It is known that the physical development of a person as a process of change and formation of morphological and functional properties depends on heredity and living conditions, as well as on physical education from the moment of birth. Of course, not all signs of physical development are equally amenable to correction at student age: the most difficult thing is height (more correctly, body length), much easier - body weight (weight) and individual anthropometric indicators (chest circumference, hips, etc. ).
In this paper, we will consider by what means and methods of physical culture each student can correct and maintain normal anthropometric indicators, in particular body weight.
Prospects for the formation of an ideal figure depending on the type of physique
wellness physique physical regimen
Unlike height, body weight (weight) is subject to significant changes in both directions with regular exercise or sports (with a balanced diet).
Before you start training, you need to accurately assess your data: general health, heart readiness for physical exertion and body type. People with different body types react differently to the same training system. What works great for one may not work for another.
As you know, the norm of body weight is closely related to human height. The simplest height-weight indicator is calculated by the formula: height (cm) - 100 = weight (kg). The result shows normal body weight for a person of this height. However, this formula is only suitable for adults with a height of 155-165 cm. With a height of 165-175 cm, subtract 105 already, with a height of 175-185, subtract 110.
You can also use the weight-height indicator (Ketley index). In this case, by dividing body weight (in g) by height (in cm), a quotient is obtained, which should be about 350-420 for men and 325-410 for women. This indicator indicates an excess of body weight or its lack.
A directed change in body weight is quite accessible at a student's age. The problem is different - it is necessary to change the usual way of life. Therefore, the prevention or treatment of obesity is largely a psychological problem. But whether or not you need to significantly change body weight, you decide for yourself when assessing the proportionality of your body. It remains to choose sports (exercises) for regular exercise, especially since some types contribute to weight loss (all cyclic - middle and long distance running, cross-country skiing, etc.), others can help "gain" body weight (weightlifting , athletic gymnastics, kettlebell lifting, etc.).
The true anthropometric proportionality of the human body, recognized by both anatomists and biodynamic specialists, is based on the views of the ancient Hellenes, in whom the cult of the human body was quite high. This was especially clearly reflected in the classical proportions of the works of ancient Greek sculptors. Their development of body proportions was based on units of measure equal to one or another part of the human body. Such a unit of measure, called the module, is the height of the head. According to Polycletus, the height of the head with a normal human figure should fit eight times the height of the body. So, according to the "square of the ancients", the scope of outstretched arms is equal to the growth of the body. The length of the thigh fits four times in height, etc.
Basic body types
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Purpose of the study: to show the significance of PBC* “POLYPROTEN Nefro” and “POLYPROTEN Balance” in the dynamics of normalization of eating behavior and clinical picture in patients with PEU on the background of anorexia nervosa. Materials and methods: 80 people (13-18 years old) with moderate and severe severity of PEI were examined. The group included patients with a BMI of 12.5 kg. / m2 - 15.5 kg. / m2. Of these, 85% are girls. Nutritional status was assessed by centile tables and BMI depending on age, by the volume of shoulder muscles and the results of bioimpedance analysis of the body. Results: at admission, all patients complained of severe weakness, decreased physical activity, 68% of patients complained of shortness of breath with little physical exertion, 85% of patients had a tendency to tachycardia, 15% had alternating tachya bradycardia (sinus node weakness) , complaints of dry skin, chilliness, hair loss, brittle nails, various dyspeptic disorders of the gastrointestinal tract (heaviness in the stomach immediately after eating in 98% of patients, nausea in 49%, constipation in 83%, a tendency to loose stools in 17% ). All patients complained against the background of severe astheno-depressive syndrome, 84% of patients complained of habitual self-induced vomiting, 32% had episodes of bulimia followed by self-induced vomiting. The basis of all complaints was the peculiarities of eating behavior: a sharp restriction in food with the exception of high-grade foods (usually protein and fat), and almost all patients observed the principles of separate nutrition with the exception of protein and fat components. The treatment was carried out according to the method proposed by us in 1997 (patent - 2154474). All patients were divided into 2 groups: in the 1st group - patients on the background of complex therapy received a balanced diet based on traditional foods; in the 2nd group, especially at the first stage, dietary correction was carried out due to PBC * "POLYPROTEN": the first 30 days of "POLY..
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STARVING, ESPECIALLY DRY. Refusal to take food and liquids for several days leads to dehydration, intoxication, and shock. MEANS FOR SUPPRESSION OF APPETITE. These drugs often contain psychotropic substances. This method of losing weight leads to changes in the psyche, often irreversible. RAW FOOD. May cause serious disturbances in the function of the gastrointestinal tract. May lead to intestinal dysbiosis. SALT DISCLAIMER. Violated water - electrolyte balance, which can lead to dysfunction of the cardiovascular system, impaired brain function. WITHDRAWAL FROM SUGAR. The function of the cerebral cortex, the heart muscle is impaired. LONG-TERM MONO-DIETS (long-term nutrition with one type of food). Avitaminosis, decreased immunity - with all the ensuing negative consequences. COLOR DIETS (composing diets from foods of the same color). Enzymatic changes occur, which leads to dysfunction of the liver, gallbladder. NO PROTEINS, FAT OR CARBOHYDRATES. It leads to metabolic disorders, hormonal disruptions (women may have problems with the cycle, men - problems with erection). If there is excess weight, then first of all it is important to understand the cause and the problem that has arisen must be solved competently. In 99% of cases, excess body weight is a consequence of “Nutritional obesity”, that is, gluttony. ..
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STARVATION. COMPLICATIONS - Gastritis, Pancreatitis. Causes of complications during severe starvation: due to a significant restriction of food intake, autolysis processes occur - self-digestion of the gastric mucosa and pancreatic tissue. The production of gastric juices, enzymes occurs, but a sufficient amount of food is not supplied. As a result, the secreted gastric juices and enzymes begin to digest the gastric mucosa and pancreatic tissue. Therefore, if you arrange fasting days, it is necessary to consume liquids of neutral acidity: mineral water without gas, low-fat milk, fruit and vegetable juices. CARB-FREE DIET. COMPLICATIONS - Headaches, Memory loss. Causes of complications: malnutrition of various structures, especially the cerebral cortex. These problems usually occur after 15 - 20 days of sitting on a no-carbohydrate diet. There are two types of carbohydrates - simple (quickly digesting) and complex (slowly digesting). Fast (simple) carbohydrates are found in sweets, white bread, cakes, pastries - they are quickly broken down, the human body does not have time to process the released energy, which turns into fat. Slow (complex) carbohydrates are "fuel" for the brain. Complex sugars are found in durum wheat, rye, brown sugar, and cereals. It should be noted that fructose - the sugar contained in honey refers to the "complex" sugars. Refusal of complex sugars causes starvation of brain tissues, weakening of vascular tone. The simplest things are remembered worse, fatigue quickly accumulates even from simple work. Blood pressure may drop, so much so that in the morning “everything floats” before your eyes, and by the evening the pressure, on the contrary, can jump. RIGID FAT LIMITATION. COMPLICATIONS - hormonal disorders - hormonal imbalance (balance - norm, imbalance - pathology), violations of the structure of bones, tooth enamel, restoration of ..
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Weight loss is justified not only by the desire to acquire a beautiful, fit figure, but also by the fact that excess weight adversely affects health. A sedentary lifestyle, malnutrition, stress or past illnesses are all causes of excess weight. If everything was limited to one cosmetology! Unfortunately, excess body weight inevitably leads to the development of metabolic syndrome (MS). What is MS? Metabolic syndrome is a formidable disease that deprives a person of the opportunity to lead a full and active life. This disease inevitably leads to early disability, the cause of which is the occurrence and progression of diseases such as coronary heart disease hypertension respiratory failure atherosclerosis diabetes pancreatitis colitis Life-threatening complications are also: varicose veins of the lower extremities with the threat of developing pulmonary embolism (mortality in the first two hours 90%) arthritis and arthrosis (the joints simply can not cope with the increased load) hormonal status disorders, leading women to an early painful menopause, and men to impotence. To determine if you are at risk for developing metabolic syndrome, calculate your body mass index (BMI). Diverse and numerous weight loss methods promise instant results. Many of these weight loss methods make a person simply starve, but during fasting, not only fats are broken down, but also useful substances that are so necessary for maintaining health. Effective weight loss is a complex and responsible process designed not only to help a person lose weight, but also to maintain health. What happens when you randomly restrict food intake and follow various mono-diets (only apples, only cabbage, only water, and so on)? With a banal restriction of food intake, the body ..
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For those who want to get better, our products and, above all, POLYPROTEN Energy are ideal. It is optimal to use this product in combination with "POLYPROTEIN Protein" according to the following weight gain program. To assess the deficiency of body mass, it is convenient to use an indicator called the Body Mass Index (BMI). BASIC WEIGHT GAINING PROGRAM BREAKFAST - full. Further, after 1.5-2 hours 50 gr. dry mix "POLYPROTEN Protein" (4 tablespoons without top - 30 g of protein). After 1.5-2 hours 100 gr. dry mix "POLYPROTEN Energy" (8 tablespoons without top - 17 gr. protein). LUNCH is complete. Then after 1.5-2 hours 25 gr. dry mix "POLYPROTEN Protein" (2 tablespoons without top - 15 g of protein). After 1.5-2 hours 100 gr. "POLYPROTEN Energy" (8 tablespoons without top - 17 grams of protein). DINNER - full (no later than 20 hours). Do not eat high-calorie foods. After 1.5-2 hours 25 gr. mixture "POLYPROTEN Protein" (4 tablespoons without top - 15 gr. protein). During the day, you can consume an unlimited amount of fruits and vegetables. TOTAL - the daily intake of protein only in the composition of dry mixes is 94 gr. At 94 gr. protein in the composition of the mixtures accounts for 833 protein-free kcal. Method of preparing the mixture: pour the dry mixture into warm water (you can use milk, sour-milk products, juices to taste). The total fluid intake should be at least 30 ml / kg of body weight per day. To expand the flavor range, you can mix in a blender with fruits or vegetables. Daily calorie content - 3000 - 3500 kcal. For reference: 1 gr. carbohydrates (pasta, bread) - 4 kcal (1 piece of bread 60 gr. - 240 kcal); 1 gr. fat (vegetable oil, butter, smoked products) -..
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People who want to learn how to lose weight and consume our products will not have to give up their usual lifestyle, incl. from your favorite foods and drinks. The only thing that will have to be done is to replace one or part of the traditional meal with the "POLYPROTEIN Protein" product, while not feeling hungry and trying to "snack" something, especially at night. The mechanism of action that leads to a decrease in body weight when taking our product is very simple, firstly, you will not need to eat something all the time, since there will be no feeling of hunger, and secondly, the product contains a large amount of easily digestible complete protein, which means that the body will spend its own energy reserves, primarily from adipose tissue, to break down protein into amino acids. It is enough to give only one figure - the protein-free calorie content of "POLYPROTEIN Protein" is only 132 kcal per 100 gr. product. To assess overweight, it is convenient to use an indicator called the Body Mass Index (BMI). BASIC WEIGHT REDUCTION PROGRAM (EXAMPLE MENU FOR SLIMMING) BREAKFAST - full. Then after 2-3 hours - 50 gr. dry mix "POLYPROTEN Protein" (4 tablespoons without top - contain 30 g of protein). LUNCH - reduce the amount of food taken by 50%. Then after 1 hour - 25 gr. dry mix "POLYPROTEN Protein" (2 tablespoons without top - 15 g of protein). at 16 - 17 hours 25 g of the dry mixture "POLYPROTEN Protein" (2 tablespoons without top - 15 g of protein). DINNER - 18-20 hours 25 gr. dry mix "POLYPROTEN Protein" (2 tablespoons without top - 15 g of protein). * it is worth paying special attention to the fact that the specialized protein mixtures "POLYPROTEN&r..
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The owners of the patent RU 2405427:
The invention relates to medicine and can be used to correct the body weight of a person. To do this, use a 3-4-day fast without limiting fluid intake. Then appoint the use of low-fat or low-fat foods for one or two subsequent days out of hunger. After that, the daily intake of low-calorie food is 1000-1200 kcal / day until 12-14 days from the start of treatment. At the same time, the patient is exposed daily from the side of the face with full-spectrum artificial light with an illumination intensity of at least 2000 lux or natural light for 1-2 hours a day simultaneously or alternately with daily physical activity. The method allows to achieve a lasting effect of weight loss, increase the availability of the method for patients, and reduce contraindications for use. 2 tab.
The method relates to medicine and can be used to correct overweight and in the complex therapy of obesity.
Overweight and obesity are characterized by an imbalance between the intake and expenditure of energy substrates. One of the reasons leading to the accumulation of excess fat is a decrease in the level of energy consumption of the body against the background of normal or excessive food intake. The main principle of the treatment of obesity is to shift the balance of "energy consumption - energy costs", both in the direction of reducing energy consumption, and in the direction of increasing energy costs. Based on this, the following approaches are used in the treatment of obesity: fasting, diet therapy, physical activity (physiotherapy exercises), drug therapy, physiotherapy, psychotherapy, and surgical methods of treatment (1, 2).
Despite the ever-increasing number of methods and means aimed at correcting body weight, their effectiveness remains rather low. According to the literature (3), only 5-10% of patients maintain their body weight achieved during treatment for 2 years. One of the reasons for the low efficiency of obesity treatment is a decrease in the level of metabolic processes in response to long-term dietary restrictions and, as a result, a slowdown in the rate of weight loss and weight gain.
A known method of treating obese patients with neuroendocrine form of hypothalamic syndrome (4). The patient is given short-term therapeutic fasting, including 3-5 days of fasting and 3 days of recovery period. After a course of fasting, the patient is administered a 0.02% solution of sodium hypochlorite intravenously, 200-400 ml intravenously, 3 times in 1-2 days. The proposed method of treatment allows to obtain a stable effect of weight loss with the normalization of lipid and carbohydrate metabolism. The disadvantage of this method is that its use is limited by the presence in the patient of the neuroendocrine form of hypothalamic syndrome, which accounts for only 5-10% of obese individuals. In addition, to obtain sodium hypochlorite, an apparatus for electrochemical detoxification of the body EDO-3 is required. Another disadvantage of this method is the possibility of its use only in a hospital setting.
A known method of reducing body weight in patients with hypertension stage 1-2a in combination with alimentary-constitutional obesity (5). In patients, the intake of water and water procedures is excluded in the first 24-48 hours of fasting (absolute hunger). In the next 10-12 days, patients are treated according to the usual scheme of therapeutic starvation, but limiting the daily intake of water to 10-12 ml/kg. This technique allows you to increase the reduction of body weight from 0.4-0.6 to 0.8-1.2 kg/day, accelerate the onset of the acidotic crisis and the beginning of active mobilization of fat from the depot (from 2-3 days), achieve earlier terms stabilization of physiological indicators of blood pressure (for 2-5 days). As a result, the terms of inpatient treatment are reduced by 1.5-2 times. The disadvantages of this method include the fact that prolonged fasting for 12-14 days, in addition to the loss of adipose tissue, leads to a pronounced loss of muscle tissue, which, as you know, is the main organ that utilizes both exo- and endogenous fat. In addition, the disadvantage of the known method is that a decrease in the level of energy metabolism as a result of prolonged starvation subsequently leads to a decrease in the rate of weight loss. In the phase of exit from starvation without a properly selected diet therapy, as a rule, a rebound effect develops, i.e. re-gaining weight, sometimes exceeding the figures before treatment. Another disadvantage of this method is that prolonged absolute hunger is contraindicated in a number of diseases and can lead to their exacerbation (diseases of the gastrointestinal tract, such as gastritis, gastric ulcer; gout, heart rhythm disturbances, sleep disturbances).
A known method for the treatment of alimentary obesity, including conducting psychotherapy in the state of wakefulness of the patient, while using verbal suggestion reinforce and enhance the motivation for weight loss, then enter the patient into a state of meditation, carry out autoheterosuggestive effect, instill indifference to food, cause anorexic-dysphatic sensations and reinforce them by mechanical irritation of the anterior projection of the stomach, esophagus. The session is repeated after 1-2 days. The last session begins with irritation by acupuncture or acupressure of reflexogenic zones or points of the hypothalamic-pituitary system, the autonomic nervous system and the gastrointestinal tract. The program for introducing into a meditative state includes a weight loss program, which is preliminarily calculated taking into account the weight loss parameters for the first two sessions and the autoheterosuggestive effect is repeated against the background of irritation of the reflex zones (6). The method requires at least three psychotherapeutic sessions. The known method has the same disadvantages as the previous one, in terms of food restriction and the "rebound" reaction after the end of treatment. In addition, mechanical irritation of the projection area of the stomach and esophagus leads to undesirable consequences in people with diseases of the gastrointestinal tract, in particular with gastroesophageal reflux, gastric ulcer, etc.
A known method for the treatment of obesity, including indirect psychotherapy in an environment of color and light accompaniment, during which the patient is told about the impact of holocolore therapy on the human body, in the process of offering food, table lamps are turned on on both sides of the cutlery on one side - green, on the other side - red so so that the light from them is directed to a plate with a high-calorie product that causes excessive appetite in the patient. Conduct behavioral psychotherapy aimed at the formation of an aversion to the specified product by visualizing this product and disgusting objects. Then a group training of psychological stability is carried out 10 times for 2 hours every other day (7). The disadvantages of this method include the fact that one part of the patients is resistant to psychotherapeutic effects, the other is overly susceptible, which leads to a persistent aversion to food and subsequent depletion of the body. In addition, aversion to certain foods causes psychological discomfort in patients both during and after the end of treatment.
A known method for the treatment of obesity, including diet therapy and psychotherapeutic effects during collective-group sessions, while the main psychotherapeutic effect is carried out for two sessions of eight hours each by the method of a marathon in conditions of asthenia, achieving failure of biorhythms and behavioral stereotypes, while developing motivation for a healthy nutrition, self-confidence and belief in success, form a weight loss program, visualize and specify treatment, keep a diary of eating behavior, exercise psychological protection in the event of a diet violation; after the main sessions, a psychotherapeutic effect is carried out during one session lasting three hours after one and three months, aimed at consolidating the results obtained, discussing and eliminating situations that provoke a relapse of obesity (8). The disadvantages of this method include the fact that asthenia and failure of biorhythms in the future can lead to an exacerbation of chronic diseases, exacerbation of somnological disorders, which are already quite common in people with obesity.
A known method for the treatment of obesity, including preliminary daily fasting, psychotherapeutic effects in the state of wakefulness by the method of group rational psychotherapy and diet therapy with the exclusion of high-calorie foods, while at the stage of group rational therapy, the achievement of the effect is associated with individual weight optimization due to the reregulation of self-regulatory systems of the food center, after which in the state of meditation, they carry out direct and indirect suggestive influence and form an active, positive emotional-volitional motivation for the implementation of the diet program, rebuilding and subordinating the motivational scheme to socially significant motivations, for which they use psychosomatic paradigms in the form of short verbal plots and synchronously reinforce them with a reflex effect in the forehead and temporal lobes with fixation of physical pressure in the epigastric region, while the volume of food is limited to 1300-1500 ml per day and high-calorie foods are excluded in within 2-3 months (9). This method is not effective enough, because. It is aimed only at limiting the intake of food ingredients without increasing the body's energy consumption. In addition, long-term dietary restrictions lead to a decrease in the level of metabolic processes (including the breakdown of fat deposited in the body), which contributes to a subsequent increase in body weight. In addition, as mentioned above, some patients are resistant to psychotherapeutic effects.
A known method for the treatment of obesity, including a preliminary conversation between a psychotherapist and a patient about the essence of the disease, the therapy being carried out, about the weight loss program, while setting the patient to an active position in the treatment, with each positive statement, a "kinesthetic anchor" is established by touching the "leading" hand patient (right - for right-handers, left - for left-handers). Then, a course of treatment is carried out for 12 weeks, consisting of a combination of unloading and non-unloading diets, which alternate so that there are five fasting and two non-fasting days in one week, meals on fasting days are carried out using the Metaboline nutrient mixture instead of breakfast, lunch, dinner and for the night; in the intervals between taking the mixture, they allow the use of raw or boiled vegetables (except potatoes) and fruits (except bananas and grapes); on non-fasting days, nutrition is carried out as usual without an increase in flour and sweet foods and with a decrease in daily fat intake to 35-40 g, while at the beginning of the course of treatment for 14 days, and then on non-fasting days, a mixture is prescribed: figs, dried apricots, prunes in 1:1:1 ratio, two tablespoons two hours after dinner. After 12 weeks and up to 6 months, the next course is carried out with the appointment of a hypocaloric diet with a reduced calorie content of 1200 kcal in the first month, followed by bringing it to a value corresponding to the body's normal needs, while for 6 months of treatment, a psychotherapist and a nutritionist conduct dynamic monitoring of by the patient to control weight loss, adherence to the diet using the established “kinesthetic anchor” to consolidate the positive result obtained and maintain the complex of recommended therapy (10). The known method is not effective enough, because. It is aimed only at limiting the intake of food ingredients without increasing the body's energy consumption. In addition, some patients are resistant to psychotherapeutic effects, and the use of a low-calorie diet, as mentioned above, leads to a decrease in the level of metabolic processes, which contributes to a subsequent increase in body weight. For this reason, the method involves long-term observation of the patient by a psychotherapist and the need for additional psychotherapeutic intervention.
Closest to the claimed is the method of Tamaz Mchedlidze correcting the weight of a person, including keeping a diary of eating behavior, fractional meals 4-6 times a day with limited intake of salt, sugar and flour products; performance of dosed physical activity, thermal treatment and massage based on the methods of classical, Thai, chiromassage and neurosedative massage. At the first meal, patients consume high-calorie carbohydrates with a high glycemic index, at the second, third and fourth meals, low-calorie carbohydrates with a low glycemic index; from the second half of the day they switch to protein foods. Physical activity is first performed with moderate intensity with a pulse value of 50-60% of the maximum pulse value, and then with an average intensity with a pulse value of 60-70% of the maximum pulse value. The value of the maximum heart rate is calculated by the formula: 208-(0.7×X), where X is age. Thermal treatment is carried out before going to bed at a temperature of 70-80°C, followed by dipping in cold water. Physical activity with moderate intensity is carried out during walking, swimming, cycling and when performing light aerobic exercises, and physical activity with medium intensity is carried out during sports walking, intensive swimming, with active fitness. Physical activity is carried out at least three lessons per week for 45 minutes. Hiromassage includes at least one of the following techniques: lymphatic drainage techniques, kneading, neurocutaneous manipulation, stroking. Thai massage includes at least one of the following techniques: acupuncture of bioactive points with the pads of the thumbs, pressure with the palms, feet. With moderate food restriction, the effect of weight loss is achieved by a combination of diet with physical activity, thermotherapy and massage, which increase the level of metabolic processes (including the breakdown of fat deposited in the body) (11). The disadvantage of this method is that the patient has contraindications to the use of thermotherapy and massage (ischemic heart disease, arterial hypertension, diseases of the joints, veins, benign neoplasms, such as fibroids, etc.). Another disadvantage is the unavailability of chiromassage, Thai and neurosedative massages for a wide range of patients due to its high cost or the lack of this type of service at the place of residence (in a polyclinic or a specialized center). In addition, the cessation of physical activity in combination with massage and thermotherapy often leads to a return of weight.
The problem to which the invention is directed is to increase the availability of the method for patients, reduce contraindications for use, and achieve a lasting effect of weight loss.
The solution to this problem is achieved by the fact that patients are prescribed a 3-4-day fast without limiting fluid intake, then taking low-fat or low-fat foods for one to two days of getting out of hunger, then daily consumption of low-calorie food 1000-1200 kcal / day up to 12- 14 days from the start of treatment; daily exposure of the patient from the side of the face to full-spectrum artificial light with an illumination intensity of at least 2000 lux or natural for 1-2 hours a day simultaneously or alternately with daily dosed physical activity.
Description of the essence of the invention
The method includes fasting the patient for 3-4 days without limiting fluid intake, then taking low-fat or low-fat foods for 1-2 days of getting out of hunger. In the following days, daily up to 12-14 days inclusive from the beginning of treatment, they consume low-calorie food 1000-1200 kcal / day. From the first day, the patient is exposed from the side of the face with full-spectrum light of artificial origin with an illumination intensity of at least 2000 lux for 1-2 hours a day simultaneously or alternately with daily dosed physical activity.
Dosed physical activity is prescribed until the pulse increase is not higher than the threshold value determined by known methods, for example, according to (11) or Table 1, after examining the patient by a specialist, recording an ECG and in the absence of contraindications.
The duration of periods of fasting and exit from hunger is determined depending on concomitant diseases. During fasting in the first 3-4 days, for example, water, rosehip broth, oat broth, etc. are used for drinking. When leaving fasting in the next 1-2 days, patients are recommended sour-milk products as low-fat or low-fat products (for example, fat-free kefir) , vinaigrette, mucous decoctions, such as rice, etc. As low-calorie foods, up to 12-14 days inclusive, products listed in the attached version of the basic low-calorie diet or close to them in calories can be used.
An example of a basic low-calorie diet for obese patients (1000-1200 kcal per day)
Breakfast 1: porridge (buckwheat, oatmeal, barley); rye bread, tea, coffee, vegetable or fruit juices.
Breakfast 2: carrot or apple or pear.
Lunch: vegetarian cabbage soup (on vegetable broth); raw or stewed vegetables (cabbage, carrots, tomatoes, cucumbers, onions, green onions, parsley, lettuce), seasoned with vegetable oil; boiled meat (or steamed cutlet); dried fruit compote (no sugar).
Afternoon snack: a teaspoon of a fruit-nut mixture (for example, prunes, dried apricots, raisins, walnuts, lemon, honey).
Dinner: fish, lean meat (boiled or steamed) or soy products; vegetable stew or garnish of cereals (buckwheat, oatmeal, pearl barley); green tea.
When exposed to artificial light, use full-spectrum lamps (fluorescent lamps) with an illumination intensity of at least 2000 lux or natural light in the open air. The duration of exposure is 1-2 hours per day. The distance from the patient's face to the light source is 50-60 cm, the patient should be opposite the light source, while not looking at it.
When using natural light, the patient is prescribed daily 1-2-hour walks in the open air, depending on the intensity of the light (for example, one hour in sunny or 2 hours in cloudy weather). The intensity of illumination in cloudy weather, as a rule, is 2000-2500 lux, in sunny weather - up to 10000 lux.
Exposure to natural or artificial light is desirable to carry out in the morning or afternoon, so as not to cause a malfunction of the circadian rhythms of the patient's body. The duration of the light therapy course is 12-14 days.
Walking, walking, etc. are used as physical activity. or active movement in a small vehicle, such as a bicycle, pedalo, non-automatic sports wheelchair driven by the patient's own efforts, etc.
In the room for physical activity, a simulator, for example, in the form of a treadmill, etc., can be used. In the first days of treatment (hunger), physical activity can be lighter, increasing to moderate in the following days. An example of the mode of selection of physical activity during the course of weight correction, depending on the patient's age, is presented in Table 2. During exercise, it is necessary to ensure that the pulse is within the limits corresponding to the age and magnitude of the load. In the presence of severe shortness of breath and excessive sweating, the patient is advised to reduce the load or stop and rest.
As additional, but not mandatory to achieve the claimed effect, water procedures (for example, Charcot's douche), physiotherapy (electromyostimulation, massage) can be used in the absence of contraindications. Contraindications to these effects are allergic skin diseases, dermatitis of a different nature, varicose veins, benign neoplasms (fibromyoma, mastopathy), progressive hypertension, the presence of a pacemaker, etc. It is possible, but also not necessary, to use methods of rational psychotherapy aimed at promoting a healthy lifestyle.
Specific Implementation Examples
1. Examples of individual implementation of the method
Patient K., aged 45, body weight at admission 101 kg, height 164 cm Diagnosis - alimentary-constitutional obesity of the 2nd degree. Concomitant diseases: neurocirculatory dystonia of hypertonic type, chronic cholecystitis. Carried out correction of body weight according to the claimed method in a hospital, including a 14-day course of unloading dietary therapy (3 days of fasting, 1 day out of hunger with a further transition to low-calorie food in the range of 1000-1200 kcal/day), phototherapy using lamps daylight, intensity 2000-2500 lux, exposure at a distance of 50-60 cm for 2 hours a day. In addition, daily physical activity was used in the treatment throughout the course - walking on the treadmill of the simulator or classes in the exercise therapy group - with a total duration of 1-2 hours a day. During the course of correction, body weight decreased by 4.5 kg. Body weight after treatment 96.5 kg.
After the end of treatment for the outpatient period, it was recommended to follow a low-calorie diet in the range of 1200-1500 kcal/day, daily walks during daylight hours for at least 40 minutes. Following these recommendations, over the past 3 months after the end of treatment, the patient has reduced body weight by another 2.7 kg.
Example 2. Patient R., aged 35, body weight 75 kg, height 170 cm, diagnosis - overweight. Concomitant diagnosis: chronic bronchitis without exacerbation, hay fever. Has addressed in occasion of seasonal increase in body weight. The patient notes that over the past 3 years in the autumn-winter period, body weight has increased by 3-5 kg. Within 12 days, body weight was corrected according to the claimed method. Diet therapy was prescribed, including 4 days of fasting, 2 days of overcoming hunger, followed by the use of low-calorie foods 1000-1200 kcal/day. The patient was prescribed physical activity simultaneously with exposure to natural light in the form of daily walks during daylight hours (preferably in the morning) for 1-2 hours a day. During the course of correction, body weight decreased by 1.5 kg.
Further recommendations included eating a low-calorie meal of 1200-1500 kcal/day, walking during daylight hours for at least 40 minutes daily. 3 months after the end of treatment and compliance with these recommendations, the patient's body weight decreased by another 4.5 kg and amounted to 69.5 kg, which is normal.
2. Group studies
The human body weight was corrected according to the claimed method in comparison with other widely used methods of body weight correction. For this, 3 groups of obese women were identified. Group I - 26 patients with body mass index (BMI) 36.2±1.63 kg/m 2 , group II - 30 women with BMI 35.9±1.63 kg/m 2 , group III - 24 women with BMI 37.7±2.23 kg/m2.
Common in the treatment regimen was: 4-day fasting without limiting fluid intake, including a rosehip decoction, followed by a 2-day exit from hunger (600 ml of kefir daily) and a further transition to a hypocaloric (1000-1200 kcal / day) diet nutrition. All patients received the same water (Charcot shower) and physiotherapy (electromyostimulation). There were no other appointments in group I. Group II additionally used daily aerobic exercise (40 minutes of walking on a treadmill and 30 minutes of exercise in the exercise therapy group).
Group III underwent correction of body weight according to the claimed method. Patients were prescribed a 4-day fast without limiting fluid intake, including a rosehip decoction, followed by a 2-day exit from hunger (600 ml of kefir daily) and a further transition to a hypocaloric (1000-1200 kcal/day) diet. While walking on a treadmill, phototherapy sessions were simultaneously performed according to the claimed method: patients were exposed to the light of full-spectrum fluorescent lamps with an illumination intensity of 2000-2500 lux at a distance of 50-60 cm from the face with an exposure duration of 40 minutes.
The effect of phototherapy on the activity of metabolic processes (energy exchange) was assessed by changing the amount of oxygen consumed - as the main oxidizing agent of metabolic processes. To determine energy consumption at rest, an indirect calorimetry method was used - oxyspirography, under conditions of thermal comfort (at a temperature of +20°C) and relative rest, 1.5 hours after breakfast and after 20 minutes of rest. In accordance with the methodology proposed by Kataev N.N. (12), the subject in a sitting position for 1 min adapted to breathing through a mouthpiece and a facial valve, then the latter was connected to the respiratory circuit of the spirograph at the level of calm exhalation. After connecting the subject to the spirograph, oxygen consumption was determined after 5-7 minutes of quiet breathing.
As a result of a two-week treatment in group I, body weight decreased by an average of 3.0±1.1 kg. At the same time, the level of PO 2 tended to decrease and amounted to 248.5±34.3 ml/min before treatment and 233.4±29.2 ml/min (p=0.14) by the end of the two-week course of treatment. This group demonstrated the process of reducing the level of energy metabolism in response to caloric restriction of the diet. In group II, body weight decreased by 4.31±1.12 kg, the level of oxygen consumption tended to increase from 242.1±24.2 to 256.1±42.4 (p=0.22). In group III, the decrease in body weight was the most pronounced - 4.93±1.02 kg, against the background of an increase in the level of oxygen consumption from 252.8±31.9 to 303.2±68.4 ml/min (p<0,001) или 120% относительно исходного уровня.
The duration of the activating effect of phototherapy on energy metabolism was determined in one case. So the level of PO 2 was initially 212.3 ml, immediately after the session it increased to 279.1 ml (131.4% of the original), 1 hour after the end of light exposure it amounted to 266.9 ml (125.7% to original), after 2 hours - 254.8 ml (120% of the original). It can be seen that exposure to light has a fairly pronounced trace reaction to energy exchange. The combination of physical activity with phototherapy against the background of a hypocaloric diet allows to achieve a steady reduction in the patient's body weight.
The advantages of the claimed method are that it can be used in patients with concomitant diseases, in which physiotherapy, massage, intense physical activity are contraindicated. The method gives a stable effect of reducing body weight, while psychological correction is not mandatory, which is important for patients who refuse psychological effects or are resistant to it. The method is easily reproducible, can be used in persons with restrictions on the performance of physical activity, including persons with limited mobility, such as wheelchair users.
Sources of information
1. Obesity: etiology, pathogenesis, clinical aspects / Ed. Dedova I.I., Melnichenko G.A. - M.: LLC "Med. Inform. Agency". 2006. - 456 p.
2. Obesity (clinical essays) / Ed. A.Yu. Baranovsky, N.V. Vorokhobina - St. Petersburg: “Izd. Dialect", 2007. - 240 p.
3. Vakhmistrov A.V., Voznesenskaya T.G., Posokhov S.I. Clinical and psychological analysis of eating disorders in obesity // Zhurn. Neurologist. and a psychiatrist. 2001. No. 12. pp.19-24.
4. Method for treating obese patients with neuroendocrine form of hypothalamic syndrome. RF patent for invention No. 2008905. IPC A61K 33/14, 1994.
5. A method for the treatment of stage 1-2A hypertension in combination with alimentary-constitutional obesity. Application for the invention of the Russian Federation No. 94004125, IPC A61K 31/01, 1995.
6. The method of Tukaev R.D. treatment of alimentary obesity. RF patent for invention No. 2008028, IPC A61M 21/00, 1992.
7. Method for the treatment of obesity. RF patent for the invention No. 2307676. IPC A61M 21/00, 2006.
8. Method for treating food addiction accompanied by obesity. RF patent for invention No. 2244569, IPC A61M 21/00, 2005.
9. Method for the treatment of obesity. RF patent for the invention No. 2153362, IPC A61M 21/00, 2000.
10. A comprehensive method for the treatment of obesity. RF patent No. 2289436. IPC A61M 21/00, 2006.
11. Tamaz Mchedlidze's method of correcting a person's weight. RF patent No. 2314783, IPC A61H 5/00, A61H 1/00, A61H 23/06, A23L 1/29, 2006.
12. Kanaev N.N. General questions of research methodology and criteria for assessing respiratory parameters / Guide to Clinical Physiology of Respiration. L.: 1980. pp. 21-37.
A method for correcting human body weight, including the use of low-calorie food, dosed physical activity, characterized in that patients are prescribed a 3-4-day fast without limiting fluid intake, the use of low-fat or low-fat foods for one or two subsequent days of getting out of hunger, then daily consumption of low-calorie food 1000-1200 kcal / day up to 12-14 days from the start of treatment; daily exposure of the patient from the side of the face to full-spectrum artificial light with an illumination intensity of at least 2000 lux or natural light for 1-2 hours a day simultaneously or alternately with daily physical activity.
The invention relates to medicine, in particular to general surgery, and is intended for the localization of foreign ferromagnetic bodies during their surgical removal from human tissues, and can also be used in measuring technology for non-destructive quality control of materials.
The invention relates to medicine and can be used to correct human body weight
Obesity and overweight have become a global epidemic with an increased risk of clinically important comorbidities, as announced by WHO in 1997. The prevalence of obesity is increasing among the adult population and among children of all ages. Over the past 40 years, the prevalence of obesity in the US has increased from 13% to 31%, and the number of overweight people in the population has increased from 31% to 34%.
A.V. Kaminsky, PhD, Senior Researcher, Department of Radioinduced General and Endocrine Pathology; Scientific Center for Radiation Medicine of the Academy of Medical Sciences of Ukraine, Kyiv
Studies from the UK and the US show a persistent increase in the prevalence of obesity with age in both men and women. Our pilot studies in 2003 showed that in Ukraine the prevalence of obesity among people over 45 years of age can be 52%, and overweight - 33% (obesity + overweight make up 85%). Normal body weight is observed only in 13% of the adult population of Ukraine.
Obesity is a complex chronic disorder of lipid metabolism with excessive accumulation of fat (triglycerides) in different parts of the body, accompanied by an increase in body weight and the subsequent development of various complications.
Obesity is the result of an excess of calorie intake with food over calorie expenditure, especially with a lack of movement, that is, the result of maintaining a positive energy balance for a long time.
Obesity is a disease and is not currently seen as a psychological problem characterized by low discipline or weak willpower. Only recent studies have been able to partially explain the biochemical and genetic factors involved in the etiology of obesity, pointing the way to more effective methods of its treatment.
In the US alone, more than 400,000 people a year die from the effects of obesity. The medical costs and disability costs associated with obesity are more than $100 billion a year. The total economic harm due to obesity exceeds that in comparison with oncological diseases. In overweight women, a moderate loss of body weight (by 10% of the original) leads to a decrease in disability by 20%.
Overweight and abdominal obesity determine the risk of developing type 2 diabetes mellitus (2-3 times more often), arterial hypertension, dyslipidemia, coronary heart disease, hyperlipidemia, atherosclerosis and its clinical manifestations, varicose veins, thrombophlebitis, cholelithiasis, arthritis, osteochondrosis, flat feet, gout, Pickwick's syndrome (attacks of hypoventilation and drowsiness up to sleep apnea), hepatic steatosis, etc. Obesity is an independent risk factor for cardiovascular diseases. Body weight is a more reliable predictor of the development of coronary heart disease than blood pressure, smoking, or impaired glucose tolerance. Morbidity and risk of premature death are directly related to the amount and type of distribution of excess fat.
Excess visceral fat is closely correlated with various pathologies and occurs in:
Prospective studies have shown that obesity is a major risk factor for type 2 diabetes. According to the latest US surveys, the risk of diabetes increases by 9% for each additional kilogram that exceeds normal body weight. The risk of developing type 2 diabetes in obese patients increases in direct proportion to body weight and duration of obesity. Large demographic studies in Sweden have shown that abdominal obesity is a major risk factor for developing DM.
The presence of obesity in diabetic patients increases cardiovascular risks and mortality. Compared with people of normal weight, the relative mortality rate is 2.5-3.3 times higher for people with diabetes and obesity (overweight 20-30%), 5.2-7.9 times higher for people with excess body weight body by more than 40%. A mass index greater than 30 kg/m 2 is critical for the onset of type 2 diabetes, and weight gain over 5-10 years precedes its manifestation. At a younger age, critical body weight is most associated with the development of DM in the future, the risk is especially high with a rapid increase in weight in the period of 20-30 years.
The results of the Finnish Diabetes Prevention Program (3200 patients with increased body weight and impaired carbohydrate tolerance) showed that even a slight decrease in body weight (by 7%) leads to a significant reduction in the negative consequences and risk of developing diabetes mellitus.
Overall, weight loss reduces the risk of all-cause mortality by 25% and the risk of cardiovascular mortality by 28%.
Obesity is defined as excess body weight of more than 25% for men and more than 35% for women compared to the ideal weight depending on height.
The World Health Organization (WHO) has proposed a unified indicator for assessing body weight - body mass index (BMI). Currently, it is the most important criterion for obesity. BMI is an important indicator for controlling health risk factors and depends, to some extent, on ethnicity. The formula for calculating this index is as follows: BMI (kg / m 2) \u003d the ratio of body weight (in kg) to height (in m 2). In many Western countries, it is called the Quetelet index (Table 1).
Obesity is considered to be an excess of BMI over 29.9 kg / m 2 (normal limits - 18.5-25 kg / m 2), which is divided into three degrees.
Waist circumference is also an important indicator of risk for abdominal obesity. For men, it corresponds to more than 102 cm, for women - more than 88 cm.
Another risk factor for complications is the degree of weight gain during life. Thus, an increase in body weight after 18-20 years by more than 5 kg increases the risk of developing diabetes, arterial hypertension and coronary heart disease.
Diagnosis of obesity should include not only anthropometric data, but also an anamnesis of the disease, a study of the state of health, health risks, laboratory tests, and an assessment of the psychological status of patients.
Height, body weight, BMI, form of fat distribution (gynoid or android), presence of thyroid pathology, cardiovascular pathology, arterial hypertension, cancer, diabetes mellitus and dyslipidemia should be assessed.
The goal of obesity treatment is to gradually reduce body weight to real values, as well as to prevent subsequent morbidity and mortality associated with obesity.
Maintaining the achieved values of body weight is a more difficult task than losing weight itself. It requires lifelong lifestyle modification, behavioral responses, and diet therapy. Therefore, weight management programs should emphasize the continuity of such therapy throughout life.
The basis of the treatment of obesity is the restriction of caloric intake and increase in physical activity, the achievement of energy balance, which is included in the concept of lifestyle.
However, it should be understood that only 42% of obese patients will follow the doctor's recommendations. For most obese patients, the target weight loss should be up to 10-15%/year.
Treatment of overweight and obesity is a multi-step process that includes a series of studies, lifestyle changes, drug therapy and, in some cases, surgery. It should not be forgotten that drug therapy for obesity is recommended as an adjunct to lifestyle modification.
Lifestyle changes include attitudes about your diet, physical activity, and body weight. Patients should keep a daily self-monitoring journal, weigh food and evaluate their calorie content. Diet therapy is complemented by emotional control, it may include periods of relaxation, meditation, and others. Also, patients can participate in classes of closed support groups (10-20 people), which are designed to create positive emotions, promote self-assertion, and allow you to visually evaluate the success of other patients. Spouses should definitely be included in the treatment process. A spouse's lack of interest in losing weight increases the likelihood of abandoning a weight loss program.
The principles of diet therapy for overweight and obesity are several important rules.
Dietary restriction in obese patients may be moderate or severe, depending on the potential health risk. There are two levels of caloric restriction - the low calorie diet (LCD; dietary calorie intake is 800 to 1800 kcal/day), which is acceptable for most obese patients, and the specialized ultra-low calorie diet (VLCD; dietary calorie intake is 250-799 kcal/day) given to patients with a high level of health risk.
Successful weight loss largely depends on following a low-calorie diet, when energy expenditure per day is greater than the number of calories received from food. The use of a low-calorie diet can reduce body weight by 10%. However, only 15% of patients follow such a diet.
The NHLBI and NAASO recommend a low-calorie diet of 1000-1200 kcal/day for women and 1200-1600 kcal/day for men (and for women who exercise regularly or weigh less than 75 kg) as standard.
In the presence of concomitant pathology (diabetes mellitus, hyperlipidemia, arterial hypertension, etc.), in addition to a nutritionist, doctors of the relevant specialties should take part in compiling the menu. Drawing up a menu without a dietitian is unacceptable!
One of the reasons why many doctors refuse to treat obesity is that they do not have enough effective and safe means to reduce body weight in their arsenal. Currently, only two drugs are approved by the FDA for long-term use: sibutramine and orlistat. At the same time, only orlistat is recommended for long-term use - safety has been assessed in the XENDOS study for 4 years, and sibutramine is limited to 1 year of use.
As monotherapy, any drug can reduce body weight by no more than 8-10% per year, from baseline values. However, to minimize the risk of obesity and diabetes, weight loss should be greater than 12%. This is a goal that cannot be achieved by drug monotherapy alone.
Medications are recommended to be prescribed to patients with obesity only as part of a comprehensive program that includes diet therapy, physical activity, behavior and dietary modification, which accelerates the process of weight loss and is carried out under the supervision of experienced doctors (endocrinologist, therapist, family doctor).
Principles of drug therapy for overweight and obesity.
Modern official medicine gives preference to drugs whose clinical efficacy has been proven by many multicenter, placebo-controlled and randomized studies using the principles of evidence-based medicine.
Drugs used to reduce body weight are divided into two main groups: drugs to reduce appetite and drugs that reduce the absorption of nutrients (fats, carbohydrates, etc.) - dietary correctors. A number of other drugs are also isolated, including trace elements, vitamins, amino acids, peptides, hormones, etc. In particular, ADA and AACE recommend the use of drugs that have passed full clinical trials and are approved by the FDA.
Not all drugs are equally safe. Centrally acting (noradrenergic) drugs such as phentermine are FDA approved but are only recommended for short-term treatment as an adjunct to the main treatment for obesity. When taking drugs based on benzphetamine or phendimetrazine, there is a high risk of abuse of these drugs.
In general, we propose to divide drugs for weight loss into several groups (Table 2). All of them allow you to change eating behavior. Effective drugs for weight loss are those that allow you to reduce the initial weight by at least 5% / year.
Centrally acting drugs that raise serotonin levels have previously been widely used for weight loss, but have serious side effects. For example, fenfluramine was removed from the US drug market because it caused valvular damage. Serotonin reuptake inhibitor drugs like fluoxetine have not shown long-term efficacy. Therefore, the FDA has not registered any of the noradrenergic drugs for the long-term treatment of obesity. Amphetamine-like centrally acting drugs, although approved for use in a number of countries, are significantly limited in their use.
Sibutramine showed long-term effectiveness in reducing body weight and reducing blood fat metabolism, however, in some patients there was a statistically significant increase in blood pressure, increased heart rate (and therefore they could not continue taking the drug). Frequent side effects in the form of xerostomia, constipation, headache and insomnia plus limited efficacy prevent its widespread use.
The FDA has approved the only drug to reduce fat absorption, orlistat (Xenical). This drug is a lipase inhibitor and blocks the absorption of some of the fats in food. Xenical is the most studied and safe drug for weight correction, does not have a negative effect on the cardiovascular system.
Comparative characteristics of the efficacy and safety of orlistat and sibutramine are shown in table 3.
Since July 1998, when Xenical was approved for use in Europe, 20 million patients worldwide have received orlistat. The drug is approved for use in 140 countries. Approved in the US by the FDA for the treatment of obesity on April 26, 1999.
Orlistat (Xenical) is a synthesized stable substance (tetrahydrolipstatin), which is similar to lipstatin, a waste product of the bacterium Streptomyces toxytricini. The molecular weight of Xenical (C 29 H 53 NO 5) is 495.74. The drug has a high lipophilicity, is well soluble in fats, and its solubility in water is very low.
The drug does not have a systemic effect, it is practically not absorbed from the intestine. Xenical mixes with drops of fat in the stomach, blocks the active center of the lipase molecule, preventing the enzyme from breaking down fats (triglycerides). Due to the structural similarity of Xenical with triglycerides, the drug interacts with the active site of the enzyme - lipase, covalently binding to its serine residue. The binding is slowly reversible, but under physiological conditions, the inhibitory effect of the drug during the passage through the gastrointestinal tract remains unchanged. As a result, about 30% of dietary triglycerides are neither digested nor absorbed, which allows for an additional calorie deficit compared to diet alone of approximately 150-180 kcal/day. Undigested triglycerides cannot enter the bloodstream and are excreted in the feces, which creates an energy deficit and contributes to weight loss. Xenical does not affect the hydrolysis and absorption of carbohydrates, proteins and phospholipids.
The oral dose of Xenical is almost completely (about 97%) excreted in the feces, with 83% being eliminated as unchanged drug.
More than three-quarters of patients treated with Xenical and dieting achieved a clinically significant weight loss (greater than 5% of baseline body weight) after 1 year. When taking Xenical and following a diet after 1 or 2 years of treatment, more than 10% of the initial body weight lost twice as many patients as when following a diet and taking a placebo. It can be predicted that patients who strictly adhere to the received recommendations (which can be judged by a decrease in body weight by more than 5% in 3 months), by the end of the first year of treatment, will greatly reduce body weight (by 14%). After an initial reduction in body weight, patients who received placebo and diet regained twice as much as patients who received diet and Xenical.
It is preferable to prescribe Xenical to all obese patients who are addicted to fatty foods. When analyzing the fat content in a patient's diet, one should keep in mind not only animal fat, but also vegetable fat, not only explicit, but also hidden fats (T.G. Voznesenskaya et al.).
In addition to the action mediated by weight loss, Xenical has an additional beneficial effect on total and LDL cholesterol levels. The use of Xenical reduces the amount of free fatty acids and monoglycerides in the intestinal lumen, reduces the solubility and subsequent absorption of cholesterol, helps to reduce hypercholesterolemia. The ratio of LDL/HDL of a well-known predictor of cardiovascular risk significantly improved after 1 and 2 years of treatment with Xenical (p< 0,001 и р < 0,001 соответственно по сравнению с группой плацебо). Достоверное улучшение за 2 года лечения Ксеникалом было отмечено и со стороны апоВ- и липопротеина – двух хорошо известных сердечно-сосудистых факторов риска.
Xenical significantly reduces high blood pressure. The decrease in body weight after 1 and 2 years was accompanied by a decrease in both systolic (SBP) and diastolic (DBP) blood pressure. In high-risk patients (baseline DBP 90 mm Hg), treatment with Xenical reduced it by 7.9 mm Hg. Art. by the end of the first year, while when taking placebo, the decrease in DBP was 5.5 mm Hg. Art. (p=0.06). Similar results were obtained in relation to SBP in high-risk patients (baseline SBP 140 mm Hg). At the same time, in patients receiving placebo, it decreased by 5.1 mm Hg. Art., and those who received Xenical - more than 10.9 mm Hg. Art. (R< 0,05). Таким образом, полученные результаты показывают, что Ксеникал в сочетании с диетой более эффективно снижает артериальное давление у больных ожирением и артериальной гипертензией, чем только диетотерапия. Снижение артериального давления уменьшает степень сердечно-сосудистого риска.
The 4-year Swedish study XENDOS, which was conducted among 3277 adult patients with obesity, studied the effectiveness of orlistat in the metabolic syndrome. It was found that about 40% of obese patients had all the signs of the metabolic syndrome (NCEP ATPIII). Weight loss with orlistat resulted in equivalent improvements in body weight, blood pressure, fasting glucose, blood lipids, and others in 60% of obese patients who did not have metabolic syndrome.
Obese individuals have an increased risk of developing type 2 diabetes. A number of studies have shown that the use of Xenical can prevent the development or slow the progression of type 2 diabetes. Among patients with initially normal results of the oral glucose tolerance test who received Xenical for 2 years, none developed diabetes. At the same time, during the same period in the placebo group, diabetes manifested itself in 1.5% of patients (p< 0,01). Кроме того, количество больных, у которых в ходе наблюдения развилось нарушение толерантности к глюкозе, в группе плацебо было вдвое больше (12,4%), чем в группе Ксеникала (6,2%, р < 0,01). Среди пациентов, уже исходно имевших нарушение толерантности к глюкозе, диабет за 2 года наблюдения в группе плацебо развивался более чем в 4 раза чаще, чем в группе Ксеникала (7,5% и 1,7%, р < 0.05). Положительная роль модификации образа жизни пациентов при приеме орлистата проявилась и в предотвращении манифестации СД 2 типа. Поэтому его рекомендуют применять лицам с высоким риском развития СД 2 типа наряду с препаратами акарбозы и метформином.
A retrospective analysis of 7 multicenter, double-blind studies showed that a 12-month course of orlistat treatment plays a significant role in reducing carbohydrate tolerance, systolic and diastolic blood pressure, HbA1c, and fasting blood glucose (XEDIMET, Sweden). The effectiveness of Xenical in combination with a diet exceeds the effectiveness of placebo in combination with a diet in terms of preventing the development and slowing the progression of type 2 diabetes mellitus.
Xenical significantly reduces the level of glycemia on an empty stomach. In patients with initially high fasting glycemia (more than 7.77 mmol / l), Xenical reduced it by 0.47 mmol / l, and the use of placebo was accompanied by an increase in glycemia by 0.36 mmol / l. A multicenter (12 center) placebo-controlled 57-week study of orlistat conducted in the USA on 391 patients treated with hypoglycemic sulfonamides showed a weight loss compared with placebo of 6.2 kg versus 4.3 kg, a decrease in waist circumference of 4.8 cm versus 2.0 cm, respectively. Patients treated with orlistat achieved a significantly greater effect with lower doses of hypoglycemic drugs than patients treated with placebo, which was manifested in the normalization of glycated hemoglobin (-0.28 vs. + 0.18%), fasting glucose (-0.02 versus + 0.54 mmol/l) and insulin levels (-5.2 versus + 4.3%). Similar results were obtained in a study in the US and Canada among 503 patients with a BMI of 28-43 who received orlistat + metformin or orlistat + metformin + sulfanilamide for one year.
Taking Xenical reduces the concentration of insulin in the blood on an empty stomach. In patients at risk with hyperinsulinemia (initially 90 pmol/l), by the end of the 4-week introductory phase in the group randomized to the future use of Xenical, insulin concentrations decreased by -17.8 pmol/l, while in the group randomized to a subsequent placebo, only - 9.4 pmol / l. After the start of therapy in the Xenical group, a further significant decrease in the level of insulinemia was observed, the amplitude of the difference between the groups was 19.7 pmol/l (p = 0.021). By the end of the second year, the difference became even more pronounced (30 pmol/l, p< 0,017). Таким образом, Ксеникал снижает концентрации инсулина более чем на 30%.
The safety and efficacy of orlistat were evaluated in 375 adolescents aged 12-16 years, whose mean age was 13.5 years, who received 120 mg of the drug 3 times a day. A placebo was given to 182 teenagers. There was a more frequent (in 27% of patients) weight loss due to visceral fat (more than 5% of the mass) in the orlistat group than in the diet and placebo group (in 16% of patients), in which weight loss took place after demineralization of bones. This allowed the FDA to approve in the United States on December 15, 2003 the use of Xenical in adolescents in the 12-16 age group. To date, it is the only weight management drug approved for use in adolescents.
Orlistat is taken with every meal with water. The presence of lipases in the gastrointestinal tract is necessary for the manifestation of the Xenical effect. Since the secretion of lipases is stimulated by the presence of food in the gastrointestinal tract, Xenical should be taken with food. The effectiveness of Xenical is optimal when taken during or up to 1 hour after a meal containing less than 30% of calories from fat. With an increase in the fat content in food, the total amount of fat excreted in the stool increases. When taking orlistat, it is recommended to use multivitamin preparations (supplements).
A number of studies have found that the content of fat in food is directly related to the frequency and severity of adverse events from the gastrointestinal tract with each dose of Xenical. The tolerability of Xenical is inversely correlated with the amount of fat in the diet. With its use, general negative phenomena are observed in the form of increased stools and steatorrhea, which was noted in a three-year study among patients receiving various combinations of orlistat with hypoglycemic drugs and a moderate diet containing about 30% fat. It should be noted that these side effects were the result of excessive fat intake and, of course, indicate the high effectiveness of the drug. Xenical should be used with a moderately low-calorie diet containing no more than 30% of calories in the form of fat. In this case, discomfort from the intestines, as a rule, is not observed.
Xenical does not interact with alcohol. Xenical increases the bioavailability of pravastatin by 30%. When prescribing Xenical in combination with pravastatin, the lipid-lowering effect is enhanced.
Based on the foregoing, we consider the most appropriate treatment regimen for moderate obesity or overweight:
For more information about the use of Xenical (orlistat) for the treatment of obesity and overweight, you can visit the website www.xenical.com.ua or call the hotline: 8-800-50-454-50 (all calls on Ukraine free).
Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.
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Ministry of Health of the Khabarovsk Territory
Regional state budgetary educational institution of secondary vocational education
"Khabarovsk State Medical College"
on academic discipline OGSE.04 "Physical culture"
Correction of physique (body weight) of a student by means of physical culture
Student of group LD-11(2): Vysotskaya Yu.S.
Teacher: M.A. Piryazev
It is known that the physical development of a person as a process of change and formation of morphological and functional properties depends on heredity and living conditions, as well as on physical education from the moment of birth. Of course, not all signs of physical development are equally amenable to correction at student age: the most difficult thing is height (more correctly, body length), much easier - body weight (weight) and individual anthropometric indicators (chest circumference, hips, etc. ).
In this paper, we will consider by what means and methods of physical culture each student can correct and maintain normal anthropometric indicators, in particular body weight.
wellness physique physical regimen
Unlike height, body weight (weight) is subject to significant changes in both directions with regular exercise or sports (with a balanced diet).
Before you start training, you need to accurately assess your data: general health, heart readiness for physical exertion and body type. People with different body types react differently to the same training system. What works great for one may not work for another.
As you know, the norm of body weight is closely related to human height. The simplest height-weight indicator is calculated by the formula: height (cm) - 100 = weight (kg). The result shows normal body weight for a person of this height. However, this formula is only suitable for adults with a height of 155-165 cm. With a height of 165-175 cm, subtract 105 already, with a height of 175-185, subtract 110.
You can also use the weight-height indicator (Ketley index). In this case, by dividing body weight (in g) by height (in cm), a quotient is obtained, which should be about 350-420 for men and 325-410 for women. This indicator indicates an excess of body weight or its lack.
A directed change in body weight is quite accessible at a student's age. The problem is different - it is necessary to change the usual way of life. Therefore, the prevention or treatment of obesity is largely a psychological problem. But whether or not you need to significantly change body weight, you decide for yourself when assessing the proportionality of your body. It remains to choose sports (exercises) for regular exercise, especially since some types contribute to weight loss (all cyclic - middle and long distance running, cross-country skiing, etc.), others can help "gain" body weight (weightlifting , athletic gymnastics, kettlebell lifting, etc.).
The true anthropometric proportionality of the human body, recognized by both anatomists and biodynamic specialists, is based on the views of the ancient Hellenes, in whom the cult of the human body was quite high. This was especially clearly reflected in the classical proportions of the works of ancient Greek sculptors. Their development of body proportions was based on units of measure equal to one or another part of the human body. Such a unit of measure, called the module, is the height of the head. According to Polycletus, the height of the head with a normal human figure should fit eight times the height of the body. So, according to the "square of the ancients", the scope of outstretched arms is equal to the growth of the body. The length of the thigh fits four times in height, etc.
Basic body types
* asthenic (ectomorphic);
* hypersthenic (endomorphic);
* normosthenic (mesomorphic).
Slender (asthenic body type or ectomorph)
Distinctive features of people with asthenic body type are light, brittle bones, long, thin limbs, a narrow, long chest, a relatively wide pelvis, narrow shoulders, long and thin muscles, and a poor layer of subcutaneous fat.
Recently, there are more men of asthenic body type. Acceleration, lack of full-fledged physical activity, an “ecological” drop in testosterone levels lead to the formation in young people of a tall, narrow-shouldered figure with underdeveloped muscles and fragile ligaments, called “unisex”.
The formation of an ideal figure in a man of asthenic body type can take several years of hard work.
You need to start building your body with strengthening the ligaments (due to stretching exercises in combination with strength gymnastics) and only then proceed to build muscle mass. To succeed, you need to resort to strength training and pay special attention to nutrition.
The workout should be hard (in terms of the complexity of the exercises and the weights used), but not long, so as not to lose the calories necessary for building muscles. Calories in men with a slender figure accumulate with difficulty, and are consumed very quickly, you need to reduce overall motor activity (running, jumping, playing sports, etc.) and try to relax more.
Stocky figure (hypersthenic or endomorph)
People with a picnic body type are characterized by rounded, soft shapes due to a well-developed fat layer, a wide red face with soft features. People with a picnic body type show a certain tendency towards obesity.
The main goal of fitness with a full (endomorphic) body type is to fight overweight (mind you, not overweight!), to build muscle hidden under a layer of fat and work out muscle relief. There is something to work on: add somewhere, subtract somewhere.
It is necessary to follow a low-calorie diet; during training, perform the widest possible range of exercises and complexes with a large number of sets and repetitions, reduce the break time between sets, add aerobic exercises associated with increased calorie consumption to the training system (running, cycling, swimming, sports games).
Athletic figure (normostenic, or mesomorph)
The athletic body type is characterized by a wide chest and shoulders, proportional torso and legs, strong skeleton and muscle structure, without excessive fat. Strong broad shoulders, trapezoidal torso with a relatively narrow pelvis. Powerful convex relief of muscles on a strong backbone. Strong arms and legs, large hands and feet, broad shoulders, narrow hips. The legs, in comparison with the upper parts of the body and especially the hypertrophic shoulder girdle, sometimes appear thin. A strong elongated head, a free strong neck with a pronounced trapezius muscle.
If you have a normal body type (athletic figure), it is unnecessary to overload, just improve your body. To do this, you need to follow a balanced diet, the training program should be varied, combine strength training, relief work and aerobic exercises.
During physical culture, excess adipose tissue is consumed to generate the required amount of energy for exercise. As a result, there is a decrease in excess weight. An increase in body weight can also lead to an improvement in body type, but only if this occurs due to the growth of muscle tissue.
A significant increase in muscle tissue can be achieved by such means of physical culture as weightlifting and bodybuilding. However, for most students, this is probably not the most suitable option, since in this case the physique of the fair sex will acquire masculine features. A much better option for girls is to practice various types of athletics.
Each sport of this category forms certain features of the figure, which, quite possibly, will be the desired results of physique correction.
When jogging, women develop a correct posture and a symmetrically developed body. Body modification through jumping exercises can reduce body weight, lead to strong development of the chest and increase the ratio of the length of the legs to the trunk. When correcting the physique with the help of such a means of physical culture as gymnastics, a small body weight, long thin legs, a narrowed pelvis are achieved, which together gives a slender athletic figure. Synchronized swimming or figure skating will allow you to correct the physique due to the formation of a strictly symmetrical body, correct beautiful posture, slender legs, development of the chest.
It should also be taken into account that the best results in the correction of physique by means of physical culture can be achieved in childhood and adolescence. During this period, the body is still developing, so undesirable body features are quite easy to correct. In adulthood, body correction is much more difficult to carry out, since the body has already been formed, growth has stopped, the growth zones of the bones are already “closed” for exposure to physical culture. However, physique correction by reducing excess body weight (i.e. reducing excess body fat) during physical education can be carried out at any age (of course, in the absence of contraindications to physical activity)
Students can engage in physique correction not only in the classroom, but also in fitness clubs, as well as on their own (evening and morning jogging at stadiums or in parks, jumping rope, performing general developmental physical exercises at home).
According to the degree of influence on the body, all types of health-improving physical culture (depending on the structure of movements) can be divided into two groups: exercises of a cyclic and acyclic nature.
Cyclic exercises are such motor acts in which the same complete motor cycle is constantly repeated for a long time. These include walking, running, skiing, cycling, swimming, rowing.
In acyclic exercises, the structure of movements does not have a stereotypical cycle and changes during their execution. These include gymnastic and strength exercises, jumping, throwing, sports games, martial arts. Acyclic exercises have a predominant effect on the functions of the musculoskeletal system, as a result of which muscle strength, speed of reaction, elasticity and mobility in the joints, and lability of the neuromuscular apparatus increase.
The types with the predominant introduction of acyclic exercises include hygienic and industrial gymnastics, classes in health and general physical fitness (GPP), rhythmic and athletic gymnastics, gymnastics according to the "hatha yoga" system.
1) Morning hygienic gymnastics
Morning hygienic gymnastics contributes to a faster bringing of the body into working condition after waking up, maintaining a high level of efficiency during the working day, improving the coordination of the neuromuscular apparatus, the activity of the cardiovascular and respiratory systems. During morning exercises and subsequent aqua procedures, the activity of skin and muscle receptors, the vestibular apparatus is activated, the excitability of the central nervous system increases, which improves the functions of the musculoskeletal system and internal organs.
2) Industrial gymnastics. This type of recreational physical education is used in various forms specifically in the workplace. Introductory gymnastics before starting work helps to activate the nerve motor centers and increase blood circulation in the working muscle groups. It is especially needed in those types of production activities that are associated with a long sitting working posture and the accuracy of performing small mechanical operations.
Physical culture breaks are organized specifically during work. The time of their implementation is determined by the phases of the configuration of the level of performance - depending on the type of activity and the contingent of workers. A physical culture pause in time must precede the phase of a decrease in working capacity. By performing exercises with musical accompaniment for unused muscle groups (according to the mechanism of active rest), the coordination of the activity of nerve centers, the accuracy of movements are improved, the processes of memory, thinking and concentration of attention are activated, which has a beneficial effect on the results of the production process.
Industrial gymnastics for a student is the discipline "Physical culture", visiting which students is very important due to the reasons described above.
3) Rhythmic gymnastics.
The highlight of rhythmic gymnastics is that the pace of movements and the intensity of the exercises are set by the rhythm of the musical accompaniment. It uses a complex of different means that affect the body. So, a series of running and jumping exercises affect the cardiovascular system to a greater extent, inclinations and squats - on the motor apparatus, methods of relaxation and self-hypnosis - on the central nervous system. Parterre exercises develop muscle strength and mobility in the joints, running series develop endurance, dance series develop plasticity, etc. Depending on the choice of means used, rhythmic gymnastics classes can be more athletic, dance, psycho-regulatory or mixed. The nature of energy supply, the degree of strengthening of respiratory and circulatory functions depend on the type of exercise.
Depending on the selection of a series of exercises and the pace of movements, rhythmic gymnastics classes can have a sports or health-improving orientation. The greatest stimulation of blood circulation up to a heart rate of 180-200 beats / min can only be used in sports training by young awake people. In this case, it is more anaerobic in nature and is accompanied by inhibition of aerobic energy supply devices and a decrease in the value of the MPC. Significant stimulation of fat metabolism with this nature of energy supply does not occur; in this regard, there is no decrease in body weight and normalization of cholesterol metabolism, as well as the development of general endurance and performance.
4) Athletic gymnastics.
Athletic gymnastics causes pronounced morpho-functional changes (mostly of the neuromuscular apparatus): hypertrophy of muscle fibers and an increase in the physiological diameter of the muscles; growth of muscle mass, strength and strength endurance. These changes are connected mainly with a long-term increase in blood flow in working muscle groups as a result of repeated repetition of exercises, which improves trophism (nutrition) of muscle tissue. It should be emphasized that these configurations do not contribute to an increase in the reserve capacity of the circulatory apparatus and the aerobic productivity of the body. Moreover, as a result of a significant increase in muscle mass, the relative characteristics of the functional most important systems worsen - the vital index (VC per 1 kg of body weight) and the highest oxygen consumption (MIC per 1 kg), apart from the fact that an increase in muscle mass is accompanied by an increase in the fat component, an increase in blood cholesterol and an increase in blood pressure, which creates favorable conditions for the formation of the main risk factors for cardiovascular diseases.
5) Aerobics.
Aerobics is a system of physical exercises, the energy supply of which is carried out through the use of oxygen. Aerobic exercises include only those cyclic exercises in which at least 2/3 of the muscle mass of the body is involved. To achieve a positive effect, the duration of aerobic exercises should be at least 20-30 minutes, and the intensity should not exceed the level of ANOT. Specifically, cyclic exercises aimed at developing general endurance are characterized by the most important morphological and functional changes in the circulatory and respiratory systems: an increase in the contractile and “pumping” function of the heart, an improvement in the utilization of oxygen by the myocardium, etc. Differences in individual types of cyclic exercises associated with structural features motor act and the technique of its implementation, are not of fundamental importance for the achievement of a preventive and healing effect.
6) Wellness walking.
Health-improving (accelerated) walking is widely used in mass physical culture: at an appropriate speed (up to 6.5 km/h), its intensity can reach the zone of the training mode (heart rate 120-130 beats/min).
Under such conditions, 300-400 kcal of energy is consumed in 1 hour of walking, depending on body weight (approximately 0.7 kcal / kg per 1 km of the distance traveled). For example, a person with a body weight of 70 kg consumes about 50 kcal when walking 1 km. At a walking speed of 6 km / h, the total energy consumption will be 300 kcal (50 * 6). With daily health-improving walking exercises (1 hour each), the total energy consumption per week will be about 2000 kcal, which provides a small (threshold) training effect - to compensate for the lack of energy consumption and increase the body's functional capabilities. This is confirmed by the results of the study of the greatest aerobic productivity. So, after 12 weeks of training in recreational walking (1 hour 5 times a week), the subjects showed an increase in BMD by 14% compared to the initial level. But such a training effect is possible only for unprepared beginners with low UFE. In more trained athletes, the health-improving effect of walking decreases, since with an increase in fitness, the intensity of overload becomes below the threshold. Increasing the walking speed over 6.5 km/h is difficult, because it is accompanied by a disproportionate increase in energy consumption.
There are a large number of complexes of general developmental and corrective physical exercises used to correct physical development. In particular, the following complex can be proposed to eliminate excess body weight:
1. Walking in place for 2 min2. I. p. - o.s. bend your arms in front of your chest and perform jerks to the sides while simultaneously turning the body to the left and right.
3. I. p. - o.s. stretch your arms forward (palms down). Perform swing movements with the legs, alternately reaching the right palm with the toe of the left foot and the left palm with the toe of the right foot.
4. I. p. - o.s. stand, legs wider than shoulders, arms along the body. Perform torso tilts to the right and left, reaching out with your hands toes.
5. Perform overhead clapping jumps 50-100 times.
6. Slow walking for 30-40 minutes. Accelerated walking (450-500 m), jogging (500-550 m).
7. Playing basketball, volleyball, football, badminton, etc. for 15 minutes.
After class, you should take a shower and rub the body with a terry towel. The given complex can be supplemented with a visit to the swimming pool (2 times a week) and participation in hiking trips at the weekend.
The educational process has its side effects: low physical activity, sedentary activity, great mental stress, regular stress. These factors can contribute to improper physical development, folding of a disharmonious physique, physical fatigue, as a result, to deviations from the norm of health indicators.
In this paper, we have considered the means and methods available to each student for the correction of anthropometric indicators (body weight in particular). You can achieve the desired result with the proper use of physical culture and an individual approach when choosing means and methods of correction.
It should be noted that along with the performance of physical exercises, for the correction of individual physical development and motor capabilities, the diet, educational and labor activities, rest and sleep are of great importance.
One of the main contributing factors is the correct motivation and volitional factor of the student. Striving for a harmonious, healthy lifestyle.
1. Dvorkin, L. S. Physical education of students [Text] / L. S.
2. Dvorkin, K. D. Chermit, O. Yu. Davydov. - M. : Phoenix, 2008.
3. Correction of physique (body weight) of students of the medical group by means of physical culture [Text]: method. instructions / E. I. Goncharova, I. B. Biryukova. - Ukhta: USTU, 2012. - 18 p.
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