Медицина / Организация здравоохранения

PhD, MD Belykh O.*, Boeva V.**

*Teaching and Research Medical Center of administration of the President of Russia

**Federal service on surveillance in healthcare of Russia

Obesity in Russia: the situation is getting worse

Nearly half of Russian adults are overweight or obese. The prevalence of obesity in Russia has more than doubled in the last 50 years despite the great attention of health workers, the media and the public, mass education campaigns about the benefits of healthy eating and increased physical activity. The country had little actual increase in obesity in the population until 2000. But after 2000, there was a lightning-fast spread of the disease. It is now not surprising, the term is "childhood obesity." It is registered that there is dramatic increase of obesity among children which is an alarming trend. There is no unique solution to this problem found. Obesity is not studied enough and is not fully realized as a national problem having serious economic consequences.

The sharp rise in the number of obese and overweight people is becoming a serious social problem. A considerable number of researches have been carried out in the world, but there are more and more overweight people and this allowed the World Health Organization to declare an epidemic of obesity.

We have inherited the genes of our ancestors - the hunters and gatherers of mushrooms and berries, the basis of which the supply was lean meat, fish, mushrooms, berries and grasses. Our ancestors were constantly in search of the food and fed once a day, mostly tonight. Their bodies were designed for accumulation and storage of nutrients in the adipose tissue, which is then used as fuel to survive periods of starvation. We have retained the ability to store fat when food is in oversupply. However, the famine in Russia defeated the present time, so that the supply of fat is not used, and continues to accumulate over the years. We no longer pursue and extract our dinner; we absolutely do not trouble in search of food. We have severely restricted physical activity. Muscles are no longer needed in the glucose in previous quantities and muscle cells reduce sensitivity to it. However, the nutrition of modern man is becoming more and more high-carbohydrate nature. A shift of the nutrition to the carbohydrate side for the last 30 years has contributed propaganda to use as little fat, replacing fatty foods carbohydrate. In 90% of the excess fats are formed due to excessive consumption of carbohydrates, and not because of the use of fats.

We continue to eat large portions of food and in greater numbers than we need despite the abundance of evidence of the benefits of maintaining a healthy weight and physically active lifestyle. We continue to be physically inactive than we should be. People with a sedentary lifestyle (as are pupils and students, and most professions) in Russia spend an average of 1000-1200 calories per day. But they receive calories in 3 - 4 times more with food than it is necessary to maintain weight. Food is available everywhere, and people are already fall asleep with food.

In addition, we have very little opportunity for exercise. Cities do not have bike lanes, sidewalks, stairs, or within walking distance of houses. But grocery stores are located on the every street the every house is almost near store. We do not need to search for shops, stand in line for food. These grocery stores are poorly stocked with "healthy food": no fresh meat and fish, ripe fruits and vegetables. People from all economic backgrounds often do not eat because they are hungry, but because they have emotional, social or cultural reasons, or simply "for the company."

As health professionals, we do not know how to help our patients lose weight. But we are expanding educational programs to combat the growing epidemic of obesity in Russia. The obesity gives a higher risk of developing diabetes, cardio - vascular and other serious comorbidities.

The volume of scientific and medical knowledge that can quickly accumulate in the field of weight management will undoubtedly lead to safe and effective measures and will help us as physicians to more effectively deal with this very common health problem.

But what can you do about this problem today? What we can choose to help our patients now? Low fat food? Low-carb diet? What works? It seems that the answer is still out on those questions. It is possible that a different diet will behave differently in different people. Experts recommend a combination of diet, emphasizing the need to count calories, self-control, and mandatory gradual increase in physical activity.

These simple measures work if people practice them.

Successful weight loss is the result of a combination of motivation, physical activity and caloric restriction. Weight maintenance is required for life, you need to control the balance between caloric intake and energy expenditure.

References:

1. Belykh O, Larina O. Assessment of lipid and carbohydrate metabolism in the nuclear industry workers. J. Clinical practice 2012; 1: 9-15.

2. WHO. Obesity and overweight. Newsletter 2012; 311.

3. State Report "The sanitary-epidemiological situation in the Russian Federation in 2010". Moscow: Federal Center of Hygiene and Epidemiology 2011.

4. Zhuravlev S., Belykh O., Larina O. The modern approach to the problem of obesity. J. Russian medical vesty 2013; 8 (3): 20-28.

5. Foster G.D., Wyatt H.R. Makris A.P. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med 2012; 153 (3): 147-157.