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Annalisa Piston

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Nutrition in Overweight and Obesity – Diets for Weight Loss

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La obesity It is a chronic disease that is defined by an excess of weight, due to the accumulation of fat mass, with respect to what a person would have due to their size, sex and age.

El diagnosis of obesity It is established by the relationship between weight and height, using the body mass index (BMI), which is calculated by dividing the weight in kg by the square of the height in meters and allows defining the degrees of obesity.

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The weight classifications according to BMI are:

  • < 18,5: low weight
  • 18,5-24,9: normal weight
  • 25-29,9: overweight
  • 30-34,9: grade I obesity
  • 35-39,9: obesity grade II
  • > 40: obesity grade III

Waist circumference measurements provide important information about fat distribution. This establishes the morphological classification of obesity, which is distinguished in android or gynoid for being characteristics of male or female, although both can manifest in both sexes:

  • Abdominal obesity, central or upper (android): the fat mass accumulates in the cervical region, in the trunk and in the upper abdomen (also known as apple-type obesity). There is an increased risk of diseases when the abdominal circumference is greater than 95 cm in men and 82 cm in women. The risk is greater for values ​​of 102 cm in men and 88 in women.
  • Gluteofemoral obesity o peripheral: adipose tissue accumulates mainly in the lower part of the body: hips, buttocks and thighs (pear-type obesity).
  • Homogeneous distribution obesity: excess fat does not predominate in any particular area of ​​the body.

Of all the factors involved, two stand out due to the possibility of being modified: excessive caloric intake and a sedentary lifestyle.

Treatment of obesity is of particular importance. The therapeutic objectives must be individualized but can be gathered at these points:

  • Identification and treatment of the factors that condition or favor overweight – obesity.
  • Reasonable reduction in body weight. An initial loss of 5-10% in 3-6 months is generally recommended.
  • Weight maintenance after reduction.
  • Improvement of the quality of life.

 Changes in diet are the basis of overweight treatment and should accompany any other therapeutic measure.

The objective of dietary treatment is not only for the patient to lose weight, but also to improve their health by offering specific guidelines that can be maintained over time.

El obesity treatment requires a radical change in the philosophy that surrounds the act of eating. Being overweight is a risk factor for the development of emotional symptoms, both anxiety and depression, due to feelings of shame and guilt for not complying with the standards accepted by society, with reduced self-esteem.

All emotional disturbances cause a decrease in the patient's quality of life.

For this reason, support and motivation are necessary, especially in patients with previous failures, to convince them that the diet is not slavery but rather a liberation from dependence on food.

It is essential to approach an emotional reeducation that allows changing eating habits on a permanent basis, eliminating all frustrating elements and focusing on weight, not as a problem, but as a result.

It is very important to assess the patient's motivation for change and discuss the fact that dietary and lifestyle changes are forever.

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diets for weight loss

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Given the prevalence of overweight In today's society, there are numerous diets to lose weight.

In any case, with equal caloric intake, weight loss is especially related to adherence to treatment and not to the different distribution of nutrients.

The diet should be adapted to the characteristics and lifestyle of each person.

From a practical point of view, a series of recommendations have been established that can facilitate therapeutic compliance:

  • Portion size control.
  • Decreased intake of foods with high energy density.
  • Intake of foods rich in essential nutrients and fiber.
  • Modification of food preparation methods.
  • Adequate distribution of food throughout the day, with reduced intake in the late afternoon or evening.

Playing with the number of daily calories and the proportion of macronutrients (proteins, carbohydrates and fats), the most widely used dietary treatment guidelines for overweight are detailed below.

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Hypocaloric diets

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The hypocaloric diets classic provide fewer calories than the person's total energy expenditure.

This caloric deficit daily is responsible for weight loss as it allows you to use stored fat as an energy source.

In general, a contribution of 500-1000 kcal less than energy expenditure or your usual intake is recommended, to achieve an approximate weight loss of 0,5-1 kg/week.

These diets provide about 1000-1200 kcal/day in women and 1500/2000 kcal in men, with a balanced proportion of macronutrients or with a certain tendency to increase protein and decrease fat and carbohydrates.

You have to estimate what the patient's maintenance calories are and after knowing them, apply a deficit.

To calculate the maintenance caloric needs, it is necessary to know the basal metabolism and the activity factor of the individual. Basal metabolism is the amount of energy needed for vital processes, represents about two thirds of total needs and varies in relation to weight, height, age, percentage of fat, gender, genetics, growth , intake and ambient temperature.

The activity factor is a rough average of the different levels of physical activity that a person can have (from 1.2 sedentary to 1.9 very active).

A reasonable and consistent caloric deficit is approximately a 15% to 20% cut in maintenance calories. In this way, a man with a maintenance caloric expenditure of 2500 kcal, can aim for a deficit of between 375 and 500 kcal, that is, 2000-2125 kcal.

On the other hand, a woman with a maintenance caloric expenditure of 1800 kcal would have a target calorie of between 1200 and 1300 kcal.

With these figures, a weekly weight loss of approximately 0.5 to 1% is estimated.

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area diets

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La Zone Diet it focuses mainly on the excess of carbohydrates that are consumed daily and that produce an excess of insulin creation, thus having a negative impact on the metabolism.

La zone diet It is based on eating five meals a day (or six), with at least two of them being quite light and not letting more than 4-5 hours pass between them, to avoid altering blood insulin levels.

This diet tries to reduce the intake of carbohydrates to turn to fat as an energy reserve. A 40-30-30 ratio of carbohydrates, proteins and fats is recommended in each meal, giving priority to polyunsaturated fats, supporting the diet with significant omega-3 supplementation and using moderation and variety as premises. With this type of diet, after meals, the glucose peak is at a minimum, keeping insulin in an ideal "zone" for health. It is a highly recommended diet for type I diabetes.

Recommended foods for zone diet are:

  • Low glycemic index carbohydrates: avoid foods such as honey or refined sugar as much as possible.
  • Proteins: fermented dairy, animal proteins such as chicken or turkey and those that come from vegetables, such as tofu, are the most indicated in this diet.
  • Fats: olive oil, olives, avocados and nuts.

La zone diet It is not a weight loss diet in itself, but it gives the necessary guidelines to maintain a balanced diet.

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Dissociated diets

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The dissociated diets they are based on the concept that the digestive system is unable to properly process certain combinations of foods.

The structure of the dissociated diet consists of dividing foods into three groups that cannot be mixed with each other:

  • Carbohydrates: These are mainly foods rich in carbohydrates, such as cereals, legumes, flour and derivatives, potatoes, sweets and chocolates.
  • protein: meat, fish and shellfish, eggs and dairy products are included in this group because they are the ones that offer quality proteins and amino acids to a greater extent.
  • Neuters: are foods in which neither carbohydrates nor proteins predominate, such as: vegetable oils, butter and various vegetables (non-starchy).

Each food group requires different absorption times, different pH (more acid or alkaline), and different enzymes for digestion. When combining foods, intermediate conditions are generated that do not favor any group. As a result it is possible to suffer digestive problems and accumulate fat.

By not mixing large doses of animal protein with legumes or cereals, palatability and sensory reward are reduced, and reducing variety and combinations reduces excessive food intake. In addition, the process of digestion of food is favored.

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Low carbohydrate diets and ketogenic diets

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Are considered low carbohydrate diets, the feeding guidelines that do not reach the recommendations of the appropriate percentage of these macronutrients, that is, they provide less than 40% of the total calories in the form of carbohydrates.

Una ketogenic diet is a low carb meal plan which can help burn fat very effectively.

“Being in ketosis” means that you are primarily using fat for energy.

This state is achieved with a prolonged fast (at least 18-24 hours) or with a very low carbohydrate diet. Under these conditions, the body obtains energy from the fatty acids stored in the body, generating lketone bodies or ketones.

The ketones they are an alternative source of fuel for the body, especially the brain, which is used when blood sugar (glucose) is low. On a ketogenic diet, the entire body switches its fuel supply to run primarily on fat. When insulin levels are very low, fat burning can be greatly increased as it is easier to access the body's stored fat reserves.

This is great when it comes to losing weight, but there are also other less obvious benefits, such as reducing hunger and having a steady supply of energy.

Accurately calculating macronutrient amounts is very important in achieving ketosis: ketones are produced if we eat very few carbohydrates (which break down quickly into blood sugar) and only moderate amounts of protein (excess protein can also turn into blood sugar):

-Protein: 1-1.5 g/kg (approximately 20% of total calories).

-Carbohydrate: <50 grams (5-10% of the total, including fiber).

-Fat: the rest (70-80% of the total).

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The goal of nutrition plans is to achieve long-term changes in habits and make the person the owner of their health through food.

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