal.

Total: 1670 kcal

Friday .

1. Breakfast : low-fat cottage cheese with berries (100g), Chinese cabbage and radish salad (150g), bran bread, green tea with lemon. 510 kcal
2. Snack : grapefruit (about 200g) 100 kcal
3. Dinner : mushroom soup (250g), boiled fish (100g), green peas (150g), a piece of black bread, rose hip decoction. 560 kcal
4. Afternoon snack: seaweed salad (200g) 70 kcal
5. Dinner : boiled turkey (100g), stewed zucchini with carrots (150g) 250 kcal
6. For the night: glass of red wine (Friday!) 80 kcal

Total: 1620 kcal

Saturday .

1. Breakfast : buckwheat porridge with milk (200g), pear, sandwich with a piece of cheese, coffee without sugar with milk. 530 kcal
2. Snack: 1 boiled egg, a handful of berries (150g) 180 kcal
3. Dinner : soup with green beans (250g), stewed vegetables with meat (200g), bread, green tea. 490 kcal
4. Afternoon snack: cottage cheese (100g), kiwi (100g) 100 kcal
5. Dinner : stew (150g), sea cocktail (100g). 300 kcal
6. For the night: glass of kefir 110 kcal

Total: 1710 kcal

Sunday .

1. Breakfast : cheesecakes with sour cream (250g), boiled beets (100g), a couple of diet cookies, tea without sugar with lemon. 480 kcal
2. Snack : orange (200g) 100 kcal
3. Dinner : fish soup (250g), buckwheat (100g), boiled meat (100g), cabbage and carrot salad (100g) 550 kcal
4. Afternoon snack: cottage cheese with berries and nuts (200g) 200 kcal
5. Dinner : vegetable casserole (250g), meatballs (100g) 290 kcal
6. For the night: a glass of yogurt 130 kcal.

Total: 1700 kcal.

Bottom line

As you can see, it’s quite easy to stick to this diet for a long time, everything is healthy, natural and tasty.

By the way, if you gain weight too quickly during pregnancy, doctors also advise expectant mothers to eat according to a similar pattern - less fat, carbohydrates and salt, more vitamins, fiber, protein, and liquids with caution.
IN principle, With with help such diets Can fully get rid of from unnecessary weight at obesity 1 degrees. Well And, Certainly, If combine With Happening healthy , approximately on 5 kg V month.

At 2 degrees diet already It has their peculiarities, she must be stricter, more products have to exclude (porridge, bread, pasta), more strict control calories.

Here If obesity already more extensive, 3 And 4 degree, here already, besides nutrition, can appoint reception medications or even surgery.

Table №8 appoint And at obesity liver.
At this You Not Just on a week, two, even Not on month change nutrition, A on all life. You reconsidering habits, diet, That How You you use food, How many once V day, V what situations You start There is more, What You Then feel.

More often Total, V recommendations By fight With obese included visit To psychotherapist. Because What binge eating – This even Not so many cause savings fat, How many way With her cope with.

Not in vain obesity counts disorder food behavior V psychotherapy

If define, Why There is inclination To food lawlessness, lose weight will easier And more efficient.
Healthy image life – little key To slimness on all life.

U you it will work out!

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Before meetings!

Obesity is one of the most serious and dangerous diseases that is the scourge of our time. It requires long-term and complex treatment, the main element of which is diet.

Without restriction and normalization of nutrition, neither medications, nor surgery, nor exercise therapy will help. Therefore, the first step on the path to recovery is a complete review of food products and the preparation of an updated menu in accordance with the requirements of doctors and nutritionists.

General principles of nutrition

Goals of a therapeutic diet for obesity:

• weight loss;
• normalization of lipid metabolism;
• regulation of water-salt balance.

Basic Rules:

• emphasis on plant fiber and dietary fiber;
• fractional meals 5-6 times a day;
• It is forbidden to visit fast food establishments: it is strongly recommended to prepare all dishes with your own hands at home from high-quality products;
• if you salt food, then only after cooking, in your own plate;
• replacing sugar with sweeteners;
• exclusion of fried, mashed, chopped foods;
• maximum daily calorie content - 1,900 kcal;
• limiting spices;
• portions should be minimal;
• cooking methods - boiling, stewing, baking;
• daily increase in protein content (up to 100 g), reduction in fat (up to 80 g, of which 40 g are vegetable), moderate amount of carbohydrates (up to 200 g).

If the patient follows a therapeutic diet in a hospital setting, the caloric content of the daily diet, with the permission of the doctor, can be reduced to 800 kcal.

Product Lists

Diet for obesity, taking into account the seriousness of the disease and the danger of consequences, is. Therefore, the lists of permitted and prohibited products are clearly regulated.

Allowed:

• buckwheat, pearl barley, barley porridge;
• green vegetables enriched with fiber: cucumbers, zucchini, cabbage;
• low-fat dairy products;
• drinks: black, herbal, green tea, rosehip infusion, chicory, coffee with milk;
• lean meat and fish;
• 1 egg per day: hard-boiled or scrambled;
• mild and low-fat sauces: tomato, white;
• flaxseed, sunflower, olive oil (15 ml per day);
• butter (5 grams per day);
• fresh berries and fruits - not very sweet;
• : vegetable, fish, with cereals, meatballs, beetroot soup, cabbage soup, borscht;
• bread: rye, wheat, whole grain, coarsely ground;
• berry and fruit compotes, jellies, mousses.

Prohibited:

• alcoholic drinks;
• grapes, raisins, dates, bananas, figs;
• baked goods from yeast, puff pastry, shortbread dough;
• animal fats;
• fatty meat and fish;
• canned food;
• pasta, semolina, white rice, beans;
• dairy products with a high percentage of fat content;
• spicy and fatty sauces: mayonnaise, mustard, horseradish;
• packaged juice, jelly, kvass, cocoa;
• sweet confectionery, ice cream, candies, chocolate;
• pickles and marinades;
• offal;
• fast food;
• bread: white, made from premium flour, buns.

If you are overweight, these two lists will become your guides for a long time in organizing proper nutrition and creating a diet menu. Depending on the severity of the disease and individual characteristics, the doctor may adjust the diet, so be sure to follow his recommendations.

Author's diets

If you are overweight, a therapeutic diet is prescribed exclusively by specialists. However, they are also developed only by doctors. There are 2 proprietary methods, the most popular today.

Pevzner

First of all, for the treatment of obesity of all degrees, diet number 8, which was developed by Manuil Isaakovich Pevzner, is taken as a basis. The Soviet general practitioner and nutritionist has many scientific works on digestion and proper nutrition to his credit. Dietary table No. 8 may seem too rigid and strict only at first glance. In fact, it offers a varied and tasty menu. Depending on the severity of the disease, you can vary dishes within the permitted foods and daily caloric intake.

This system reflects all the postulates that were stated above: frequent and small meals, reducing daily calories, reducing fat.

The Pevzner diet has several options.

• basic recommendations and product lists;
• This diet has been developed for type 2 diabetics with obesity and other concomitant diseases;
• differs in variability and an expanded list of permitted products;
• duration - up to six months.

Table No. 8a:

• recommended for excessive excess weight and the absence of concomitant diseases;
• characterized by a reduction in daily calorie content to 1,100 kcal;
• quantitative composition of BJU: proteins - 80 g per day, carbohydrates - 70 g, fats - 60 g;
• duration - no more than a month (the doctor selects this parameter individually).

Table No. 8o:

• it is prescribed quite rarely, since it is designed for the treatment of obesity of II and III degrees in the absence of health problems, which is practically impossible;
• reducing the daily calorie intake to 700 kcal;
• requires constant supervision by a specialist;
• quantitative composition of BZHU: proteins - 50 g per day, carbohydrates - 60 g, fats - 30 g;
• duration - no more than 2 weeks.

Pokrovsky

Much less known is the reduced (low-calorie) Pokrovsky diet, which can also be used in the complex treatment of this disease.

Alexey Alekseevich Pokrovsky was a Soviet biochemist and academician of the Academy of Medical Sciences. His scientific works are devoted to the effect of products on cell membranes. For a long time he headed the department that clarified nutritional standards for different groups of the population.

Basic postulates:

• exclusion of foods and dishes that stimulate the appetite;
• the use of “zigzags” in nutrition - contrasting and;
• multiple meals;
• limited consumption of easily soluble and quickly absorbed carbohydrates - sugar and jam;
• daily restriction of salt (up to 5 g) and liquid (up to 1.5 l) to normalize water-salt metabolism;
• reducing the amount of animal fats by increasing vegetable fats;
• the feeling of fullness is achieved by large volumes of low-calorie foods (fruits, vegetables).

Sample menu for two contrasting days

Examples of fasting days (arranged once a week):

• : drink 1 glass of low-fat milk or kefir every 2 hours;
• : 400 grams of low-fat cottage cheese, 50 grams of low-fat sour cream, 2 cups of coffee without sugar, 2 cups of rosehip infusion;
• : 350 g of boiled chicken with vegetable side dish, 2 cups of coffee without sugar, 2 cups of rosehip infusion;
• : 1 kg of fresh green apples or vegetables (cucumbers, cabbage, tomatoes are suitable);
• fat: 300 grams of the fattest sour cream, 2 cups of coffee with heavy cream without sugar.

Diets for different degrees

Depending on the severity of the disease, specialists adjust diets, so it’s a good idea to see the differences between these options.

Individual cases

In addition to generally accepted postulates and dietary tables, specialists necessarily focus on special, individual cases of obesity. Each of them requires minor but important changes in diet:

• with the visceral type, it is prohibited to include fats and fast carbohydrates in the menu;
• for fatty liver, dietary table No. 5 is prescribed;
• if women are overweight, the consumption of protein foods can be reduced, while men cannot do this in any way: their diet must include lean meat every day;
• if excess weight is accompanied by diabetes, it is possible to use not only table No. 8, but also No. 9;
• when a special menu is drawn up, which necessarily contains a lot of plant fiber and carbohydrates (they need energy), a special role is given to delicious desserts with a minimum amount of sugar;
• Table No. 10 is recommended;
• for abdominal pain, the DASH diet is most often prescribed, which wisely combines lean meat, fish, vegetables, fruits and low-fat dairy products in the diet;
• A diet for overweight adolescents during puberty is developed very carefully: it must be balanced and avoid deficiencies of vitamins and microelements.

These points must be taken into account when choosing a power system.

Sample menu for the week

If it is not possible to take into account all the nuances of the disease and use the help of specialists, you can always take a universal menu for the week. It is suitable for the treatment of any type of obesity. It is based on table No. 8 according to Pevzner.

Menu for 7 days

Diets for obesity are therapeutic, since their main goal is to cure a person from this disease. But at the same time, it is necessary to use other methods - exercise, take medications that block appetite and normalize digestion. Surgery may even be necessary. In the fight against excess weight, you need to use all known methods.

Diet 8 for obesity (otherwise called table 8, Pevzner diet) is a special diet with reduced energy value, developed for people with high body weight: alimentary obesity. Allows you to achieve weight loss to a physiological level or close to it, normalize metabolism, but is designed for a long period of time.

Diet No. 8, as well as its variations 8A and 8o, is the main therapeutic diet for the treatment of obesity, was developed back in the 30s of the last century by the Soviet gastroenterologist and scientist Mikhail Pevzner. The effectiveness of the method has been tested by several generations of people.

The level of modification of the energy intensity of consumed food depends on the degree of obesity and individual energy needs of a person (age, gender, level of physical activity, work intensity). The energy value of the diet varies: 1400-1800 Kcal for women and 2100-2700 Kcal for men:

• 90-110 gr. protein (60% of the animal);
• 80-85 gr. fats (30% vegetable);
• 150-170 gr. carbohydrates.

Salt is limited to 5-6 g/day. The volume of freely consumed liquid is about 1-1.5 liters.

A few words about obesity

Nutritional obesity develops when the calorie content of food consumed exceeds energy expenditure. Body weight and the volume of subcutaneous fat gradually increase, which is distributed approximately equally.

There are 4 degrees of nutritional obesity:

• I - actual mass is 15-29% more than normal;
• II – excess weight by 30-49%;
• III – weight above normal by 50-100%;
• IV – weight exceeds the norm by more than 100%.

The basis of obesity treatment is a special diet and properly selected physical activity.

You can roughly determine your normal weight using Brock's formula: subtract 100 from your height in centimeters. Of course, this is not an exact value, but a figure to guide you by.

Indications for diet for obesity

• Diet No. 8 is effective for obesity of 1 and 2 degrees.
• Diet No. 8A is prescribed to patients with grade 3-4 obesity.
• Diet No. 8o is also prescribed for grades 3-4, when no effectiveness is observed when following tables No. 8 and 8A.

Diet Features 8

In more detail about permitted and prohibited foods below, we will outline the general principles of the nutrient composition of the diet. In general, the diet is considered complete, multifaceted, and the diet is voluminous and nutritious. If all recommendations are followed, the body receives a full range of vitamins, fiber and lipotropic substances that oxidize fats (found in fermented milk products, seafood and soy). The energy value is reduced by reducing fats and fast carbohydrates.

Squirrels

The protein content is within normal limits and provides about 20% of the total daily caloric intake; animal proteins slightly predominate over plant proteins. Buckwheat, cabbage, and radish are optimal sources of vegetable protein. Animal proteins (up to 150 g/day) are lean meats. Pork is limited and fatty meat, as well as meat products, are completely excluded. Fish - low-fat varieties, seafood is welcome.

Carbohydrates

Rapidly absorbed carbohydrates are completely excluded. It is not advisable to use sugar substitutes (xylitol, fructose, sorbitol), which have a high energy value.

It is advisable to consume only carbohydrates with a low glycemic index. Widely used: radishes, fresh cucumbers, cabbage of all types, zucchini, turnips, tomatoes; it is better to eat partially raw. Potatoes, carrots, beets, rutabaga, pumpkin, as well as salted and pickled vegetables are limited. Carbohydrates should be distributed evenly between meals.

Bread is excluded altogether or limited to 100 grams. per day.

Fats

Not only the quantitative fat content is important, but also the qualitative one. Limiting fat to 30% of the calorie intake should be achieved through the introduction of low-fat foods. It is important that the body receives mono- and polyunsaturated fatty acids in equal proportions, which are rich in vegetable oils: flaxseed, olive, mustard.

Fiber and dietary fiber

In order to create a feeling of fullness, the diet increases the content of foods with a high amount of dietary fiber: raw vegetables, bran, herbs. Having low calorie content, they create the required volume and increase the feeling of fullness.

In addition to the diet, fasting monodays are introduced 1-2 times a week with an energy value of about 1000 Kcal:

• apple - up to one and a half kilograms of fresh apples per day;
• cottage cheese - up to half a kilogram of low-fat cottage cheese + 2-3 glasses of green tea;
• watermelon - up to 1.5-2 kilograms of watermelon pulp;
• kefir - up to 1.5 liters of kefir.

Features of diets 8A and 8o

These are more restrictive diets that are prescribed to patients with high degrees of obesity. They are distinguished by a reduced energy content of the diet.

Table 8A involves limiting the energy value of the diet to 1200-1300 Kcal:

• 80 gr. proteins (up to 70% animal origin);
• 60 gr. fats (30-35% vegetable fats);
• 130 gr. carbohydrates.

In case of obesity of III-IV degree and the ineffectiveness of the diets described above, an 8o table with an energy value of 600-800 Kcal is prescribed:

• 40-50 gr. proteins;
• 30-40 gr. fat;
• 50-70 gr. carbohydrates.

Free fluid is limited to 0.8–1.2 l/day. It is prescribed for a period of no more than a month and only in a hospital, under the supervision of doctors.

When introducing diets 8A and 8o, you cannot start with a low-calorie diet. First, a moderately reduced diet is introduced (table 8), and a gradual transition to low-energy diets is made. With such a smooth transition, the body does not experience serious stress and gradually adapts to a hypocaloric diet. Fasting, a sharp reduction in calories and strict mono-diets aggravate an already impaired metabolism.

Why is it important?

People who begin their journey to an ideal weight by sharply restricting food calories and completely eliminating their favorite foods face food depression - persistent psychological discomfort and dissatisfaction with the diet they have to follow.

In studies by Japanese scientists, it was found that a monotonous and tasteless diet has a negative effect on the psyche of a person losing weight. There is progressive apathy, depression, anxiety, irritability, poor sleep and dissatisfaction with one's life. This condition is due to the fact that when following a diet, the body experiences a lack of useful and necessary elements for the body, and the brain is in a stressful state.

Very often, food depression often disrupts weight loss: in an attempt to regain the lost taste of life, a person begins to mindlessly and uncontrollably consume forbidden foods, overeats, but still does not get the pleasure from food that he had before. This condition is more typical for women.

Eating depression causes great harm, so doctors warn people against strict diets and sharp restrictions on their usual diet. Even if they are prescribed for health reasons, it is necessary to reduce the caloric content of the diet and avoid harmful foods gradually. You should also learn how to correctly use acceptable seasonings and spices (dill, parsley, etc.) - they can give even a dietary dish a pleasant taste and aroma.

Remember! The higher the degree of obesity, the longer the adaptation period lasts, i.e. Caloric and dietary restrictions should be gradual.

If you need to adhere to a low-calorie diet, it is important to control not only your weight, but also your overall well-being and health. If side effects such as weakness, nausea, fatigue, chills, the smell of acetone from the mouth, gastrointestinal dysfunction, dry skin, menstrual irregularities in women, heart rhythm disturbances develop, the diet should be discontinued. In light of the possible development of such complications, serious diets should only be carried out under the supervision of a physician.

Authorized Products

The main permitted products are presented in the table; similar, extended tables can be found on the Internet and printed for clarity. They can and should be consumed, but not exceed the daily calorie content.

Product	Squirrels, gr.	Carbohydrates, gr.	Fats, gr.	Number of kcal per 100 g. product
Vegetables and fruits
Zucchini	0,6	4,6	0,3	24
Broccoli	3,0	5,2	0,4	28
Cauliflower	2,5	5,4	0,3	30
Tomatoes	0,6	4,2	0,2	20
cucumbers	0,8	2,8	0,1	15
Soybeans	34,9	17,3	17,3	381
Baked apples	0,5	12,3	0,5	59
Fresh green apples	0,42	9,7	0,41	47
Cereals and porridges
Oatmeal porridge on water	3,0	15,0	1,7	88
Viscous buckwheat porridge	3,2	17,10	0,8	90
Wheat bran	15,1	53,6	3,8	296
Rye bran	11,2	32,0	3,2	221
Bread
Whole grain bread	10,1	57,1	2,3	295
Bran bread	7,6			272
Rye bread	4,7	49,8	0,7	214
Dairy
Skimmed milk	2,0	4,8	0,1	31
Low-fat cottage cheese 0%	16,5	1,3	0,0	71
Kefir 0%	3,2	4,5	0,1	32
Meat and meat products
Lean beef	22,2	0,0	7,1	158
rabbit	21,0	0,0	8,0	156
Boiled chicken breast	29,8	0,5	1,8	137
Boiled chicken drumstick	27,0	0,0	5,6	158
Boiled chicken fillet	30,4	0,0	3,5	153
Boiled turkey fillet	25,0	—	1,0	130
Fish and seafood
Boiled fish	17,3	0,0	5,0	116
Pike	18,4	—	0,8	82
Zander	19,2	—	0,7	84
Cod	17,7	—	0,7	78
Squid	21,2	2,0	2,8	122
Shrimps	22,0	0,0	1,0	97
Mussels	9,1	0,0	1,5	50
Fats and oils
Sunflower oil	0,0	0,0	99,0	899
Linseed oil	0,0	0,0	99,8	898
Beverages
Green tea	0,0	0,0	0,0	—
Black tea	20,0	6,9	5,1	152
Mineral water	0,0	0,0	0,0	—
Tomato juice	1,1	3,8	0,2	21
Rosehip compote	0,1	17,6	0,0	70

The amount of product consumed is calculated taking into account its calorie content and the permissible energy value of the daily diet. For example, 50 gr. bran bread for breakfast will be: 272:2 (do not forget that the calorie content in the table is per 100 grams of product) = 136 Kcal. We subtract these 136 Kcal from the daily calorie content, for example: 1700-136 = 1564 Kcal - the remainder of the calorie content for the day and the rest of the products. In a similar way, the amount of proteins, fats and carbohydrates that each product contains in a certain amount is calculated.

Features of diet preparation

• Bread: rye and bran up to 100 g/day;
• Breakfast: porridge, dishes with eggs, cottage cheese;
• Soups: with vegetable broth, once a week - with low-fat fish or meat broth, without salt. The meat for the soup is boiled for 15 minutes, the first broth is drained, the meat is filled with water, i.e. a secondary broth is obtained;
• Second courses: with lean boiled beef, rabbit, lean poultry (100 g/day), or low-fat fish - pike perch, pike, cod, carp, seafood - shrimp, mussels, squid.
• Garnish: vegetable - tomatoes, cucumbers, cabbage, lettuce, zucchini (up to 200 g/day).
• Dairy products: curdled milk, kefir, low-fat milk, low-fat cottage cheese.
• Appetizers: vinaigrettes, vegetable salads with vegetable oil.
• Drinks: black and green tea, natural coffee (not strong), mineral water, unsweetened fruit, berry and vegetable juices, compotes. The total volume is 5-6 glasses per day, including soups.
• Culinary processing: steamed, boiled and stewed, baked dishes.

Prohibited and Restricted Products

Foods that should not be consumed are a strict recommendation and should be followed. The following are completely excluded from the diet:

• bakery products made from premium flour and wheat bread;
• confectionery, cookies, candies, chocolate, sugar, jam, preserves, honey, ice cream, jelly;
• any alcohol and alcohol-containing drinks;
• fatty meat: goose, duck, fatty pork, meat products - sausages, ham, frankfurters, pates, canned food, offal, stewed meat, lard;
• instant food products;
• fatty fish: sprat, herring, mackerel, eel, sturgeon, halibut, saury, catfish, caviar;
• beef, pork, confectionery fat, spreads;
• strong broths with meat, fish and mushrooms;
• cream, full-fat cottage cheese, sweet yogurt, glazed cheese curds, fermented baked milk, baked milk, salty and fatty cheeses;
• rice, legumes;
• bananas, grapes, melon and other sweet fruits;
• dates, figs, raisins, nuts, seeds, dried fruits;
• semolina;
• pasta;
• salted, fried, smoked foods;
• spicy and fatty snacks;
• juices from sweet fruits and berries;
• cocoa;
• mayonnaise and spices that stimulate appetite: pepper, mustard, horseradish, various seasonings and fatty hot sauces.

The consumption of potatoes, carrots, rutabaga, beets, and salt (5-6 grams) is limited, and in case of persistent hypertension, it is completely excluded.

Diet menu for obesity

The diet is based on permitted foods. Fractional meals are provided (5-6 meals), in small portions, snacks are excluded.

75% of the diet should be consumed during the day, up to 16 hours. You should not eat food at night.

Menu for a week for obesity of 1-2 degrees:

Monday
Breakfast	low-fat cottage cheese 1 apple
Lunch	unsalted dietary cookies sour fruit juice
Dinner	vegetable soup boiled fish with lettuce unsweetened compote
Afternoon snack	mineral water bread
Dinner	baked jacket potatoes tomato salad currant compote
Tuesday
Breakfast	viscous buckwheat porridge hard-boiled chicken egg whole grain bread green tea
Lunch	2 baked apples
Dinner	vegetarian cabbage soup boiled chicken fillet vegetable stew from zucchini, tomatoes, herbs compote
Afternoon snack	vegetable juice rye bran
Dinner	skim cheese carrot and apple puree curdled milk
Wednesday
Breakfast	oatmeal porridge with berries (cranberries, red currants) low-fat cottage cheese Apple juice
Lunch	baked apples low-fat yogurt (1-2%)
Dinner	broccoli soup lean boiled beef with natural tomato paste weak coffee without sugar
Afternoon snack	low-fat cheese compote
Dinner	seaweed salad whole grain bread low-fat kefir
Thursday
Breakfast	Steam omelette Green tea
Lunch	Low-fat cottage cheese with lingonberry sauce compote
Dinner	buckwheat soup with vegetables steamed turkey fillet green mix salad
Afternoon snack	diet cookies fruit juice
Dinner	boiled fish cucumber salad tomato juice
Friday
Breakfast	cottage cheese casserole made from low-fat cottage cheese green tea
Lunch	baked apples bread
Dinner	slimy oatmeal soup boiled beef radish, celery and green onion salad
Afternoon snack	vegetable caviar kefir
Dinner	boiled shrimp the vinaigrette compote
Saturday
Breakfast	steamed cheesecakes natural coffee without sugar
Lunch	baked apples
Dinner	vegetarian borscht baked rabbit with vegetables sea ​​and white cabbage salad
Afternoon snack	curdled milk bread
Dinner	fishmonger fresh tomato salad vegetable juice
Sunday
Breakfast	poached eggs (2 pcs)
Lunch	sandwich with low-fat cheese and whole grain bread 1 raw apple
Dinner	spinach soup boiled chicken with lemon juice buckwheat stewed with carrots and onions compote
Afternoon snack	low-fat cottage cheese, seasoned with yogurt lemon jelly
Dinner	boiled fish apple and carrot salad vegetable smoothie made from celery, tomatoes, cucumber and mineral water

The specified diet for a week is conditional - dishes and their combination can be changed. The most important thing in a daily diet for obesity is not to exceed the daily calorie intake established by your doctor.

Diet variations (8A and 8o) do not fundamentally differ in the composition of the products, but the calorie content of the diet is reduced due to smaller portions in weight and the amount of proteins, fats, and carbohydrates.

Pros and cons of diet No. 8

Benefits of the diet:

• safe, gradual weight loss that occurs without stress to the body;
• affordable diet - all products and dishes are quite affordable, available all year round (you need about 1,200 rubles for a week);
• suitable as a regular meal for obese people;
• with full, long-term compliance, it leads to normalization of body weight.

Flaws:

• weight loss is very slow, and may be completely absent in the first month. This means that some people will have to stick to the diet for several years. However, from a medical point of view, this is a plus - only gradual weight loss is safe for health;
• Psychological breakdowns are possible, so a therapeutic diet should be prescribed under the supervision of a doctor.

Nutritionist opinion

The therapeutic diet according to Pevzner refers to a balanced, energy-reduced diet, is not a “starvation” diet and is well tolerated by patients. The weight loss that can be achieved by following the table is minus 1% per week. In addition to diet, feasible physical activity is recommended to achieve increased neuromuscular tone and good health. Exercise helps the body speed up the adaptation of metabolism, quickly switch to new eating behavior, and maintain muscle mass. It is important that the load is equivalent to individual physiological capabilities, without excessive training, which causes the opposite effect. Walking is recommended, from 3 to 10 km per day, Nordic walking, swimming, cycling.

A huge impact is being placed on reconsidering eating behavior. Many obese people view eating as the main pleasure in life, and eat not only to be full, but also to cope with stressful situations, failures, bad mood, apathy, and depression. To properly motivate yourself to achieve results, individual and group psychotrainings, hypnosis, as well as support from loved ones are recommended. Frequent walks in the fresh air help a lot. If losing weight is associated with violence against the body and a feeling of constant hunger and discomfort, the result will be negative and will lead to a psychological breakdown, weight gain and even more weight gain.

It is important to adequately assess the situation and not set excessive goals - to lose weight to a comfortable level, and not to model parameters.

Diet for obesity associated with diabetes

Obesity and diabetes very often go hand in hand: impaired metabolism leads to weight gain, which can be very significant. For diabetics, following a diet is vital - it is strictly forbidden to gain everything, but also to starve: such experiments can result in severe hypoglycemia, ketoacidosis and diabetic coma.

Obese people have probably noticed that whenever they visit a doctor, they are prescribed a blood test for sugar, and this is true: uncontrolled weight gain is the cause of diabetes in 44% of cases.

Why are obese people prone to diabetes?

To answer this question, you need to understand the functions and characteristics of adipose tissue.

So, adipose tissue is distributed evenly throughout the body (normally), making up about 20-25% of body weight in men, and 20-25% in women. There are 2 types of adipose tissue in the body - each has its own structure and performs different functions:

• brown, coli 5%. Its amount decreases with age. It is localized in the heart, kidneys, neck, upper back and shoulders. Performs the most important function - it processes fat deposits in white tissue and turns it into energy, which is used for the needs of the body.
• white, about 95% of all adipose tissue. It is localized under the skin of the abdomen, buttocks, thighs, in the mesentery, omentum and under the peritoneum. The tissue accumulates fat and retains energy reserves, protects internal organs from mechanical damage and creates a kind of cushion for them, performs a thermal insulation function, accumulates fat-soluble elements and substances, and also releases substances into the blood that affect the sensitivity of tissues to insulin.

It is white adipose tissue that is involved in the pathogenesis of diabetes mellitus, to a greater extent surrounding the internal organs (visceral). It is well supplied with blood and innervated. The tissue is also rich in beta-adrenergic receptors, which are highly sensitive to the action of catecholamines - hormones of the adrenal cortex, but has few alpha-adrenergic receptors. The latter, in turn, are the most sensitive to insulin. As a result, white adipose tissue is more sensitive to the action of a number of hormones that break down fats into fatty acids, and less sensitive to the action of insulin, which prevents their breakdown. This situation leads to a decrease in the sensitivity of tissues and organs to insulin and metabolic disorders.

It is insulin that slows down the breakdown of fat cells into components, which means it inhibits the release of large amounts of fatty acids into the blood and processes glucose, which enters the body with food. People with normal weight maintain a balance between the work of fat-breaking hormones and insulin. In obese people, excess adipose tissue affects not only the appearance, but also the organs: there is an increased level of hormones in the blood that break down fats to form fatty acids. There are more receptors that bind these hormones than there are receptors for insulin: free fatty acids are formed in huge quantities, and insulin cannot stop this. Fatty acids enter the liver cells to a greater extent and interfere with the binding of insulin. First, the liver becomes resistant to insulin, and then other tissues and organs.

Glucose does not enter the cells, remains in the blood: organs and tissues do not receive energy, energy hunger is formed, which further increases appetite - already 1 hour after eating a person feels hungry, because. cells that have not received nutrition send a signal to the brain. The hypothalamus is stimulated and the person feels hungry.

In parallel, against the background of energy starvation, free fatty acids accelerate the production of glucose in the liver and hyperglycemia (high blood sugar) worsens - it affects the brain, heart and skeletal muscles. In response, the pancreas produces even more insulin, but gradually the body's strength is depleted - a persistent deficiency of the hormone develops. It is in this complex way that excess weight becomes the cause of type 2 diabetes.

It is necessary to fight excess weight, even if a person has diabetes, a disease that a priori complicates this fight and in itself leads to weight gain.

Additional motivation for patients should be:

• the possibility of reducing blood glucose levels, and therefore reducing the dose of medications taken, insulin therapy;
• reducing the risk (or severity, if the disease already exists) of arterial hypertension and coronary artery disease, which can become fatal;
• reducing the risk of diabetes complications that worsen the quality and life expectancy: diabetic retinopathy, nephropathy and limb damage;
• a chance to extend your life.

General principles

The approach to a diet for diabetes mellitus for patients receiving replacement therapy varies between domestic doctors and Western specialists. In the West, it is believed that the diet should not strictly limit simple carbohydrates. Domestic medicine dictates the exclusion of simple sugars from the diet.

Proper nutrition during the initial stage of the disease is considered not only as an opportunity to stop the progression of diabetes, but also as a therapeutic factor - you can not only reduce the dose of glucose-lowering medications taken, but also abandon them (of course, not on your own, but as prescribed by a doctor). Table No. 9, developed back in Soviet times, is still relevant today – it is prescribed to patients undergoing treatment in a hospital. Principles: Reducing total calories, severely limiting or eliminating simple carbohydrates, and reducing the amount of fat, especially animal fat. But the features of the diet are always adjusted by the doctor, taking into account the degree of increase in blood sugar, the weight and age of the patient, concomitant pathologies, energy problems and others. Read about therapeutic nutrition for diabetes in our detailed article.

Only comfortable weight loss with gradual, smooth weight loss guarantees that the weight will not return after the end of the diet. Of course, you will have to adhere to the right diet and physical activity, but these are not sacrifices, but the basis of health and longevity!