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According to Rosstat, from 2020 to 2022 the increase in new cases of obesity in our country amounted to more than 10%. The number of obesity cases in the world is also increasing, according to WHO data over the last decade. What factors lead to an increase in the prevalence of obesity in Russia and in the world?
— The key law of nutrition science says: the energy value of the diet must correspond to energy expenditure. Otherwise, either exhaustion or obesity will develop. Since the world is experiencing an increase in obesity, it means that for many people the balance has shifted towards excess calorie consumption. And this is due to the fact that the well-being of residents of developed countries and many third world countries has been growing over the past decades. Many products have become much more accessible to the general public in different countries, primarily processed meat products - sausages, sausages, etc. And they often contain up to 30% pure fat, which contains 9 kcal per gram. For comparison, there are only 4 kcal per gram of protein or carbohydrates. Sugar has also long been a widely available product; sweets are cheap and consumed in large quantities. Yes, the body needs carbohydrates as a source of energy, but we consume them much more than necessary, often without measure. This leads to obesity and often provokes diabetes and other diseases.
Along with the abundance of food from modern technological civilization, we also received modern transport, elevators, etc. The level of daily physical activity has sharply decreased, and food has become more accessible. At the same time, we are often lazy to do physical education. Therefore, it is very important to accustom people to physical activity from childhood and to create a culture of physical activity.
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© Liudmila Chernetska
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Can the emergence of processed foods on sale and the spread of fast food be attributed to the causes of the obesity epidemic?
— The development of the food industry makes life easier for people in many ways; we don’t have to waste time on cooking. So there is nothing wrong with the very existence of such ready-made products, you just need to create a culture of nutrition and moderation. Moreover, this must be done already from the intrauterine stage of development, because if a pregnant woman overeats, health problems may arise not only for her, but also for the child. And if a child is overfed, he may develop fatty liver hepatosis - when an excess of fat cells appears in the liver. This disease is then difficult to cope with, and it arises due to the eating habits inherent in the family.
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What other factors form the basis for obesity—what contribution, for example, does chronic stress make?
— Stress itself cannot cause obesity, but since delicious food is the easiest and most accessible way to relieve stress, it often provokes overeating. And, of course, since mental and psychological problems also cause stress, they can also often cause eating disorders.
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You talked about different dietary traditions, but is there such a thing as a genetic predisposition to excess weight?
— There is a certain genetic predisposition, but still a
greater
role is played by the eating traditions that have developed in a particular family and eating habits.
— Can a lack of micronutrients and amino acids provoke overeating? For example, does the body lack a certain vitamin, and in its “search” does it whet the appetite in general?
— At the very beginning, I spoke about the basic law of nutrition science, energy balance. But there is a second law - the chemical composition of the diet must correspond to our physiological needs. Deficiency of vitamins, minerals, amino acids leads to pathologies. The problem is that the energy expenditure of modern man has decreased, and this has happened in less than a century. Accordingly, we can no longer, without the risk of becoming obese, consume the same volumes of food as our ancestors at the beginning of the last century, when, for example, the calorie intake of a soldier in the tsarist army was 4.5 thousand calories. We expend less energy and must consume less food. At the same time, our need for vitamins and microelements and amino acids has not changed.
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© skynesher
This dilemma can be resolved, firstly, by increasing the level of general knowledge about nutritional culture, saturating the diet with foods that are rich in beneficial chemical compounds, and reducing the consumption of simple carbohydrates to a minimum. Secondly, and this task has already been set for the food industry today, we must fill our food market with food products enriched with useful substances - micronutrients.
These products are intended for both preventive and therapeutic nutrition. The consumption of such specialized products is especially important for older people. Because they can no longer consume food in the same volume as in youth, due to a decrease in basal metabolism. But the physiological need for micronutrients that we are talking about has not gone away. For them, fortified food products should become an additional source of vitamins and microelements.
— Failures in the endocrine system are often cited as the cause of obesity. How often are hormonal problems the root cause of weight gain?
— Yes, there are a number of pathologies that lead to weight gain, most often these are disorders of the thyroid gland. However, these causes account for only a small proportion of obesity cases. The vast majority of cases are simply due to an imbalance between energy expenditure and energy consumption when a person overeats. For example, almost all of us love confectionery, and they have an extremely high calorie content; it is almost impossible to spend such amounts of energy with a modern lifestyle.
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© Sanja Radin
— How does obesity itself affect the body’s hormonal levels?
— In this case, we are talking about the multi-level impact of excess nutrition, it is expressed not only in obesity, but also in changes in lipid metabolism, excessive deposition of cholesterol in blood vessels, the development of atherosclerosis, deterioration of blood supply, and clogging of capillaries. Obesity often leads to the development of cardiovascular diseases, coronary heart disease, heart attacks and strokes, and also provokes type 2 diabetes.
In general, a vicious circle of ill health is forming, from which it is no longer easy to break out, although it is possible, of course. The later a person comes to his senses, the more difficult it is for him to recover. Moreover, many, instead of comprehensively changing their nutritional system, begin to carry out short-term hunger strikes, which only lead to weight loss for a short time, then these kilograms return.
— How much can basal metabolism differ from person to person, and how does it change with age?
— The level of basal metabolism is the level of energy expenditure in a state of complete rest, when a person, figuratively speaking, lies with his eyes closed in a warm bed. The level of basal metabolic rate can vary greatly, for one person, say, it is 900 kcal, for another it is already 1500... Of course, if the level is low, then it is very easy to gain weight, but there are people for whom it is so high that they can eat anything in any quantity and stay thin. However, with age, metabolic rate decreases in everyone without exception. Not very quickly, about 5-10% per decade, but it can still have an impact if a person does not adjust his diet.
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© fcafotodigital
— What physical activity best helps control body weight? Sports or better walking and other non-training activities?
- For weight loss, this does not matter, only energy consumption is important, the correspondence of the energy calorie content of the diet to energy expenditure. To lose weight, this ratio must be in deficit. Extreme sports stress can harm the body; there is no need to go to extremes. What is important is not so much the intensity as the regularity, then the load can gradually increase as your physical fitness improves. It’s important to be active not only at the stadium or in the gym; you don’t have to be lazy about walking, taking a walk, etc.
— The concept of “body positivity” appeared in the late 1990s, when frankly emaciated models were considered the standard of beauty. However, over time, body positivity, which opposed such extremes, itself became the ground for extremes - the topic began to be increasingly commercialized by both bloggers and large corporations. As a result, body positivity is now being criticized for actually normalizing extreme forms of obesity. What do you think about this current?
— We all understand perfectly well what a normal weight is, when we evaluate ourselves or others, fashion or some ideological trends cannot influence this. However, in part, at their core, the ideas of body positivity are correct; there is no need to put pressure on fat people, humiliate them, etc. If you want to help, then you need to do it gently, delicately. For example, respect the attempts of your loved one who is overweight to review the food system and support him in this. It is important to increase the general level of education of the population in matters of health and proper lifestyle. For example, when high-calorie foods such as confectionery and fast food are advertised on television, it would be appropriate to place an image of a bathroom scale next to it, reminding people of the consequences of excessive consumption of such food.
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© Dacharlie
— Sometimes, for medical reasons, obesity is treated surgically, and in recent years, drug treatment methods have also appeared. Does it make sense to resort to such interventions without changing eating habits and lifestyle?
— Surgical interventions are permissible only in cases of urgent need: a threat to human health or life. Surgery is definitely not an easy solution for obesity.
The same applies to special medications. It’s definitely not worth taking them on your own, without a doctor’s prescription. Because obesity can be caused, for example, by a hormonal disorder, then the help of an endocrinologist is needed. And if obesity is a consequence of an incorrect nutrition system, then the diet needs to be reviewed and changed, and this is the only way to solve the problem.
Why do many, if not most, people have poor natural appetite regulation? And we often eat without experiencing real physiological hunger?
— For people, food is not only a physiological need, but also an important part of culture. For example, we are interested in trying new things, getting acquainted with the cuisines of other peoples; many cultural ideas and traditions are associated with food intake. Another question is that nutritional culture is important; moderation in food must be taught from childhood, in the family.