Метаболічний синдром і здоровий образ життя

Abstract

В статті розглянуто особливості застосування немедикаментозних засобів лікування та профілактики щодо корекції станів, що об’єднуються терміном метаболічний синдром, відповідно до міжнародних рекомендацій та національних уніфікованих клінічних протоколів, де основними заходами є підтримання здорового способу життя ,основаного на раціональному харчуванні, спрямованого на схуднення або підтримання нормальної маси тіла ,відмова від куріння і надмірного вживання алкоголю, а також дозовані фізичні навантаження; В статье рассмотрены особенности применения немедикаментозных средств лечения и профилактики по коррекции состояний, объединяемых термином метаболический синдром, согласно международных рекомендаций и национальных унифицированных клинических протоколов, где основными направлениями являются поддержание здорового образа жизни ,основанного на рациональном питании, направленном на похудение или поддержание нормальной массы тела ,отказ от курения и чрезмерного употребления алкоголя, а также дозированные физические нагрузки; Goal – the analysis of large-scale studies has shown that among the adult population the MS is diagnosed 30% of population depending on characteristics and criteria used for the MS diagnosis (metabolic syndrome) Social importance of the MS problem is associated with the increased educational activity in patients` surroundings, necessity of implementation of the main principles of primary prevention of obesity and diabetes especially among children and young people, promotion of healthy diet principles, the increased role of physical culture and sports. Therapeutic interventions in the treatment of MS patients should be directed to the main elements of the pathogenesis of this syndrome, namely the reduction of body weight, the optimal level of blood pressure (BP), metabolic control, prevention of acute and remote cardiovascular complications. Despite the large number of studies devoted to the problem of obesity treatment, lots of the ways of reducing excess weight, this task remains extremely complicated and requires great effort both the doctor and the patient. Nowadays it is stated that the only thing that really leads to a reduction fat mass is an energy deficit or another words - predominance of energy consumption over its receipt. Therefore, non-pharmacological interventions aimed at the creation of this deficit are of priority importance in the treatment of obesity. Patients should be aware that currently there is no drug that is able completely eliminate the health risks associated with obesity, but at the same time, the change in lifestyle can prevent the progression of metabolic disorders and seriously reduce the risk of complications. The treatment of obesity, as well as treatment of any chronic disease must be continuous – without any break. After reaching the weight loss the efforts of the doctor and patient should be directed to maintain the effect and prevent relapses of disease. Activities aimed at reducing the weight and maintaining the achieved result should include: a balanced diet, explaining to patients about proper way of living with changing eating habits, keeping a food diary and doing exercises. Reduction of body weight by 5-10% over 6-12 months (optimal reduction is considered to be 2-4 kg, but not more than 5 kg per month) is accompanied by a reliable reduction of the risk to health and feasible for most patients. For the compilation of a balanced diet it is necessary to calculate the number of calories allowed to consume per day based on individual energy consumption. And based on the daily calorie norm it is possible make the menu for the day (reducing caloric intake should be achieved the mainly due to reducing fat and partially at the expense of carbohydrates). Staff in primary health care system must take into account the emotional and personal characteristics of the patient at prescribing and making the individual diet programs to prevent the instability of interest of treatment, give practical advice taking into account cultural, religious, ethnic and economic standards. Physical exercising (workout) is an important component of recommendations to change lifestyle. At the stage of body weight reduction doctors add another food to the reduced calorimety diet and allow having a negative energy balance. Under the influence of loads of moderate intensity insulin sensitivity is improving, triglycerides is reducing, HDL cholesterol is increasing, the functional reserves of the cardiovascular and respiratory systems are improving. At the maintenance stage the physical activity becomes even more important being one of the main prognostic factors in maintaining the desired weight. Before the start of physical exercising it is necessary to assess the patient's tolerance to physical loads using veloergometry or treadmill test. It is especially important to carry out a load test if there is coronary heart disease (CHD), when a patient is after the age of 40 and after the age of 30 with risk factors such as IHD, hypertension, DM, smoking and dyslipidemia. To reduce body weight (maximum energy reduction) aerobic exercises are shown, which are continuous rhythmic exercises and involve large muscle groups for quite a long time, increasing the heart rate. The most common varieties of aerobic exercise is the so-called cyclic kinds of sport: walking, swimming, running, skating, skiing, cycling, tennis, basketball, dancing and fitness. Therefore, the main measures of non-pharmacological MS treatment is to maintain a healthy lifestyle based on a diet aimed at weight loss or maintenance of normal body weight, giving up smoking and excessive alcohol consumption, and also dosed exercising with the support of a doctor or nutritionist.