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  CONSULTATION DA OBESIDADE

 

 

  Nutrition in Obesity

 

 

  The importance of Nutrition Consultation

 

  Did you know that in Portugal 5 million people (almost half of the Portuguese population) are overweight?

  And about 14.2% are obese? 1% suffer from severe obesity?  

  Obesity is considered the epidemic of the 21st century the numbers speak for themselves – about 13% of men and 15% of  _cc781905-5cde-3194-bb3b- 136bad5cf58d_    women are obese – this being a scary number. since they contribute to the emergence of many

  medium-term health problems such as hypercholesterolemia, non-insulin-dependent diabetes,  _cc781905-5cde-3194-bb3b-136bad5_cf58d_ 051cc58d_ 05 -bb3b-136bad5cf58d_         problemas ortopédicos, baixa auto estima e muitos outros como cardiovascular diseases, the

  osteoarticular diseases, various types of cancer and even physical and psychological problems, … work absenteeism,

  para    a significant decrease in the quality of life and contributes to a shortening of the life span.

  Obesity also affects many Portuguese children, with around 31.5% of children

  overweight, of which about 11% are obese.

  Be careful, overweight and obesity in children are not noticeable   as in adults.

  Often, only after an assessment of anthropometric parameters (weight, height, BMI, percentile tables, …),

  which should be done by a Pediatrician or nutritionist with a lot of experience in Pediatrics, if

  can identify.

  The diet of obese children must be varied and balanced and contain all the nutrients necessary to

  a suitable development. It is necessary that the energy supplied is adequate, weight maintenance

  or to promote weight loss, depending on the child's age, percentile,

  whether or not you have any disease associated with obesity. Monitoring should always be carried out

  by a nutritionist with extensive experience in Pediatrics.

  Obesity is a chronic disease that requires early and continued intervention. just like that

  we will be able to obtain rewarding results in the fight against this disease, which is already a serious problem

  for the Portuguese population.  

 

 

  OBESITY / OVERWEIGHT

 

 

  What is Overweight/Obesity

 

  Overweight and Obesity are different degrees of excessive accumulation of fat in the body,

  in such a way as to harm health.

  The ideal weight does not exist. Normal weight is an individualized value that depends on several factors:

  physiological (age, sex, height, etc...) genetic, pathological and cultural.

  There are several ways to classify an individual's excess weight by associating the physiological factors with each other:

   _cc781905-5cde-3194-bb3b-18d_bad555

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     Indice de massa corporal (IMC)

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     Perímetro da Cintura

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     Bioimpedância

 

    The most used is the one based on the Quetelet Index or Body Mass Index (BMI).

 

 

  WHY WE FEEL HUNGER AND SATIETY

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  TREATMENT FORMS

 

  The most commonly used forms of treatment are two:

 

  •  a calorie-restricted eating plan combined with adequate physical activity, or

  • a calorie-restricted food plan combined with physical activity and drug therapy.

  • Drug Therapy

  • Physical activity

  • Food Therapy

  • Lifestyle modifications

  The overwhelming majority of authors agree that the treatment of obesity should undergo a series of reeducational measures.    _cc-78cde9 _cc-78cde9 -3194-bb3b-136bad5cf58d_   These measures concern not only behavior and eating habits but also sedentary lifestyles

  a population that does less and less exercise, at the same time that the consumption of fats increases.

  There is clear evidence that moderate and sustained weight loss of only 5% to 10% of initial body weight,

  is sufficient to provide clinically significant improvements in obesity-associated comorbidities.

  Several studies have shown that modest weight loss is associated, among other benefits, with reduced

  of blood pressure, improvement of insulin sensitivity and glycemic control in diabetics and a profile

  less atherogenic lipid.

  In light of this clinical evidence, recent guidelines emphasize moderate weight loss as an objective

  adequate and realistic for controlling excess weight and not achieving a supposed ideal weight,

  often impossible to achieve.

  In fact, according to the European Clinical Practice Guidelines (2008), “adequate goals for weight management should aim

  for realistic weight loss, with a view to reducing health risks, and should include weight loss promotion

  weight, weight maintenance and prevention of weight regain.”

  Patients should understand that, as obesity is a chronic disease, weight management must last a lifetime

  and that it has broader goals than simple weight reduction, such as risk reduction

  of complications and the improvement of the individual's general health status.

  Follow -up

 

  The follow-up of obese or pre-obese patients must follow some guidelines:

​

  • It must be carried out on a regular basis;

  • The rate of weight loss will depend on the cases but, in general, a loss of 2 to 4 kg/month will be adequate.

    (depending on the individual's initial weight), and amounts of

    water and glycogen and less fat. Subsequently, the losses are preferably of fat.

    It is very important to measure your waist circumference at the same time as your weight, to know if you are losing weight

    fat mass. Correct weight loss is measured in centimeters rather than kilos;

  • A loss of less than 0.5 kg per week can demotivate the individual, causing the treatment to be prolonged for a long time.

    The verification of the decrease in abdominal volume, reflecting, to a large extent, the loss of fat, helps to motivate the patient;

  • Once the desired weight is reached, the energy needs will be lower, so you should readapt the

      calorie intake to prevent weight regain, achieving maintenance.

 

 

 

  THERAPEUTIC  com  MEDICINES

 

 

  Drug therapy helps to treat obesity. In our country, drugs approved for the treatment of

  obesity    are limited to a group of drugs of peripheral action, ie. which decrease the absorption of food in the intestine.

 

  Drug therapy should be part of an action plan for weight control, which includes

  behavioral changes, eating habits and physical activity.

 

 

  Medication alone is not a solution. It has to be combined with a proper meal plan and practice.

  regular physical activity, stipulated by your doctor or nutritionist.

 

 

  

 

 

PHYSICAL ACTIVITY

 

 

 

  Physical activity, in addition to increasing daily energy expenditure, increases lean mass, which leads to an increase in

  in long-term basal metabolism.  Has numerous health benefits and improves many comorbidities

  often associated with obesity.

  Regular physical activity must be understood as fundamental for all health and not just for the issue of excess weight.
  Regarding the latter, it is very important, either for its prevention, or to help reduce it, or to enable

  may the weight loss last forever.
  Adequate nutrition and regular physical activity are not mutually exclusive, as they act through different mechanisms,

  although regular exercise allows for a lighter food restriction.
  Exercise helps you lose weight both during your practice and in the hours that follow, that is, an individual

  regularly active consumes more calories at rest than if you were sedentary.

  Physical activity mobilizes more intra-abdominal fat than diet and it is known that this is the most

  threatening and harmful to health and which underlies most complications of increased body fat,

  such as increased blood pressure, lipids, insulin resistance and diabetes,

  the risk of cardiovascular accidents, etc.    In short, it is unthinkable to lose weight WELL without having a physically active life.

  To obtain the best results, it must meet a series of conditions:

  • PeriodicityIt is necessary to practice physical activity regularly if it is to be beneficial

      for health and weight control. It is recommended that ideally, 1 hour of walking be performed daily;

  • Duration. It should usually last from 45 to 60 minutes. The sports that consume the most fat are aerobics

     (long duration and moderate intensity) such as walking, swimming, etc.;

  • Intensity. This must be chosen according to the individual's possibilities and preferences;

      depending on the intensity of the activity, the energy expenditure will vary.

 

    The following table shows the relationship between types of activities and energy consumption.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  In order to obtain definitive results, dietary habits and lifestyle must be permanently changed.

 

 

  FOOD THERAPY

 

  The treatment to lose weight involves carrying out an appropriate Food Plan for each case. Plan is hypocaloric,

  that is, it provides fewer calories than we need for everyday life. Only in this way, the energy that is stored

  in the body fat will be used, and thus we lose weight.

  The Food Plan followed for the necessary time stipulated by the doctor or nutritionist should not be too strict,

  with the risk of losing, in addition to fat, important amounts of muscle.

 

 

 

 

 

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     _cc781905-5cde-3194-bb3b- 136bad5cf58d_ LOSE WEIGHT TOO QUICKLY HAS IMPOSED RISKS SO MANY

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     _cc781905-5cde-3194-bb3b- 136bad5cf58d_ FOR HEALTH

 

 

 

    A right Food Plan must be balanced from a caloric point of view. For example: 30% of energy must come from fats,

    55% of the carbohydrates and 15% of the proteins. Concluding the foods rich in carbohydrates, the so-called

  "farinaceous", cannot be put aside in a weight loss treatment! On the other hand, the amounts of fat should

    be reduced.

  The Food Plan must be sufficient in other nutrients, namely, vitamins, minerals, water, fibers.

  Meals must be spread out throughout the day and two extremes should be avoided: on the one hand, eating just one or two

  "super meals", hypercaloric, leaving the body without food for hours; on the other hand, spend the day "snacking"

  small amounts of food, without ever having a real meal.

 

 

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_   

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     DEIXAR O ORGANISMO HORAS SEM COMER E "VINGAR-SE" EM UMA OU

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     DUAS REFEIÇÕES DIÁRIAS OU PASSAR O DIA A "PETISCAR" SEM FAZER

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     VERDADEIRAS REFEIÇÕES SÃO SITUAÇÕES QUE FACILITAM

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     O AUMENTO DE PESO

 

 

 

    It is important to have three main meals (breakfast, lunch and dinner) and two or three small meals.

   If after dinner exercise is almost non-existent (e.g. lying down or sitting on the sofa) it is desirable that the meal be

    a little less plentiful than lunch.

    In short, we should prefer appreciable amounts of vegetables, calorie-free drinks (water, tea, barley),

    sufficient amounts of foods rich in carbohydrates (potatoes, rice, pasta, bread, grains, beans,…) and fruit,

   meat and fish and reduced amounts of high-fat foods (oils, butter and margarine, cakes, cookies,

   cheese,  sausages, pâtés, certain sauces) and sweets.

 

 

   It is important to organize what you are going to eat throughout the day well in advance and stock up on the most

   vantajosos, thus avoiding giving in to easy but unrecommended temptations… A good way to start

    a meal is with vegetables, in salad or soup, for example.

 

     

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_   

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     USE THE IMAGINATION AND VARIETY OF NEW EXPERIMENTS

      _cc781905- 5cde-3194-bb3b-136bad5cf58d_     _cc781905-5cde- 3194-bb3b-136bad5cf58d_     _cc781905-5cde-3194- bb3b-136bad5cf58d_     E NOVAS FORMAS DE OS COZINHAR

 

 

 

  The cuisine chosen to prepare the food must be tasty and low in fat: stews and stews should be preferred

  with less fat, stews, planters, grilled, boiled, stewed. To put aside: traditional fried foods,

  baked in the oven with fat and added with fatty sauces (eg mayonnaise).

  When we do not know the composition of the food we eat and are packaged, it is important to give

  a look at the food label and see how many calories and fat they contain.

  We should reject those high in fat and/or calories and choose better alternatives.

 

  Examples of Food Plans

  Here are three meal plans with different calorie content that can be used

  in a weight loss treatment.
  Each plan has three options. You should start the day with one of them and follow it until the end of the day.

  Then you can vary it throughout the week. The indicated dishes and the cooking method are just examples.
  It should be noted that this food plan as part of the weight loss treatment does not exclude

  the follow-up that should be given by your doctor and nutritionist

  (specialist qualified to make a food plan adapted to your case).

 

 

 

 

​

     1200  KCAL_cc781905-5cde-3194-bb3b- 136bad5cf58d_       1500_cc781905 -5cde-3194-bb3b-136bad5cf58d_ KCAL     _cc781905- 5cde-3194-bb3b-136bad5cf58d_  1900  KCAL

 

 

​

 

    LIFESTYLE MODIFICATION

 

    The correct intervention consists of achieving, gradually and progressively, the recommended changes

    to the overweight or obese person are acquired by them as something to keep for life.

  It must be insisted that, in order to maintain the weight obtained after losing weight (this is the most difficult task),

  the new acquired habits must be maintained.

​

  We advise:

​

  • Drink at least 1.5 liters of water a day, especially outside of meals

  • Always have a full breakfast

  • Eat at least 5-6 meals a day. It is very important to have a small meal mid-morning and mid-afternoon

  • Do not snack between meals

  • Replace full-fat milk with skim milk, regular yogurt with unsweetened low-fat yogurt, and white bread with bread and mix, rye or whole wheat (complete)

  • Avoid fried foods, sauces and puffs

  • Follow as regular a time as possible for meals

  • Weigh yourself at least once a week, at the same time and on the same scale, with light clothing

  • Walk an hour every day

  • To achieve a satisfactory result, an integrated treatment plan for obesity or overweight is advised,

      in which three indispensable actions must coincide:

  • Reduce the intake of high-fat and high-calorie foods through a proper diet.

  • Increase energy expenditure by promoting the maintenance or increase of regular physical exercise.

  • Establish a treatment and support program that allows for lifestyle reeducation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

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