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How to start losing weight with diabetes

How to start losing weight with diabetes

The first step is the decision to change. It is a matter of personal decision, perseverance, personal responsibility. I do not transfer responsibility for myself to those around me. There is no need to fear the decision.

Why does weight increase?

Did you know that in the last 40 years, energy intake in food has increased by 23%, but we move up to four times less? The law of conservation of matter and energy applies: we receive energy in food and transfer it in movement. It is a universal law of physics. Every food has energy in it. He does not gain weight from anything else, only from food.

Energy is transferred in motion

We transmit different amounts of energy during different activities. Much less energy is transferred when cooking and ironing than when walking in the forest or swimming. Weight loss is associated with targeted activity. Regular exercise is also important in the prevention of type 2 diabetes.

In a study that looked at women who were physically active for at least 7 hours a week compared to women who exercised less than 30 minutes a week, the risk of diabetes was reduced by almost 40%. After an intensive lifestyle change, the incidence of diabetes decreased by up to 60% after three years. An increase in physical activity was effective in the prevention of diabetes independently of changes in weight or nutrition. Even one-time exercise has a positive effect on improving insulin sensitivity, even in obese prediabetics and diabetics.

The effect of the movement is felt within 48-72 hours after its completion. Regular exercise of more than 150 minutes per week has been shown to have a significant impact on metabolic control. Strength and aerobic exercise have comparable effects on improving glycemic control and reducing cardiovascular risk. More important than the type of activity is its regularity and intensity.

Diet of an obese diabetic

The goal of obesity treatment is to reduce weight by 5-10% and maintain this weight. Diet therapy plays a key role in achieving treatment goals. A change in diet is inevitable and must be fundamental. The treatment of the obese is always based on inducing a negative energy balance, where energy intake is less than energy expenditure. By reducing energy intake by 500-1000 kcal, weight loss of 0.5-1 kg per week is achieved. A reduction of energy intake by 15-30% compared to normal energy intake is sufficient and appropriate for a patient with a stabilized weight. It was not proven that the various diets were better than the classic low-energy diet. The easiest way to reduce energy intake is to increase the volume of vegetables in the diet. The rule of half applies. Half of the plate should be vegetables and the remaining half will be divided in half again (carbohydrates and proteins).

Basic principles of eating – ten for success

1. Replacement of sweetened soft drinks with calorie-free liquid.

2. Excluding the consumption of sweet products like cookies, cakes, tarts. An exception is hypoglycemia. Significant restriction of the consumption of pastry and bread.

3. Do not sweeten with white (table) sugar, brown (cane) sugar or honey. It is convenient and safe to use artificial, non-energetic sweeteners (aspartame (E951), acesulfame K (E950), cyclamate (E952), saccharin (E954), stevia (E960) or sucralose (E955), which are non-energetic and are not included in the daily sugar intake. They replace the taste of sugar. Sweeteners with energy value, substitute sugars sorbitol (E420), mannitol (E421), birch sugar – xylitol (E967), but also fruit sugar – fructose, are caloric, but increase blood sugar more slowly than table sugar – sucrose.

4. Exclusion of alcohol intake, especially beer and spirits. In case of social necessity, a glass of dry red wine is suitable. Beer contains a lot of carbohydrates, which causes its high caloric value. Distillates contain a higher percentage of alcohol, which itself is almost twice as caloric compared to carbohydrates.

5. Do not eat food between main meals or snacks (snack, breakfast, second dinner). Do not buy small snacks during the day.

6. Take only once and in reasonable quantities. Don’t worry.

7. Fruit is suitable. However, it is necessary to include it in the energy intake.

8. Eating vegetables. It has a lot of volume and little energy. At the same time, chewing and thus the duration of eating is longer.

9. Make a grocery list and stick to it when shopping. Don’t buy junk food. If you buy them, you will eat them later. Don’t compromise when buying.

10. Compile your menu in compliance with the principles of rational eating according to books for diabetics authorized by doctors.

Types of SUITABLE diets

– Short-term dietary measures

It is about maintaining strict dietary measures over several days or weeks (e.g. so-called low-energy diets of about 600 kcal/2,500 kJ, often abbreviated VLCD – very low calorie diet). They have a very limited indication. After their termination, the weight of a poorly educated patient usually returns to its original value. They are mostly applied for 7, 14 to 30 days.

The diet is indicated if there is a need for rapid improvement of the patient’s health condition, such as the treatment of heart and respiratory failure in obese patients, rapid preparation of patients for surgery or adjustment of diabetes compensation, in diabetics treated with insulin or PAD, it is necessary to proceed very carefully, preferably during hospitalization . The second indication is a cooperative, educated patient who has adapted to a lower energy intake and has exhausted his dietary options; it is likely that the weight loss achieved will be sustainable in the long term.

One- to two-day diets – lighter fruit or vegetable days or a one-day inclusion of a VLCD diet are suitable, because the metabolism is broken and the patient reduces weight again. These procedures are also used for diabetics, but it is necessary to adjust the doses of insulin or OAD.

– Mediterranean diet

It is characterized by the intake of a large amount of various vegetables, fruits, whole grains, low-fat dairy products, and vegetable oils. The intake of saturated fat, trans fatty acids, refined sugar and sodium is limited.

– Low-fat diet

The basis is vegetables with a high fiber content, legumes, fruits, whole grains, the so-called fat-free dairy products, fish, egg white. The carbohydrate content is 70-77% of the daily intake (including 30-60 g of fiber, 10% of fat and 13-20% of protein).

– Strict low-fat diet (Ornish diet, Pritkin diet)

The energy content from fat is reduced to 10%. Vegetables, fruits and cereals, legumes, lean meat and low-fat dairy products are preferred. This diet has been shown to have a positive effect on glycemic control, body weight, blood pressure and cholesterol.

– NFI (Natural Food Interactions)

An alternative diet leading to sustainable weight loss is a plant-based diet (PBD). The NFI diet is alternative diet to the basic type of diabetic diet, which is rational nutrition and its principles. It is in full harmony with her. It is nutritionally balanced, which means that it contains the necessary daily doses of carbohydrates, proteins and fats, minerals, trace elements and vitamins. According to him, foods of plant origin, fruits, vegetables, cereals, mushrooms, nuts and seeds are used to prepare meals. No animal products are used in the diet plans.

Specific situation. Diet with blood thinners

During warfarinization, it is necessary to exclude a large amount of food with a high and at the same time unstable vitamin K content. Avoid sudden changes in the diet and one-time excesses. A stable, average amount of vitamin K is recommended in food. Therefore, it is necessary that the consumption of foods containing vitamin K be as constant as possible. It is necessary to avoid sudden changes in diet. The most important source of vitamin K is green and leafy vegetables and herbs. These foods do not need to be excluded from the diet, only fluctuations in diet must be avoided. Important sources of vitamin K include: amaranth leaves, avocado, broccoli, Brussels sprouts, cabbage, canola oil, tea leaves, chives, cilantro, cucumber skin (but not peeled cucumbers), endive, kale, kiwi, lettuce, mint leaves , mustard seeds, olive oil, parsley, peas, pistachios, red seaweed, spinach, scallions, soybeans, soybean oil, tea leaves (but not tea), celery leaves, watercress. Cranberry juice and other cranberry products may increase the effect of warfarin, so concomitant use is not recommended.

Medical treatment of obesity

Pharmacological treatment of obesity is recommended in patients with a BMI ≥ 30 or in patients with a BMI of 27.0-29.9 with the simultaneous occurrence of concomitant diseases (high blood pressure, diabetes, elevated cholesterol), after the failure of lifestyle modification, with the aim of increasing the patient’s cooperation and maintain the achieved weight loss. We evaluate the effectiveness of drug treatment after the first 3 months of treatment and also in the following period. We consider > 5% weight loss in non-diabetics and > 3% weight loss in diabetics as satisfactory weight loss.

A more realistic indicator of treatment success is a decrease in waist circumference or body composition measurement. Currently, bariatric (metabolic) surgery also finds its place in indicated cases. Currently, there is both injectable and tablet form of obesity treatment. With injection treatment, people can expect a weight loss of 5-8 kg. Treatment can delay the development of diabetes from prediabetes (increased fasting and postprandial blood glucose) in patients with metabolic syndrome. The treatment leads to an improvement in the severity of the obstructive sleep apnea syndrome, an improvement in the length and quality of sleep.

The change can be started at any time

A change in weight brings a significant benefit to overall physical health. The change can begin at any age. Weight loss is also reflected in psychological changes and processes. The result of efforts that successfully change the patient’s appearance changes his relationship to the environment. The increased attention of the surroundings embarrasses a person. There is no need to be oversensitive to the reaction of the environment. Mental instability experienced in personal relationships can become a source of anxiety. At other times, euphoria and atypical feelings of increased self-confidence and self-assertion can be experienced. Adapting to such a change is difficult. It is necessary to have strong inner determination and endurance. Someone wise said: Start with the possible and you can do the impossible.

MUDr. Jozef Lacka, PhD., MBA
Barbora Lacková

01 – Modified: 2023-09-26 14:50:22 – Feat.: 0 – Title: Obesity may not be visible – what is hidden obesity and how to measure it 02 – Modified: 2023-08-06 06:46:18 – Feat.: 0 – Title: What to eat for OBESITY? 03 – Modified: 2023-08-06 06:41:19 – Feat.: 0 – Title: Obesity threatens life 04 – Modified: 2022-07-14 09:00:00 – Feat.: 0 – Title: I’m overweight ? A simple test will show this

01 – Modified: 2023-09-26 14:50:22 – Feat.: – Title: Obesity may not be visible – what is hidden obesity and how to measure it 02 – Modified: 2024-01-23 13:28:51 – Feat .: – Title: Stress in a diabetic Which foods will help? 03 – Modified: 2023-11-20 19:51:04 – Feat.: – Title: How to move with excess weight? 04 – Modified: 2023-11-21 14:46:42 – Feat.: – Title: RNDr. Petr Fořt, CSc.: Food can prolong life, but also shorten it 05 – Modified: 2023-10-19 06:17:40 – Feat.: – Title: Adjusting the diet for low blood pressure