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4 . 2020

Obesity as a global challenge of the 21st century: clinical medical nutrition, prevention and therapy

Abstract

The article presents modern data on the prevalence of overweight and obesity, provides updated information on personalized programs for managing body weight, individual recommendations for a healthy diet, adequate physical activity and long-term lifestyle changes. It is shown that dietary therapy is the basic treatment method in weight loss programs and is aimed at long-term maintenance of a negative energy balance in the patient's organism by limiting the calorie intake. A significant place in the article is devoted to the use of diets modified by calorie value and macronutrient content which are recommended for obese patients. A strategy for the prevention of obesity and its associated diseases is presented.

Keywords:dietary therapy, overweight, obesity, type 2nd diabetes, low-calorie diet

Funding. The research was carried out at the expense of the subsidy for the implementation of the state task.

Conflict of interest. Authors declare no conflict of interest.

Contribution. All authors participated in concept development, analysis and interpretation of the data, and finally approved the manuscript for publication.

For citation: Sharafetdinov Kh.Kh., Plotnikova O.A. Obesity as a global challenge of the 21st century: clinical medical nutrition, prevention and therapy. Voprosy pitaniia [Problems of Nutrition]. 2020; 89 (4): 161-71. DOI: https://doi.org/10.24411/0042-8833-2020-10050 (in Russian)

References

1. Ametov A.S. Obesity. A modern view of pathogenesis and therapy: A training manual. Moscow: GEOTAR-Media, 2019; 1: 384 p. (in Russian)

2. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019; 15 (5): 288–98. DOI: https://doi.org/10.1038/s41574-019-0176-8

3. Bray G.A., Kim K.K., Wilding J.P.H. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017; 18 (7): 715–23. DOI: https://doi.org/10.1111/obr.12551

4. WHO. Obesity and Overweight, 2020. URL: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight

5. Hales C.M., Carroll M.D., Fryar C.D., Ogden C.L. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, No. 360. Hyattsville, MD: National Center for Health Statistics. 2020. URL: https://www.cdc.gov/nchs/products/index.htm

6. Federal State Statistics Service. Selective observation of the diet of the population. URL: https://gks.ru/free_doc/new_site/food18/index.html

7. Balanova Yu.A., Shal’nova S.A., Deev A.D., et al. Obesity in the Russian population - prevalence and associations with risk factors for chronic noncommunicable diseases. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2018; 23 (6): 123–30. DOI: http://doi.org/10.15829/1560-4071-2018-6-123-130 (in Russian)

8. Owen C.G., Kapetanakis V.V., Rudnicka A.R., et al. Body mass index in early and middle adult life: prospective associations with myocardial infarction, stroke and diabetes over a 30-year period: the British Regional Heart Study. BMJ Open. 2015; 5 (9): e008105. DOI: https://doi.org/10.1136/bmjopen-2015-008105

9. Joshy G., Korda R.J., Attia J., et al. Body mass index and incident hospitalisation for cardiovascular disease in 158 546 participants from the 45 and Up Study. Int J Obes (Lond). 2014; 38 (6): 848–56. DOI: https://doi.org/10.1038/ijo.2013.192

10. Azimi A., Charlot M.G., Torp-Pedersen C., et al. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease. Heart. 2013; 99 (9): 655–60. DOI: https://doi.org/10.1136/heartjnl-2012-303066

11. Guh D.P., Zhang W., Bansback N., et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009; 9: 88. DOI: https://doi.org/10.1186/1471-2458-9-88

12. Kyrou I., Tsigos C., Mavrogianni C., et al. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe. BMC Endocr Disord. 2020; 20 (1): 134. DOI: https://doi.org/10.1186/s12902-019-0463-3

13. Ackerman I.N., Osborne R.H. Obesity and increased burden of hip and knee joint disease in Australia: results from a national survey. BMC Musculoskelet Disord. 2012; 13: 254. DOI: https://doi.org/10.1186/1471-2474-13-254

14. Li C., Ford E.S., Zhao G., Croft J.B., et al. Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005–2006. Prev Med. 2010; 51 (1): 18–23. DOI: https://doi.org/10.1016/j.ypmed.2010.03.016

15. Dobbins M., Decorby K., Choi B.C. The association between obesity and cancer risk: a meta-analysis of observational studies from 1985 to 2011. ISRN Prev Med. 2013; 2013: 680536. DOI: https://doi.org/10.5402/2013/680536

16. Arnold M., Pandeya N., Byrnes G., et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol. 2015; 16 (1): 36–46. DOI: https://doi.org/10.1016/S1470-2045(14)71123-4

17. Lee S.M., Choi I.S, Han E., et al. Incremental treatment costs attributable to overweight and obesity in patients with diabetes: quantile regression approach. Obesity (Silver Spring). 2018; 26 (1): 223–32. DOI: https://doi.org/10.1002/oby.22080

18. Anis A.H., Zhang W., Bansback N., et al. Obesity and overweight in Canada: an updated cost-of-illness study. Obes Rev. 2010; 11 (1): 31–40. DOI: https://doi.org/10.1111/j.1467-789X.2009.00579.x

19. WHO. Obesity and Overweight. Geneva: World Health Organization, 2015. URL: http://www.who.int/mediacentre/factsheets/fs311/en/

20. Fadeeva M.I., Cavel’eva L.V., Golubkina Yu.Yu., et al. Correction of eating disorders in obese patients. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2018; 7 (2): 51–9. DOI: DOI: https://doi.org/10.24411/2304-9528-2918-12005 (in Russian)

21. Cheskin L.J., Poddar K.H. Obesity management. In: Catharine Ross A., et al. (eds). Modern Nutrition in Health and Disease. 11th ed. Lippincott Williams and Wilkins; Wolters Kluwer, 2014: 786–99.

22. May M., Schindler C., Engeli S. Modern pharmacological treatment of obese patients. Ther Adv Endocrinol Metab. 2020; 11: 1–19. DOI: https://doi.org/10.1177/2042018819897527

23. Clinical guidelines for the treatment of morbid obesity in adults. Federal Electronic Medical Library, 2014. URL: http:// http://femb.ru/feml (in Russian)

24. Jensen M.D., Ryan D.H., Apovian C.M., et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014; 129 (25, suppl 2): S10238. DOI: https://doi.org/10.1161/01.cir.0000437739.71477.ee

25. Expert Panel Report: Guidelines (2013) for the management of overweight and obesity in adults. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel, 2013. Obesity (Silver Spring). 2014; 22 (2): S41–410. DOI: https://doi.org/10.1002/oby.20660

26. Raynor H.A., Champagne C.M. Position of the Academy of Nutrition and Dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016; 116 (1): 129–47. DOI: https://doi.org/10.1016/j.jand.2015.10.031

27. Yumuk V., Fruhbeck G., Oppert J.M., et al. An EASO position statement on multidisciplinary obesity management in adults. Obes Facts. 2014; 7: 96–101. DOI: https://doi.org/10.1159/000362191

28. Samsonov M.A. The main stages of the scientific activity of the Clinical Nutrition Clinic of the Institute of Nutrition RAMS (1930–2005). Voprosy pitaniia [Problems of Nutrition] 2005; 74 (5): 37. (in Russian)

29. Wadden T.A., Byrne K.J., Krauthamer-Ewing S. Obesity: management. In: M.E. Shils (ed.). Modern Nutrition in Health and Disease. 10th ed. 2006: 1029–42.

30. Bogdanov A.R. Diagnosis and personalized diet therapy of chronic heart failure in obese patients: Autoabstract of Diss. Moscow, 2017 (in Russian)

31. Koliaki C., Spinos T., Spinou M., et al. Defining the optimal dietary approach for safe, effective and sustainable weight loss in overweight and obese adults. Healthcare. 2018; 6: 73. DOI: http://doi.org/10.3390/healthcare6030073

32. Gapparova K.M., Pilipenko V.I., Zeigarnik M.V., et al. Effect of low-calorie diets with the inclusion of protein substitutes for food on anthropometric and clinical-biochemical parameters in obese patients. Voprosy dietologii [Problems of Dietology]. 2011; 1 (1): 24–30. DOI: http://doi.org/10.20953/2224-5448-2011-1-24-30 (in Russian)

33. Li Z., Treyzon L., Chen S., et al. Protein-enriched meal replacements do not adversely affect liver, kidney or bone density: an outpatient randomized controlled trial. Nutr J. 2010; 9: 72. DOI: http://doi.org/10.1186/1475-2891-9-72

34. Flechtner-Mors M., Boehm B.O., Wittmann R., et al. Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Diabetes Metab Res Rev. 2010; 26 (5): 393–405. DOI: http://doi.org/10.1002/dmrr.1097

35. Chen W., Liu Y., Yang Q., et al. The effect of protein-enriched meal replacement on waist circumference reduction among overweight and obese Chinese with hyperlipidemia. J Am Coll Nutr. 2016; 35 (3): 236–44. DOI: http://doi.org/10.1080/07315724.2014.989625

36. Atallah R., Filion K.B., Wakil S.M., et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials. Circ Cardiovasc Qual Outcomes. 2014; 7 (6): 815–27. DOI: http://doi.org/10.1161/CIRCOUTCOMES.113.000723

37. Selezneva K.S., Isakov V.A., Sentsova T.B., Kirillova O.O. An analysis of the efficacy of low-calorie and isocaloric diets in obese patients with non-alcoholic steatohepatitis. Voprosy pitaniia [Problems of Nutrition] 2014; 83 (5): 72–8. (in Russian)

38. Nutrition and Type 2 Diabetes: Etiology and Prevention. In: M.A. Pereira (ed.). CRC Press, 2014.

39. Goff L.M., Cowland D.E., Hooper L., Frost G.S. Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis. 2013; 23 (1): 1–10. DOI: http://doi.org/10.1016/j.numecd.2012.06.002

40. Ma X.Y, Liu J.P., Song Z.Y. Glycemic load, glycemic index and risk of cardiovascular diseases: meta-analyses of prospective studies. Atherosclerosis. 2012; 223 (2): 491–6. DOI: http://doi.org/10.1016/j.atherosclerosis.2012.05.028

41. Bonfrate L., Wang D.Q., Garruti G., Portincasa P. Obesity and the risk and prognosis of gallstone disease and pancreatitis. Best Pract Res Clin Gastroenterol. 2014; 28 (4): 623–35. DOI: http://doi.org/10.1016/j.bpg.2014.07.013

42. Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: The Look AHEAD Study. Obesity (Silver Spring). 2014; 22: 5–13. DOI: http://doi.org/10.1002/oby.20662

43. Look AHEAD Research Group. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes. One-year results of the Look AHEAD trial. Diabetes Care. 2007; 30 (6): 1374–83. DOI: http://doi.org/10.2337/dc07-0048

44. EFSA Panel on Dietetic Products, Nutrition and Allergies. Essential composition of total diet replacements for weight control. EFSA J. 2015; 13 (1): 3957. DOI: http://doi.org/10.2903/j.efsa.2015.3957

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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