- There is a common misconception that losing weight should last as long as it took weight gain.

Is it true?

- There is no such rule.

Gaining weight can be faster than losing it.

The rate of weight loss is limited by the total energy expenditure of the body, and weight gain is limited only by how much a person can eat.

The excess is first deposited in the form of glycogen in the liver and muscles, and then fat already begins to accumulate - most of all, its reserves are formed around the heart and other internal organs, and not in the subcutaneous tissue.

With further weight gain, fat begins to be deposited in the liver, in other internal organs, and in the muscles in the form of fat droplets.

- Sounds scary...

- And there is.

Obesity leads to disastrous consequences.

For example, to non-alcoholic fatty liver disease, when more and more of its cells are filled with fat and gradually die off.

Because of this, the liver loses volume - it can shrink up to 20% of its original size.

Because its cells, degenerated into fat, are eventually replaced by connective tissue.

In the United States, this disease ranks first on the list of reasons for liver transplantation.

  • Natalia Pavlyuk

  • © Photo from the personal archive

- That is, compliance with beauty standards in the case of obesity is a secondary issue compared to harm to health?

- Certainly.

Obesity provokes inflammation in the body, malfunctions in its functioning.

Due to excess calorie intake, markers of inflammation change.

And this, in turn, leads to more severe consequences of ordinary acute respiratory infections or SARS.

There is an increased risk of chronic diseases such as atherosclerotic, coronary heart disease, strokes, as well as cancer and diabetes.

- And after what indicator of BMI (body mass index) do such serious risks arise?

How to prevent such problems? 

- BMI is a very convenient indicator.

The main problems begin after BMI 30, this is obesity of the first degree.

But indications for weight loss begin already with a BMI of 26-27.

The most optimal body mass index is in the range of 21-23.

- It often happens that a person has a normal body mass index, but he still does not like his appearance and he strives to lose weight to some kind of visual standard.

How do nutritionists see it?

- In this case, you need to look at the percentage of adipose tissue.

Because the bone structure, muscle volumes are different for everyone.

Some kind of "jock" weighing 100 kg and an obese person are two completely different cases.

By the way, excess muscle tissue for health is only slightly less harmful than excess fat.

So bodybuilding is not the most useful hobby.

The balance of psychological comfort and health is also important.

Of course, if a person is moving towards anorexia, you need to turn to specialists who will tell you how to correct your physical form.

For example, increase the percentage of muscle, and not just lose weight.

Because we are losing weight, including at the expense of internal organs.

And with a prolonged nutritional deficiency, even the brain, which lacks the necessary substances, begins to “lose weight”.

In advanced cases, the hormonal system also begins to falter.

However, if a person just wants to have a BMI, for example, not 22, but 20, then why not, if this is important for his psychological comfort?

Because if every day you experience dissatisfaction with your reflection in the mirror, this is also stress.

And stress provokes the production of the hormone cortisol, which is also not very useful.

Therefore, you need to find the optimal balance.

And the way we look is not affected by weight, but by the percentage of adipose tissue, its distribution in the body.

All this can be worked out with a nutritionist and trainer.

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  • © Peter Dazeley

- On the Internet, disputes about how best to maintain a normal weight do not subside - count calories or practice interval, intuitive eating?

It is believed that counting the calorie content of meals can lead to an eating disorder ...

- Official dietetics has long relied on an approach based on food groups and their ratio in the diet.

This is a food pyramid, for sure everyone has seen it somewhere.

True, in fact, this is not a pyramid, but a whole series of recommendations for each food group.

They tell you how much and what to eat at each meal.

Each country has its own recommendations, although the general principles, of course, coincide.

The bottom line is that most people, when compiling their diet, cannot take into account more than three or four factors.

Caloric content is only one of them, doctors have long abandoned the idea of ​​focusing only on it.

The amount of incoming vitamins, microelements, proteins, fats, fiber, etc. is also important. According to the recommendations, you can choose a balanced diet for anyone.

Everything is measured not in calories, but in portions - so many servings of fruits, so many vegetables, etc. For example, as a rule, it is advised to eat about 500 grams of vegetables per day.

And such recommendations are given for each group of products - fats, dairy and starchy foods.

For example, whole grain products need more than three servings per day, where a serving is a slice of whole grain bread.

And according to this principle, we can very easily form an individual balanced diet for each person.

Eating this way is much easier than constantly counting calories.

- That is, such a scientific approach provides for the preservation of a varied diet during weight loss?

So that a person does not “spend” all the calories on a meager set of not the most useful products?

- Yes exactly.

In addition, the benefits of the Mediterranean diet, as well as the DASH diet and its variations, have been scientifically proven.

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  • © Jonathan Knowles

- And what can be said about the now fashionable interval, intuitive nutrition?

- The consequences of interval nutrition are still poorly understood, so it is not recommended by doctors.

In general, this method is interpreted very broadly - someone is starving for part of the day, someone practices fasting days.

As a doctor, I can recommend interval nutrition to those who are not at all able to count portions, think about it, and at the same time have a lot of excess weight.

It is better to lose weight on interval nutrition than to suffer the consequences of obesity, this is obvious.

I had, for example, a patient who spent his whole life holding two fasting days a week, but overeating on the other days.

Such people at least somehow control their diet.

- You touched on the topic of motivation, but do nutritionists have any psychological tricks to awaken it in patients?

No, it depends on the person himself.

But you need to understand that if he begins to eat right, if the body gets everything it needs, then the risk of food breakdowns is reduced.

So a properly built diet is 80% of success, only 20% of people break down with such a diet.

As people change their diet, their eating habits change over time.

However, it is useless to use intuitive eating if before that a person ate mainly cakes and fast food.

First, he has disrupted the natural regulation of hunger and satiety.

Secondly, how can his body "know" that he needs healthy foods if he has not been accustomed to them?

First, a person should eat right for at least 2-3 months, get enough protein, whole grains, etc. And only then can one think of some kind of intuitive approach.

- Is it true that farm products are more saturated with useful substances?

Can growing conditions affect the quality of the final product?

- Oh sure.

For example, different vegetables may contain different amounts of pesticides.

And if we talk about meat, then it is not a fact that in meat, which is obtained with the help of growth accelerators, hormones, the same ratio of proteins and fats as in meat of natural cultivation.

A similar situation is in the case of plants - if there is a normal ripening cycle, then the plant has time to accumulate minerals.

Also, the composition of vegetables and fruits depends on the characteristics of the soil.

However, we must proceed from objective realities, and if only store-bought vegetables are available to us, then it is better to use them than nothing.

These products are not always of poor quality.

And some similarly refuse chicken meat, saying that it is of poor quality.

They switch to red meat, but this is harmful - you can eat it no more than two or three times a week. 

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— You have already mentioned the Mediterranean diet as an option for proper nutrition.

They also often write about the nutrition of the highlanders, the Japanese ... Is there anything in common in the diet of all centenarians?

- From a scientific point of view, the "queen" of all diets is precisely the Mediterranean.

It has been proven to actually promote longevity.

- Probably, it is not very accessible to those who live outside the Mediterranean region.

Is it possible to develop a conditional long-lived diet based on the foods we are used to?

- The Mediterranean diet is not about specific foods, it's just a different approach to nutrition.

We can build this diet on our own from completely available ingredients.

For example, it so happened with us that the basis is some kind of protein dish, accompanied by a starchy side dish.

And vegetables, fruits - they are already as an addition.

The Mediterranean diet is based on whole grains, vegetables and fruits.

And meat is used as an additive for taste, not as a base.

And much more often fish is used.

In addition, a lot of monounsaturated fats are used.

One of them is olive oil.

In principle, this is similar to the recommendations that we talked about above.

Vegetables and fruits should occupy the largest part of the diet.

Then come protein foods - from 50 to 100 grams for each meal.

For example, beef for lunch, fish or poultry for dinner.

Fish can be any, but once a week it is recommended to eat exactly its fatty species - mackerel, herring, trout.

Of course, the most useful salmon, but it is quite expensive.

Plus, beans must be included in the diet, at least a couple of times a week, as well as 20-30 grams of nuts per day or 150-200 grams per week.

Fats must be present - 2-3 teaspoons of oil, including flaxseed.

- Is it particularly useful?

- Yes, it is the richest

α-linolenic acid.

Like camelina oil.

More plant-based omega-3s are found in chia seeds and walnuts.

This is followed by dairy products - at least one glass a day of milk or kefir should be drunk.

Cottage cheese is also included in a healthy diet, from 200 to 400 grams per week.

As well as cheese and eggs, which can be consumed from four to eight a week. 

Do not forget about whole grains - cereals or bread - at least three servings a day.

All this is a balanced diet.

And if you eat the right amount of such products every day, then you simply don’t want sweets or fast food.