The men took the weight of the women.
Antonina Vladimirovna! At the beginning of the summer, a psychologist-narcologist from the Moscow Department of Health listed addiction to coffee, addiction to work and commitment to material comfort among the top three bad habits of Muscovites. What do you think?
Antonina Starodubova: I would put smoking, alcohol abuse and, of course, low physical activity in the first place among bad habits. But as a nutritionist, I want to talk about non-compliance with the principles of healthy eating.
It is probably no coincidence that he has devoted more than 150 scientific publications to the topic of obesity. Do many Muscovites suffer from it?
Antonina Starodubova: According to Rosstat and the Federal Research Center for Nutrition, Biotechnology and Food Safety, about 22% of Russian adults are obese and about 62% are overweight. Moscow is not among the leading regions in the prevalence of obesity or overweight. Although the tendency to increase body weight is already observed throughout the world, even in Mediterranean countries, where previously the lifestyle and eating habits helped the population to avoid such risks.
In our country, for whom is this problem more acute, for men or for women?
Antonina Starodubova: In Russia, for a long time, obesity was considered more of a female problem. Over the past decade, the situation has radically changed: the difference in the prevalence of male and female obesity has decreased, and it can be said that obesity in men has become more common than in women.
how can you explain this?
Antonina Starodubova: Unfortunately, men, like women and children, began to move less. Not everyone can refuse or at least limit the intake of high-calorie, fatty, sweet or salty foods, which have become more affordable these days. But obesity is not always associated with overeating. A person may have endocrinological and other diseases, as well as psychological problems, which can also contribute to the appearance of overweight.
Fashion for sports and diets
Like all doctors, you talk about the health benefits of movement. But let’s take a look at Moscow. More and more young people run in the mornings and go to work not by subway, but by bicycle, gyms are full of people, in city parks, Moscow Longevity participants practice Nordic walking with coaches paid by the city budget. Is there any benefit from this?
Antonina Starodubova: I think that the fashion for movement and sports, and what the city is doing to promote and introduce a healthy lifestyle, will have a lagging effect, which we will see over time based on statistical data. But even if a person, due to increased physical activity, manages to fix body weight, improve well-being and improve mood, this is already a very good result. And a gradual decrease in body weight by 5-10% during the year for an obese person is also a significant reduction in the risks of cardiovascular diseases and diabetes. But once again I emphasize: weight loss should occur slowly, gradually. A sharp decrease can lead to weakness, exacerbation or the appearance of certain diseases, and subsequently also an increased risk of the so-called rebound, sometimes even more pronounced weight gain.
Is it worth going on a diet? There are already many…
Antonina Starodubova: As a doctor, I will note: any diet is a medical intervention for a certain period, and the results of this intervention must be monitored by a specialist. One visit to a nutritionist, endocrinologist, therapist or doctors of other specialties is not enough, examination, diagnosis, treatment and implementation of medical recommendations are necessary for a long time. In all other cases, the word diet should not even be used.
Infographic “RG” / Anton Perepletchikov / Lyubov Protsenko
Our Clinical Nutrition Clinic of the Federal Center for Nutrition Research and Biotechnology is often treated by patients who have made a “successful diet” on their own. In a short period of time, they could lose weight, for example, by 30 kilograms, and then, unfortunately, the body weight increased again, sometimes up to 50 kilograms. To avoid this, it is necessary to follow the principles of a healthy lifestyle and healthy eating, undergo a medical examination in a timely manner and sharply limit the diet only on the advice of a doctor.
We don’t count calories.
What is a healthy diet? No formulas?
Antonina Starodubova: First of all, varied and tasty food. And there are also three laws, which are always remembered by the scientific director of our center, academician of the Russian Academy of Sciences Viktor Tutelyan. The first is the law of correspondence between the energy we consume, the caloric content of food, and our energy intake. That is, “how much did you eat, how much do you want to spend”! The second is the law of utility and equilibrium. Due to food, we need to provide the body with everything it needs: proteins, fats, carbohydrates, vitamins, minerals and other substances, in certain amounts and proportions. And the third, which we most often forget, is compliance with the diet. These are the three main meals: breakfast, lunch and dinner. Also, light snacks are possible between them.
So how do you follow these laws? Do you count calories?
Antonina Starodubova: No, now nutritionists do not recommend counting calories. It is enough for an ordinary person to know the principle of a dish. It should be 20-25 centimeters in diameter. We mentally divided it into four parts. We put white meat, poultry, for example, or low-fat red meat, say, veal or fish for a quarter for lunch – in a word, a complete protein source. Fill the second part with porridge or durum wheat pasta – complex carbohydrates. And half of the plate – vegetables – there are more – and fruits or berries – sources of dietary fiber, minerals and other nutrients. There must also be clean water to quench your thirst.
Are there foods that nutritionists prohibit?
Antonina Starodubova: Nutritionists do not forbid anything. But we recommend a series of restrictions. First of all, the edible salt. On the day, it is recommended to use a total of no more than 5 grams, one teaspoon (this is in all dishes). And the average Russian consumes up to 11-13 grams of salt. To reduce the amount of salt, it is worth giving up “salting” at the table, eating less pickles, salted fish, sausages and other long-term storage products, where there is a lot of salt. Keep in mind that from bread we get a significant amount of salt in the diet, so it is better to buy low-salt and unsalted bread or cook it at home, which will allow you to control the salt content.
It is important to control and consume sugar. According to existing recommendations, it should be up to 10% of the daily energy value of the diet, which, in terms of the average citizen, is 50 grams per day. But now scientists are pushing for a reduction of up to 5%, or 25 grams per day. Saturated fats, found in animal products, as well as trans fatty acids found in baked goods, margarine, fried foods, and fried foods, should also be limited.
What exactly leads to obesity?
Antonina Starodubova: There are a number of factors, they can be different for patients. Some of them cannot be influenced, for example, genetic predisposition, diseases that lead to weight gain, the effect of drugs, age-related changes in metabolism. But there are factors that we can change: sleep and wake patterns, physical activity and, of course, diet. The main reason for weight gain is due to the fact that we eat more than we need.
The Museum of Bad Habits showed what deviations from a healthy diet can lead to.Photo: Alexander Korolkov
Heart, liver, joints…
The museum of bad habits showed how all our abuses affect different organs…
Antonina Starodubova: Obesity is an excessive accumulation of adipose tissue, mainly visceral, which does not accumulate subcutaneously, but in the abdominal cavity, around vital organs, mainly the heart. It is the excess content of visceral adipose tissue that adversely affects health. Its excess can occur not only in obese patients, but also in people with normal body weight due to the fact that the body composition is disturbed, there are few muscles.
This is especially true for patients with a sedentary lifestyle. These people suffer from high blood pressure, and someone suffers from early cardiovascular events in the form of myocardial infarction and stroke. They are also at higher risk of developing type 2 diabetes. Liver damage is one of the major problems today. A new term has even appeared: metabolically associated fatty liver disease, which is precisely associated with the pathological accumulation of fat in the liver with malnutrition and low physical activity, while until recently it was believed that this organ mainly suffered from dependence on alcohol.
Let’s not forget about the increased load on the joints: knee, hip, spine, which are under constant pressure from a larger body mass and therefore “wear out” and deform earlier, which leads to the early onset of osteoarthritis, osteoarthritis, its severe course and rapid progression, the emergence of the need for replacement of the hip or knee joints. I cannot fail to mention the increased risk of oncological diseases, many of which are much more common in patients with obesity than in patients with normal body weight. At the same time, both directly, due to obesity, such as cancer of the endometrium, gallbladder, esophagus, and due to non-compliance with the principles of a healthy diet, such as the development of colorectal cancers with insufficient intake of dietary fiber. .
A visitor to the museum of bad habits will learn about the possibility of such consequences, will be horrified once again… And what’s next?
Antonina Starodubova: To begin with, you can calculate your body mass index using the formula developed in the mid-19th century by the Belgian mathematician, astronomer and sociologist Adolf Quetelet: divide your body weight in kilograms by your height in meters squared. The norm is 18.5 to 24.9. 30 and above, already obesity of the first, second, third degree … So, it’s time to see a doctor. In the same pavilion “Healthy Moscow” – now they are working throughout the city. There, the body mass index will be calculated and, if necessary, a referral will be given for an examination to the clinic.
By the way
Alcohol is a very high-calorie product. If a milliliter of pure alcohol (2.5 ml of vodka) contains 7 kilocalories, then the same amount of fat contains 9 kilocalories. In addition, a person who drinks also loses control over what they eat, which means they overeat.
Key recommendations from a dietitian
1. It is never too late to start following the principles of healthy eating.
2. Healthy habits instilled in childhood make it much easier to stick to a healthy diet throughout life. Try to teach children the basics of healthy eating.
3. Enjoy a variety of delicious food and drinks. The principles of healthy eating can be adapted to your preferences, traditions and budget. Do not become a hostage to “proper nutrition.”
What is useful to know?
The daily norm of salt in food is 5 grams. How much it contains:
– In 1 sausage – an average of about 0.8 g
– On 100 g of boiled smoked sausage – more than 5 g
– A standard serving of store-bought meatballs is about 200g, it can contain almost 4g
– In 100 g of herring – 5.7 g
– Ordinary semi-hard cheese (for example, “Russian”) – 1.5 g, the same as in 100 g of rye bread. Even in 100 grams of sweet puff pastry – 1.7 g of salt.
– A pickled cucumber – 4.3 g
– 100 g bag of salted seeds – 10 g
– In a hamburger from fast food chains – more than 5 g.
How much sugar:
– In 100 g of tiramisu – 5 spoons
– In 1 can of sweet carbonated drink up to 7 tablespoons
– In a glass of purchased orange juice – 5 tablespoons, freshly squeezed – 3.