Obesity is defined by the World Health Organization (WHO) as “abnormal or excessive fat accumulation in the body to a degree that impairs health”. Obesity is increasing rapidly in our country as well as the whole world, and it is estimated that 1 billion people will live with this disease by 2030. Despite the extent of this epidemic, the fight against obesity is very difficult due to the inability to understand the difficulties experienced in the lives of individuals due to obesity. Being overweight or obese; It increases the risk of many health problems such as hypertension, hyperlipidemia, cardiovascular diseases, stroke, Type 2 diabetes, some types of cancer, muscle-joint diseases and respiratory system diseases.
There can be many different underlying causes of obesity and no single plan can address it. Every individual must take Useful steps that work for his country, community and himself. However, inconsistencies in how obesity is perceived; It has led to isolation, misunderstanding and inconsistency among individuals. These special occasions are an opportunity for each of us to initiate important discussions about obesity in our close circle and to encourage positive action among our target audience.
Since 2010, Turkey Healthy Nutrition and Active Life Programme, Adult and Childhood Obesity Prevention and Physical Activity Action Plan 2019-2023 has been updated and implemented in our country. In addition, our Ministry; Türkiye Diabetes Program implements Salt Reduction Programs.
It is important to eat healthy and increase physical activity in preventing obesity.
Prevention of obesity and chronic diseases related to obesity and vitamin and mineral deficiencies, which are frequently seen today, is important for both the individual and the society. healthy lifestyle; It is based on a healthy diet and an increased level of physical activity for an active life.
In order to make a healthy choice from the foods in the food groups, the fiber, fat, salt and added sugar content of the foods should be taken into account, based on the color variety of the foods, the structural characteristics, the health and disease status of the individual, age and gender, physical activity and physiological (pregnant and lactating) status. choices must be made.
The goal is to choose and consume a food from each food group on the plate at each meal. As it is next to the plate, it is important to provide the recommended water consumption in daily nutrition, to include olive oil in daily nutrition, to support an active life as a complement to a healthy lifestyle.
For our health, moderate-intensity physical activity at least 5 days a week and at least 30 minutes a day in adulthood, and at least 60 minutes a day in childhood, moderate and vigorous physical activity should be done.
In daily nutrition; Consumption of fresh vegetables and fruits, whole grain products, dairy products, fish, chicken and other lean meats and legumes are healthy choices. Consumption of processed and ready-to-eat foods with high fat and sugar content are unhealthy choices.
To prevent the development of chronic diseases associated with nutrition in adults;
A healthy eating habit that will positively affect body weight, blood lipid profile, blood pressure, blood sugar level and bone health should be gained from an early age.
Food variety should be increased, and foods from various food groups should be consumed at every meal as needed.
Body mass index should be between 20-24.9 kg/m2. However, it should be noted that this reference range is only used to give a general idea to adult individuals, and the important thing is the body composition of the person. It is excessive fat in the abdomen that causes chronic diseases such as type 2 diabetes and cardiovascular diseases. Therefore, it is important to evaluate body composition at regular intervals. In underweight, overweight or obese individuals; Body weight management should be provided with nutritional therapy, exercise program and behavioral therapy tailored to individual needs. It is important to preserve muscle mass during weight loss. Maintaining ideal body weight should be sustainable, frequent weight gain and loss should be avoided.
The most appropriate nutrition model for adults to reach a healthy weight and maintain this weight is a diet in which both nutritional needs are met and the total energy intake does not exceed the total energy need.
Total and saturated fat, cholesterol and sugar intake should be reduced. Daily intake of saturated fat should not exceed 10% of total energy. Saturated fats are found in full-fat milk and dairy products and meat and meat products. In order to reduce saturated fat in the daily diet, low-fat milk and products and meat and products should be preferred, and the amount of saturated fat added to meals or foods should be reduced. The amount of simple sugar consumed daily should be planned so that it does not exceed 10% of the total daily energy intake. In order to reduce the intake of simple sugars, the consumption of pastries, sweets, chocolate and ready-made packaged products containing added sugar should be reduced. As with foods, beverages with added sugar should be avoided, and fruit consumption should be preferred instead of fruit juice.
Vegetable oils (olive oil, sunflower oil, corn oil, soybean oil, canola oil, etc.) should be preferred instead of saturated fats such as margarine, butter, lard, tallow and coconut oil.
Fiber intake should be increased due to consumption of vegetables, fruits, whole grains, legumes and oilseeds. Foods with a low glycemic index (the effect of carbohydrates on blood sugar levels) should be preferred.
The use of sugar and sugar-added foods and bakery products should be reduced, and foods with a high glycemic index should be consumed by replacing them with alternatives with a lower glycemic index. For example, white bread, rice pilaf, brown bread, bulgur pilaf and brown flour should be preferred instead of white flour.
Attention should be paid to the seasonal consumption of vegetables and fruits, and at least 400 g of vegetables and fruits should be consumed per day. Potatoes and high-starch vegetables are not included in this amount. Vegetables should be included in main meals. Snacks should include vegetables and fruits. Variety should be provided in the consumption of vegetables and fruits.
Adequate intake of calcium and vitamin D is very important for the protection of bone health and prevention of osteoporosis in adulthood, as in all age groups. For bone health, 2-3 glasses of milk and/or yogurt should be consumed every day. Low-fat milk and dairy products should be preferred. In order to get enough daily vitamin D, sun rays should be used effectively.
Excessive protein consumption should be avoided. High protein diet triggers the development of osteoporosis by increasing urinary calcium excretion.
Consumption of prepackaged products should be limited. In order to choose the healthier ones among these products, it is necessary to have the knowledge of reading the nutritional label. The nutritional label information on the packaging of purchased foods should be evaluated, and those with low fat and sugar content should be preferred.
The amount of oil added to the dishes should be reduced by using appropriate cooking methods. For example, instead of frying foods, cooking methods in the oven, boiled, grilled, steamed or microwaved should be preferred. Fish should be consumed at least twice a week (300-500 g). While cooking fish, grill, oven, steam cooking methods should be used, frying should not be preferred.
Incorrect applications in cooking methods increase nutrient losses. Foods such as vegetables and pasta cooked in water should be cooked in less water and boiled water should not be poured.
The frequency of eating outside the home should be reduced, and low-fat meals should be preferred when eaten.
Consumption of salt, salted foods and foods with high salt content (such as pickles, pickled foods, olives) should be reduced, and salt should not be added without tasting the food. It should be noted that the salt used is iodized salt.
Fluid consumption should be increased and at least 8-10 glasses of water and beverage should be consumed daily. 35 mL/kg or 1 mL/kcal of fluid should be consumed per body weight. The presence of conditions such as hot weather, fever, diarrhea and vomiting cause water losses from the body. In this case, daily fluid intake should be increased.
Drinks containing caffeine should not be included in the daily fluid calculation.
Consumption of caffeine-containing coffee types and carbonated/still beverages and energy drinks should be limited. Although 100-300 mg of caffeine per day for adults is not harmful, these amounts can cause an increase in heart rhythm and blood pressure in people who are caffeine sensitive.
Regular eating habits should be acquired and late eating should be avoided. Maintaining meal order is one of the modifiable risk factors in weight control and prevention of chronic diseases.
Regular physical activity positively affects mood, reduces stress and provides more comfortable sleep. Physical activity should be increased and the habit of exercising should be gained 2-3 hours after a meal. At least 5,000 steps should be walked every day, and the number of steps should be increased to 10,000 over time. At least 150-300 minutes of moderate-intensity aerobic exercise (brisk walking, brisk dancing, etc.) or 75 minutes of high-intensity exercise per week should be done. In addition, muscle strengthening (weight lifting, push-ups, etc.) exercises should be performed at least 2 times a week.
Tobacco should not be used and alcohol intake should be avoided.
Adult individuals should have their blood sugar, blood lipids and blood pressure values checked at regular intervals.
How to treat obesity, where to apply?
Obesity; If it is not treated, it goes into a cycle that shortens the life span with its side effects, impairs the quality of life, and adversely affects tissues and organs.
Treatment of Obesity; Medical nutrition (diet) therapy, Exercise therapy, Behavior change therapy, Drug therapy, Surgical therapy. Diet therapy, increased physical activity and behavioral therapy are the three main components of "weight loss" therapy.
Medical nutrition therapy consists of evaluating the nutritional status of the obese individual by dietitians and planning a diet that will ensure adequate and balanced nutrition in accordance with the age, gender, physical activity level, physiological state and nutritional habits of the individual.
A multidisciplinary approach is important in order to increase the success of losing body weight in obese individuals and to stay away from fast and wrong weight loss methods (because the weight lost quickly is regained quickly).
For the successful execution of obesity treatment; a triple program of “diet, exercise and behavior change” treatment; It should be applied by a team of professional groups such as doctors, dietitians, psychologists, psychiatrists, physiotherapists and exercise specialists.
In order to obtain accurate information on nutrition-related issues and to receive medical nutrition therapy for overweight and obese individuals; You can benefit from the "Nutrition / Obesity Counseling" service provided in District Health Directorates / Community Health Centers and Healthy Life Centers through your Family Physician.
SOURCE: https://hsgm.saglik.gov.tr/tr/haberler/avrupa-obezite-gunu-20-may-2023.html