40 yoshda qanday qilib zararsiz vazn yo’qotish mumkin

Yupqa bo’lish – ko’plab go’zal xonimlarning orzusi. Axir, biz noziklikni go’zallik, salomatlik va yoshlik bilan bog’laymiz. Muammo shundaki, biz ortiqcha iste’mol va jismoniy harakatsizlik davrida yashayapmiz, shuning uchun sayyoramizda ortiqcha vaznli odamlar ko’payib bormoqda. Parhez va jismoniy mashqlar sog’lom vazn yo’qotishning ikkita ustunidir, ammo 40 yoshdan keyin vazn yo’qotish tobora qiyinlashadi. Keling, 40 yildan keyin vazn yo’qotishga yordam beradigan vazn yo’qotish haqidagi asosiy faktlarni ko’rib chiqaylik.

Tibbiy ma’lumotnoma

Semirib ketish diabet, yurak-qon tomir kasalliklari, saratonning ayrim shakllari, o’pka va osteoartikulyar kasalliklar va erektil disfunktsiyaning asosiy xavf omilidir. Aksincha, ko’plab tadqiqotlar shuni ko’rsatadiki, vazn yo’qotish barcha sabablarga ko’ra o’limni kamaytiradi va ko’pincha birga keladigan kasalliklarni yaxshilaydi [1-4].

Tesariy:

  • Ortiqcha vazn, ortiqcha vazn – normadan oshib ketadigan tana vazni.
  • Kaloriyalar «kilokaloriya» atamasining engil versiyasidir;
  • Diet – biz uni tor ma’noda ishlatamiz – ovqatlanish, uning maqsadi tana vaznini kamaytirishdir.

Shu bilan birga, Internet har xil mish-mishlar va tasdiqlanmagan ma’lumotlar bilan to’lib-toshgan, ular nafaqat foydasiz, balki zararli bo’lishi mumkin (masalan, ovqatlanish buzilishiga olib keladi). 

Muhim: vazn yo’qotish qandaydir super maqsad bo’lmasligi kerak, chunki normal vaznli odamlarda dieta metabolik o’zgarishlar tufayli kilogramm ortishi uchun xavf omili bo’lishi, shuningdek, lipidlar va uglevodlar almashinuvining buzilishiga olib kelishi mumkinligini ko’rsatadigan tadqiqotlar mavjud. 7] !

Men vazn yo’qotishim kerakmi?

Ortiqcha vazn borligini aniqlashning turli usullari mavjud. Eng oddiylaridan biri tana massasi indeksini (BMI, biz bu erda batafsil yozganmiz ) yoki Quetelet indeksini hisoblashdir. U ko’pincha turli tadqiqotlarda vazn yo’qotish samaradorligini baholash uchun ishlatiladi va ortiqcha vaznni baholash uchun xalqaro miqyosda qabul qilingan yagona mezondir [8]. 

BMI ni hisoblash uchun siz ko’plab onlayn kalkulyatorlardan birini ishlatishingiz mumkin ( bizning variantimiz ) yoki formuladan foydalanib o’zingiz hisoblashingiz mumkin: tana vazni (kg) m kvadratda balandlikka bo’linadi.

Olingan natijaga qarab:

  • <18,5 – kam vazn (etishmovchilik)
  • 18,5-25 – normal vazn
  • 25-30 oldindan semirish (ortiqcha vazn)
  • 30-35 – birinchi darajali semirish
  • 35-40 – ikkinchi darajali semirish
  • >40 – uchinchi darajali semirish (morbid) [8].

Biroq, BMI juda aniq ko’rsatkich emas, chunki u yog ‘/mushaklar nisbatini hisobga olmaydi, shuning uchun homilador ayollar, sportchilar, keksa odamlar va hokazolarda haqiqiy rasmni aks ettirmasligi mumkin. [8].

Ortiqcha vazn mavjudligini aniqlashning boshqa parametrlariga quyidagilar kiradi: bel atrofini o’lchash (erkaklar uchun ≤ 94 sm, ayollar uchun ≤ 80 sm bo’lishi kerak) [8]; bel aylanasining tos atrofiga nisbati (erkaklarda norma 0,9 dan, ayollarda 0,85 dan kam) va boshqalar [9].

Muhim ko’rsatkich – bu tanadagi yog ‘ulushi. Odatda, erkaklarda 25% gacha, ayollarda esa 30-32% gacha bo’lishi kerak, garchi bu ko’rsatkichlar turli tadqiqotchilar orasida farq qilishi mumkin. Tana yog’ining foizini aniqlash qiyin, ammo uni quyidagi formuladan foydalanib taxmin qilish mumkin [9]: 

Kattalardagi yog ‘% = (1,39* BMI )+(0,16* yosh )– (10,34* jins )–9

ayollar uchun jins = 0, erkaklar uchun esa jins = 1. 

Tana yog’ini hisoblash uchun ko’plab onlayn kalkulyatorlar ham mavjud.

Bioimpedans testi («aqlli tarozi») ham ortiqcha vaznni aniqlashning mashhur usuli hisoblanadi, ammo BMIga nisbatan hech qanday afzalliklarga ega emasligi ko’rsatilgan [9].

Nega men vazn ortib ketyapman?

Ortiqcha vazn olishning klassik modeli – bu odamning oziq-ovqatdan energiya olishi uning sarf-xarajatlaridan oshib ketishi. Biror kishining kunlik energiya sarfi quyidagilarni o’z ichiga oladi:

  • bazal metabolizm tezligi (tananing hayotiy funktsiyalarini – nafas olish, ovqat hazm qilish va boshqalarni saqlab qolish uchun sarflaydigan minimal energiya miqdori).
  • endogen termogenez (tana haroratini ushlab turish)
  • jismoniy faoliyat bilan bog’liq energiya xarajatlari. Bazal metabolizm tezligi [10]. 

Sarflaganidan ko’ra ko’proq energiya (kaloriya) oladigan tana uni tana yog’i sifatida saqlashni boshlaydi, chunki yog’ yomg’irli kun uchun energiyani saqlashning eng samarali usuli hisoblanadi.

Bu nazariya juda sodda va tushunarli, shuningdek, odamlar kaloriya tanqisligida bo’lganida, ular vazn yo’qotishni boshlashlari bilan tasdiqlanadi. Biroq, u energiya iste’moli va sarfini mustaqil omillar sifatida ko’rib chiqadi va endokrin va asab tizimlari bilan bog’liq muhim qayta aloqa mexanizmlarini o’tkazib yuboradi. Xususan, masalan, haddan tashqari vazn yo’qotish paytida bazal metabolizm darajasi sekinlashishi ko’rsatilgan [11]. Xuddi shu mexanizmlar vazn yo’qotgandan keyin bir holatda vaznni ushlab turishni qiyinlashtiradi (bu haqda nima qilish kerakligi quyida tavsiflanadi).

Semirib ketishning yana bir nazariyasi uglevod-insulin modeli bo’lib, u uglevod iste’moli ortiqcha vaznning asosiy sababi, insulin esa yog’ni saqlash uchun asosiy tetikdir. Taxminlarga ko’ra, insulin darajasining oshishi adipotsitlarda (yog ‘hujayralari) energiya to’planishiga olib keladi va uning boshqa to’qimalarga etkazib berilishini cheklaydi, bu esa energiya sarfini oshirishga, energiya sarfini kamaytirishga, kilogramm ortishiga va semirishga olib keladi [12]. Biroq, bu mexanizm, aftidan, asosiy emas, chunki, masalan, glisemik indeksda farq qiladigan dietalar tana vazniga turli xil ta’sir ko’rsatadi [13]. 

Shunday qilib, olimlar endi vazn ortishi uchun murakkab mexanizmga moyil bo’lmoqdalar [13].

Semirib ketishning rivojlanishi uchun xavf omillari orasida genetik xususiyatlar [14], depressiya (yuqori dalillar), shuningdek, bolalik va o’smirlik davridagi semizlik va etarli darajada uxlamaslik (o’rtacha dalillar) [15].

Ba’zi dorilar kilogramm ortishiga yordam beradi, masalan, antidepressantlar (amitriptilin, mirtazapin va boshqalar), antipsikotiklar (olanzapin, ketiapin, risperidon), gipoglikemik dorilar (glimepirid, gliklazid) va boshqalar. [16]

Qanday qilib vazn yo’qotishim mumkin?

Og’irlikni yo’qotishning asosiy usullari – parhez, jismoniy faollik (trening), psixoterapiya, maxsus dori-darmonlarni qabul qilish va jarrohlik davolash. Birinchi ikkita usul foydalanish mumkin va juda xavfsizdir, chunki ular og’irlik bilan bog’liq asosiy muammolar – energiya iste’moli va energiya sarfi nomutanosibligidan kelib chiqadi. Diet kaloriya iste’molini kamaytirishga yordam beradi va jismoniy faollik, shunga ko’ra, ularning iste’molini oshiradi. Bundan tashqari, ko’plab tadqiqotlar [17-20] ko’rsatilgandek, faqat jismoniy mashqlar bilan shug’ullanadigan guruhlarga qaraganda, parhez tarkibiy qismi bo’lgan guruhlarda aniqroq vazn yo’qotishi kuzatiladi. Ammo faqat parhez orqali vazn yo’qotish suyak mineralizatsiyasining buzilishiga va mushak massasining pasayishiga olib kelishi mumkin, bu noqulay omil, chunki mushaklar tanamizdagi energiyaning asosiy iste’molchisidir [21-24]. Shuning uchun parhez va jismoniy faollikning kombinatsiyasi eng maqbuldir, chunki mashqlar suyak mineral zichligining pasayishiga yo’l qo’ymaydi, yurak-qon tomir tizimi va metabolizmni yaxshilaydi va mushak massasining saqlanishiga yordam beradi [18, 20, 23, 25-29].

Qaysi dieta men uchun to’g’ri?

Turli xil dietalar mavjud – keto dietasi, O’rta er dengizi dietasi, intervalgacha ro’za tutish, mono dieta va boshqalar. Umuman olganda, ularning har biri vazn yo’qotishga yordam beradi, chunki ularning barchasi kaloriya iste’molini cheklashga qaratilgan, shuning uchun ular vazn yo’qotish uchun teng darajada tavsiya etilishi mumkin [30-32]. Barcha parhezlarning asosiy printsipi kaloriya tanqisligiga erishishdir (ya’ni, jami kunlik energiya sarfi oziq-ovqatdan olinadigan energiyadan oshib ketishi uchun). 

Siz har xil formulalar yordamida umumiy kunlik energiya iste’molini hisoblashingiz mumkin (masalan, Xarris-Benedikt, shuningdek, hisob-kitoblar uchun ko’plab onlayn kalkulyatorlardan foydalanishingiz mumkin);

Xarris-Benedikt tenglamasi:

Umumiy energiya sarfi: BMR (bazal metabolizm darajasi) * AMR (faol metabolizm darajasi), bu erda:

Ayollar uchun BMR:

BMR = 447,593+(9,247*kg vazn)+(3,098*bo’yi sm)- (4,330*yillarda yosh)

Erkaklar uchun BMR:

BMR = 88,362+(13,397*kg vazn)+(4,799*bo’yi sm)-(5,677*yillarda yosh).

Faol metabolizm (AMR), turmush tarziga qarab:

  • harakatsiz turmush tarzi – 1,2;
  • O’rtacha faollik (engil jismoniy faoliyat yoki haftada 1-3 marta mashq qilish) – 1,375;
  • O’rtacha faollik (haftada 3-5 marta darslar) – 1,55;
  • Faol odamlar (intensiv yuklar, haftada 6-7 marta mashq qilish) – 1,725;
  • Sportchilar va shunga o’xshash yuklarni bajaradigan odamlar (haftasiga 6-7 marta) – 1,9.

E’tibor bering, tenglama BMR dan olib tashlangan yoshni o’z ichiga oladi – bu yosh bilan bazal metabolizm tezligining pasayishini aks ettiradi. Yaxshi xabar shundaki, 700 dan ortiq postmenopozal va premenopozal ayollar ishtirok etgan 10 ta tadqiqotning kichik meta-tahlili vazn, yog ‘massasi yoki mushak massasidagi o’zgarishlarda farq qilmadi, shuning uchun yosh vazn yo’qotish uchun bunday to’siq bo’lmasligi mumkin [33] .

Sizning kaloriya iste’molingiz ushbu ko’rsatkichdan kamroq bo’lishi kerak. Qanchalik kamroq vazn yo’qotishni qanchalik tez xohlayotganingizga bog’liq, ammo o’rtacha 10-20% ni tashkil qiladi. Esda tutingki, asta-sekin vazn yo’qotish ko’proq va eng muhimi, uzoq davom etadigan natijalar bilan tavsiflanadi [34]. Bunga qo’shimcha ravishda, avariyali dietalarga rioya qilish odatda qiyinroq.

Oziq-ovqatdagi energiyaning asosiy manbalari yog’lar va uglevodlardir, shuning uchun kaloriya tanqisligiga erishishning ikkita asosiy strategiyasi mavjud – uglevodlarni iste’mol qilishni kamaytirish (mashhur keto dietalari variant) va yog’larni iste’mol qilishni kamaytirish. Ikkala usulning samaradorligi juda o’xshash [30, 32], ammo ba’zi ma’lumotlarga ko’ra, uglevodlarga boy dietalar samaraliroqdir) [35-37].

Qanday jismoniy faoliyat kerak?

Kuchli aerob mashqlari (yugurish, aerobika, velosipedda yurish, poygada yurish, raqsga tushish) tana vazni, BMI va bel atrofiga maksimal ta’sir ko’rsatadi [38, 39], ammo kuch mashqlari mushak massasini saqlash uchun foydalidir va ishtahani kamaytirishga yordam beradi. vaqt o’tishi bilan ochlik gormoni leptinni kamaytirish orqali [28, 40].

Yana nima yordam berishi mumkin?

Psixoterapiya va qo’llab-quvvatlash vazn yo’qotish va ko’proq darajada natijalarni saqlab qolish uchun zarur bo’lgan muhim omillardir. Psixoterapiyaning har xil turlari (masalan, kognitiv xulq-atvor terapiyasi (CBT), guruh CBT, ongga asoslangan terapiya va boshqalar) ortiqcha ovqatlanish va emotsional ovqatlanish epizodlarini kamaytirishda samarali ekanligi ko’rsatildi [41-47]. Xulq-atvor terapiyasi (masalan, maqsadni belgilash, motivatsion suhbat, relapsning oldini olish, kognitiv qayta qurish va boshqalar) semizlik bilan og’rigan kattalardagi darsga qatnashish va jismoniy faollikka sezilarli ijobiy ta’sir ko’rsatadi [48].

Kilo yo’qotish uchun ilovalar samaralimi (kaloriyalarni hisoblash, faollikni kuzatish va h.k.)?

Har qanday ilovalar qisqa vaqt ichida (bir necha oy) vazn yo’qotish, shuningdek, o’z-o’zini nazorat qilish uchun samarali vosita ekanligi ko’rsatilgan [49-55], lekin shaxsiy maslahatlar yoki oflayn kombinatsiyadan ko’ra kamroq natijalarga olib keladi . va onlayn darslar [51, 56]. Biroq, bunday ilovalar kaloriyalarni hisoblash, tana vaznini kuzatish, jismoniy faollikni hisoblash va hokazolar uchun qulaydir.

Semirib ketish uchun yana qanday davolash usullari mavjud?

Farmakologik davolash 

Semirib ketishni davolash uchun dorilar shifokor tomonidan belgilanishi kerak va ulardan foydalanish uchun ko’rsatmalar ortiqcha vazn bilan bog’liq kasalliklar mavjud bo’lganda BMI >30 yoki >27 bo’ladi [8].

Orlistat, ichak lipaz inhibitori, semizlik uchun hipokalorik parhez bilan birgalikda buyurilishi mumkin. Uning turmush tarzini o’zgartirish bilan samaradorligi meta-tahlillarda ko’rsatilgan [57, 58]. U juda ko’p yon ta’sirga ega va retsept bilan sotiladi.

Sibutramin ikki ta’sirli dori bo’lib, to’yinganlik tuyg’usini tezlashtiradi va tananing energiya sarfini oshiradi. Agar vazn yo’qotishning boshqa barcha usullari samarasiz bo’lsa, shifokor tomonidan semirish uchun buyuriladi [8]. Retsept bo’yicha chiqariladi. 

Kilo yo’qotish uchun inqilobiy dorilardan biri glyukagonga o’xshash peptid 1 retseptorlari agonistlari, masalan, liraglutid, eksenatid va eng mashhur semaglutid (Quincenta, Ozempic). Dastlab, bu dorilar 2-toifa qandli diabetni davolash uchun ishlab chiqilgan va bu ham ulardan foydalanishning asosiy ko’rsatkichidir, ammo keyinchalik ular semiz odamlarda tana vaznini 15-20% ga kamaytirishda samarali ekanligi ko’rsatildi [59-63] . Biroq, uzoq muddatda semaglutidni qabul qilishni to’xtatgandan so’ng, vaznning qisman tiklanishi sodir bo’ladi [64]. Bunday dorilar ancha qimmat va Rossiyada retsept bilan sotiladi. 

Semizlik uchun shifokor tomonidan boshqa kasalliklar bilan birgalikda buyurilgan boshqa farmakologik vositalar mavjud, masalan, 2-toifa qandli diabet uchun, vaznni tuzatish maqsadida metformin buyurilishi mumkin [8].

Barcha dori-darmonlar hech qachon bitta terapiya sifatida belgilanmaydi kombinatsiyalangan davolash har doim qo’llaniladi – turmush tarzini o’zgartirish (diet, jismoniy mashqlar), psixoterapiya;

Jarrohlik davolash

Jarrohlik davolash (bariatrik jarrohlik) boshqa davolash usullari samarasiz bo’lgan 18-60 yoshdagi morbid semizlik (BMI>40 yoki BMI>35 va birga keladigan surunkali kasalliklar) bilan og’rigan bemorlarga tavsiya etiladi.

Operatsiyalarning har xil turlari mavjud – gastrik bypass, ichakni aylanib o’tish, oshqozon bandi, intragastrik ballon va boshqalar. Ularning barchasi asosan iste’mol qilinadigan oziq-ovqat miqdorini kamaytirishga qaratilgan. Jarrohlik aralashuvi juda samarali (tana vaznini 10 kg yoki undan ko’proq yo’qotish), ammo ko’plab yon ta’sirga ega, masalan, oqsil almashinuvining buzilishi, anemiya, vitamin etishmasligi, osteoporoz va boshqalar. Bundan tashqari, takroriy operatsiyalar ko’pincha talab qilinadi [65-68].

Liposaktsiya semizlikni davolash usuli emas, chunki u kasallikning patogeneziga ta’sir qilmaydi va katta miqdordagi yog’larni olib tashlashga imkon bermaydi, ammo u yaxshi vizual effektga ega, bu vazn yo’qotishning boshqa usullaridan yaxshiroq bo’lishi mumkin. .

Qanday qilib yana qo’shimcha funt olishdan qochishim mumkin?

Ko’pgina vazn yo’qotish usullari bilan vazn yo’qotish taxminan 6-9 oy davomida sodir bo’ladi, so’ngra og’irlik platosi va keyin kilogramm qayta tiklanadi. Gap shundaki: organizmdagi metabolik o’zgarishlar ishtahaning oshishiga, qabul qilingan oziq-ovqatdan energiyaning yanada samarali olinishiga, lipolizning pasayishiga (yog’larning parchalanishi) va bazal metabolizmning pasayishiga olib keladi. Bundan tashqari, umumiy faoliyat kamayadi (idishlarni yuvish, do’konga yurish). Bu jarayonlar, shuningdek, vaqt o’tishi bilan dastlab tana vaznining pasayishiga olib kelgan parhez va jismoniy mashqlar samarasini to’xtatib qo’yishi (vazn bir nuqtada to’xtaydi yoki hatto o’sishni boshlaydi) uchun ham javobgardir [11, 69-73] . 

Uzoq muddatda vazn yo’qotishingizni saqlab qolish uchun foydalanishingiz mumkin bo’lgan ba’zi strategiyalar:

  • ratsiondagi protein miqdorini oshirish (ko’plab tadqiqotlarda tasdiqlangan!) 
  • tolani ko’proq iste’mol qilish (mevalar, sabzavotlar va boshqalar)
  • sezilarli vazn yo’qotish bosqichida dietada tanaffuslar 
  • jismoniy faollikni oshirdi [74-79].

Shunday qilib, vaznni bir xil saqlash uchun siz kaloriyalarni cheklash yo’lini davom ettirishingiz va jismoniy mashqlarni oshirishingiz kerak bo’ladi.

Umuman olganda, odamlarning atigi 15 foizi yuqoridagi tavsiyalarga rioya qilmasa, jarrohlik va farmakologik bo’lmagan holda 10% yoki undan ko’proq vazn yo’qotishi mumkin. 

Kichkina o’zgarishlarga (masalan, kaloriyalarni 100 kkalga kamaytirish yoki kuniga 1000 qadamga faollikni oshirish va hokazo) yondashuv ham vaznni saqlashga yordam beradi, chunki odamlar bunday maqsadlarni o’z hayotlariga integratsiyalash va keyin ularni saqlab qolish osonroqdir [80] ].

Bundan tashqari, CBT va boshqa turdagi psixoterapiya, qo’llab-quvvatlash va murabbiy / klinisyen bilan yakkama-yakka uchrashuvlar vaznni boshqarish dasturini yaxshi to’ldirishi mumkin [81-83].

Manbalar:

  1. Capristo E va boshqalar. Og’irlikni yo’qotadigan dori-darmonlarning o’lim va yurak-qon tomir hodisalariga ta’siri: Ortiqcha vaznli va semirib ketgan kattalardagi randomizatsiyalangan nazorat ostida sinovlarni tizimli ko’rib chiqish. Nutr Metab Cardiovasc Dis, 2021.
  2. Mathur R va boshqalar. Ratsionga asoslangan vazn yo’qotish aralashuvlarining endotelial funktsiyaning biomarkerlariga ta’siri: tizimli ko’rib chiqish va meta-tahlil. Eur J Clin Nutr, 2023 yil. 
  3. Ríos C, Irarrázaval S. Tiz osteoartriti uchun faqat parhez orqali vazn yo’qotish. Medwave, 2019 yil.
  4. Nitschke E va boshqalar. Oziqlanish va jismoniy faollik bo’yicha mutaxassislar tomonidan kattalar umumiy aholi uchun ta’minlangan ovqatlanish va jismoniy faollik tadbirlarining ta’siri: tizimli ko’rib chiqish va meta-tahlil. Oziq moddalar, 2022.
  5. Pélissier L va boshqalar. Oddiy vaznli odamda dietaning ko’proq kilogramm olish xavfi bormi? Tizimli tahlil va meta-tahlil. Br J Nutr. 2023 yil. 
  6. Joo M va boshqalar. Oddiy vaznli (tana massasi indeksi < 25 kg / m2) kattalardagi juda past karbongidratli ketogenik parhezlarning lipid profillariga ta’siri: meta-tahlil. Nutr Rev. 2023 yil.
  7. Huang S, et al. Association of magnitude of weight loss and weight variability with mortality and major cardiovascular events among individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. Cardiovasc Diabetol. 2022. 
  8. Лечение ожирения у взрослых. Клинические рекомендации Российской ассоциации эндокринологов, 2019 г
  9. Клиническое руководство National Institute for Health and Clinical Excellence (NICE), Obesity: identification, assessment and management, 2014, с последними изменениями от 26 июля 2023
  10. Blasco Redondo R. Resting energy expenditure; assessment methods and applications. Nutr Hosp. 2015. 
  11. Dulloo AG. Physiology of weight regain: Lessons from the classic Minnesota Starvation Experiment on human body composition regulation. Obes Rev. 2021. 
  12. Ludwig DS, Ebbeling CB. The Carbohydrate-Insulin Model of Obesity: Beyond «Calories In, Calories Out». JAMA Intern Med. 2018 Aug 1;178(8):1098-1103.
  13. Hall KD, et al. The Carbohydrate-Insulin Model of Obesity Is Difficult to Reconcile With Current Evidence. JAMA Intern Med. 2018 Aug 1;178(8):1103-1105.
  14. Locke AE, et al. Genetic studies of body mass index yield new insights for obesity biology. Nature. 2015. 
  15. Solmi M, et al. Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta-analyses of cohort studies and randomized controlled trials. Eur J Clin Invest. 2018.
  16. Domecq JP, et al. Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015. 
  17. Twells LK, et al. Nonsurgical weight loss interventions: A systematic review of systematic reviews and meta-analyses. Obes Rev. 2021. 
  18. Batsis JA, et al. Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005. J Am Geriatr Soc. 2017. 
  19. Schwingshackl L, et al. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis. Syst Rev. 2014. 
  20. Amorim Adegboye AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev. 2013.
  21. Soltani S, et al. The effects of weight loss approaches on bone mineral density in adults: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int. 2016. 
  22. Zibellini J, et al. Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials. J Bone Miner Res. 2015. 
  23. Mesinovic J, et al. Exercise attenuates bone mineral density loss during diet-induced weight loss in adults with overweight and obesity: A systematic review and meta-analysis. J Sport Health Sci. 2021.
  24. Zibellini J, et al. Effect of diet-induced weight loss on muscle strength in adults with overweight or obesity – a systematic review and meta-analysis of clinical trials. Obes Rev. 2016. 
  25. Yazdanpanah Z, et al. Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials. Osteoporos Int. 2022. 
  26. Khalafi M, et al. A comparison of the impact of exercise training with dietary intervention versus dietary intervention alone on insulin resistance and glucose regulation in individual with overweight or obesity: a systemic review and meta-analysis. Crit Rev Food Sci Nutr. 2023.
  27. Memelink RG, et al. Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: A systematic review and meta-analysis. Diabet Med. 2023. 
  28. Roth A, et al. Effects of exercise training and dietary supplement on fat free mass and bone mass density during weight loss – a systematic review and meta-analysis. F1000Res. 2022. 
  29. Panunzi S, et al. Comparative efficacy of different weight loss treatments on knee osteoarthritis: A network meta-analysis. Obes Rev. 2021.
  30. Johnston BC, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA. 2014. 
  31. Naude CE, et al. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One. 2014. 
  32. Yang Q, et al. The effects of low-fat, high-carbohydrate diets vs. low-carbohydrate, high-fat diets on weight, blood pressure, serum liquids and blood glucose: a systematic review and meta-analysis. Eur J Clin Nutr. 2022.
  33. Thomson ZO, et al. Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions: a systematic review and meta-analysis. Menopause. 2020 Dec 21;28(3):337-346. 
  34. Ashtary-Larky D, et al. Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis. Br J Nutr. 2020. 
  35. Mansoor N, et al. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr. 2016.
  36. Chawla S, et al. The Effect of Low-Fat and Low-Carbohydrate Diets on Weight Loss and Lipid Levels: A Systematic Review and Meta-Analysis. Nutrients. 2020. 
  37. Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013.
  38. Armstrong A, et al. Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta-analysis. Obes Rev. 2022. 
  39. Ballard AM, et al. The Effects of Exclusive Walking on Lipids and Lipoproteins in Women with Overweight and Obesity: A Systematic Review and Meta-Analysis. Am J Health Promot. 2022. 
  40. Rostás I, et al. In middle-aged and old obese patients, training intervention reduces leptin level: A meta-analysis. PLoS One. 2017. 
  41. Jacob A, et al. Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: A meta-analysis. Health Psychol. 2018. 
  42. Linardon J, et al. The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. J Consult Clin Psychol. 2017. 
  43. Grenon R, et al. Group psychotherapy for eating disorders: A meta-analysis. Int J Eat Disord. 2017. 
  44. Daniela Mercado, et al. The outcomes of mindfulness-based interventions for Obesity and Binge Eating Disorder: A meta-analysis of randomised controlled trials. Appetite. 2021. 
  45. Sosa-Cordobés E, et al. How Effective Are Mindfulness-Based Interventions for Reducing Stress and Weight? A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022. 
  46. Toledo PR, et al. Interpersonal psychotherapy for treatment of obesity: A systematic review and meta-analysis. J Affect Disord. 2023. 
  47. Rogers JM, et al. Mindfulness-based interventions for adults who are overweight or obese: a meta-analysis of physical and psychological health outcomes. Obes Rev. 2017. 
  48. Burgess E, et al. Behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity: a systematic review and meta-analysis. Clin Obes. 2017. 
  49. Beleigoli AM, et al. Web-Based Digital Health Interventions for Weight Loss and Lifestyle Habit Changes in Overweight and Obese Adults: Systematic Review and Meta-Analysis. J Med Internet Res. 2019. 
  50. Chew HSJ, et al. Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. J Med Internet Res. 2022. 
  51. Wieland LS, et al. Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Cochrane Database Syst Rev. 2012. 
  52. Antoun J, et al. The Effectiveness of Combining Nonmobile Interventions With the Use of Smartphone Apps With Various Features for Weight Loss: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth. 2022. 
  53. Islam MM, et al. Use of Mobile Phone App Interventions to Promote Weight Loss: Meta-Analysis. JMIR Mhealth Uhealth. 2020. 
  54. Tang MSS, et al. Effectiveness of Wearable Trackers on Physical Activity in Healthy Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth. 2020. 
  55. Fakih El Khoury C, et al. The Effects of Dietary Mobile Apps on Nutritional Outcomes in Adults with Chronic Diseases: A Systematic Review and Meta-Analysis. J Acad Nutr Diet. 2019. 
  56. Chew HSJ, et al. Effectiveness of Combined Health Coaching and Self-Monitoring Apps on Weight-Related Outcomes in People With Overweight and Obesity: Systematic Review and Meta-analysis. J Med Internet Res. 2023.
  57. Aldekhail NM, et al. Effect of orlistat on glycaemic control in overweight and obese patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2015.
  58. Sahebkar A, et al. Effect of orlistat on plasma lipids and body weight: A systematic review and meta-analysis of 33 randomized controlled trials. Pharmacol Res. 2017. 
  59. Sarma S, Palcu P. Weight loss between glucagon-like peptide-1 receptor agonists and bariatric surgery in adults with obesity: A systematic review and meta-analysis. Obesity (Silver Spring). 2022. 
  60. Stretton B, et al. Weight loss with subcutaneous semaglutide versus other glucagon-like peptide 1 receptor agonists in type 2 diabetes: a systematic review. Intern Med J. 2023. 
  61. Arastu N, et al. Efficacy of subcutaneous semaglutide compared to placebo for weight loss in obese, non-diabetic adults: a systematic review & meta-analysis. Int J Clin Pharm. 2022. 
  62. Liu Y, et al. The Weight-loss Effect of GLP-1RAs Glucagon-Like Peptide-1 Receptor Agonists in Non-diabetic Individuals with Overweight or Obesity: A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials. Am J Clin Nutr. 2023.
  63. Iannone A, et al. Clinical outcomes associated with drugs for obesity and overweight: A systematic review and network meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023. 
  64. Klair N, et al. What Is Best for Weight Loss? A Comparative Review of the Safety and Efficacy of Bariatric Surgery Versus Glucagon-Like Peptide-1 Analogue. Cureus. 2023. 
  65. Colquitt JL, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014. 
  66. Kotinda APST, et al. Efficacy of Intragastric Balloons for Weight Loss in Overweight and Obese Adults: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Obes Surg. 2020. 
  67. Franken RJ, et al. Treatment Options for Weight Regain or Insufficient Weight Loss After Sleeve Gastrectomy: a Systematic Review and Meta-analysis. Obes Surg. 2022. 
  68. O’Brien PE, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019. 
  69. Busetto L, et al. Mechanisms of weight regain. Eur J Intern Med. 2021.
  70. van Baak MA, Mariman ECM. Mechanisms of weight regain after weight loss – the role of adipose tissue. Nat Rev Endocrinol. 2019. 
  71. Rosenbaum M, Foster G. Differential mechanisms affecting weight loss and weight loss maintenance. Nat Metab. 2023.
  72. Flore G, et al. Weight Maintenance after Dietary Weight Loss: Systematic Review and Meta-Analysis on the Effectiveness of Behavioural Intensive Intervention. Nutrients. 2022. 
  73. Silva AM, et al. What is the effect of diet and/or exercise interventions on behavioural compensation in non-exercise physical activity and related energy expenditure of free-living adults? A systematic review. Br J Nutr. 2018. 
  74. Martínez-Gómez MG, Roberts BM. Metabolic Adaptations to Weight Loss: A Brief Review. J Strength Cond Res. 2022.
  75. van Baak MA, Mariman ECM. Dietary Strategies for Weight Loss Maintenance. Nutrients. 2019.
  76. Barrea L va boshqalar. Semirib ketishda vazn yo’qotish muammosi: mavjud bo’lgan eng yaxshi strategiyalar bo’yicha dalillarni ko’rib chiqish. Int J Food Sci Nutr. 2022. 
  77. Yoxansson K va boshqalar. Semirib ketishga qarshi dori-darmonlar, parhez va mashqlarning juda past kaloriyali dietadan yoki past kaloriyali dietadan keyin vazn yo’qotishga ta’siri: randomizatsiyalangan nazorat ostidagi sinovlarni tizimli ko’rib chiqish va meta-tahlil. Am J Clin Nutr. 2014 yil. 
  78. Clifton PM va boshqalar. Kam uglevodli, yuqori proteinli dietalarni iste’mol qilish tavsiyasidan so’ng uzoq muddatli vaznni saqlash – tizimli tahlil va meta-tahlil. Nutr Metab Cardiovasc Dis. 2014 yil. 
  79. Wycherley TP va boshqalar. Standart proteinli, kam yog’li dietalar bilan solishtirganda energiya bilan cheklangan yuqori proteinli, kam yog’li ta’siri: randomizatsiyalangan nazorat ostida bo’lgan sinovlarning meta-tahlili. Am J Clin Nutr. 2012 yil. 
  80. Graham HE va boshqalar. Kilogrammni boshqarish uchun kichik o’zgarishlar usuli samaralimi? Randomize nazorat ostidagi sinovlarni tizimli ko’rib chiqish va meta-tahlil. Obes Rev. 2022. 
  81. Kheniser K va boshqalar. Semizlik uchun uzoq muddatli vazn yo’qotish strategiyalari. J Clin Endocrinol Metab. 2021 yil. 
  82. Middleton KM va boshqalar. Uzoq muddatli parvarishning vazn yo’qotishning uzoq muddatli ta’siriga ta’siri: tizimli ko’rib chiqish va meta-tahlil. Obes Rev. 2012 yil. 
  83. Mamalaki E va boshqalar. Kilogrammni yo’qotish uchun texnologiyaga asoslangan tadbirlarning samaradorligi: meta-tahlil bilan randomizatsiyalangan nazorat ostida sinovlarni tizimli ko’rib chiqish. Obes Rev. 2022.

Fikr bildirish

Email manzilingiz chop etilmaydi. Majburiy bandlar * bilan belgilangan