Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed by SIAHMSR medical team

  Mediterranean diet to manage obesity, diabetes &  De-stressing pranayama to reduce stress  - The comprehensive Package to manage obesity & Metabolic syndrome.

  Obesity or excessive body mass and weight is a preventable health crisis,  which is a major cause of many types of morbidities or  illnesses affecting the population  like diabetes ,cardiovascular diseases, cancers ,hormonal diseases and metabolic syndrome. Obesity is a major health problem affecting both children and adults alike in developed, developing and low income countries of the world

  The previous decades have witnessed undernutrition and underweight with associated ill health and lowered immunity as a health crisis. But in the current decade more people are obese than being underweight in the global populations except in sub-Saharan Africa and Asia where malnutrition or undernutrition is still a major problem.

Although several factors contribute to the risk of obesity, nutrition and diet has a crucial role in managing obesity and maintaining healthy weight. This is particularly important for people having diabetes. Metabolic syndrome is a condition associated with central obesity [ fat deposition more on trunk or middle area of your body], high blood pressure and insulin resistance eventually leading to diabetes.  These groups need to be more concerned about obesity management . Diabetes associated with metabolic syndrome often leads to very serious complications such as heart attack, stroke and other life style disorders.  

Well -chosen diet plans may help you get rid of excess weight and thus manage obesity. Here we are discussing general tips to manage obesity as well as Mediterranean diet to promote weight loss. Various research studies  have confirmed that Mediterranean-derived diet plans are beneficial  in the management of obesity, type 2 diabetes, metabolic syndrome,  cardiovascular diseases ,cancer & neurodegenerative diseases.

SIAHMSR recommends some de-stressing pranayama yoga practice also for managing obesity developing as a consequence of stress and hormonal imbalances.

  Causes of Obesity

·        Heredity

Obesity is linked to heredity in some people. Certain rare genetic disorders may cause intractable obesity like Padre Willi syndrome. Genes have definite role in obesity and weight gain.

·        Physical inactivity or sedentary lifestyle

Prolonged inactivity may promote weight gain as the carbohydrates and fats consumed through daily diet are not burned into energy and instead deposited as fat contributes to obesity.

·        Eating large quantities of food & low qualities of food

  Eating large quantities of carbohydrates and high glycemic index [sugars] foods increase the risk of weight gain. The amount of calories people eat and drink has a direct impact on their weight. Consume the same amount of calories every day that the body burns them over time, and weight remains stable. As you eat more than the body could burn, weight goes up.

    The quality of food sources of these nutrients matter a lot than relative quantity in the diet.

Foods and eating patterns may help to keep calories in control 

Milled, refined grains and the foods made with them such as white rice, white bread, white pasta, processed breakfast cereals ,potatoes & sugary drinks are rich in easily digested carbohydrates.  That means Foods having high glycemic index and glycemic load. Such foods cause rapid elevation in blood sugar and insulin levels that it can cause hunger to spike soon and may lead to overeating. In short these foods increase the risk of weight gain, obesity, diabetes, and heart disease.

  Studies have found that merely following a low-fat diet may not help to lose weight than following a moderate- or high-fat diet. The problem of following with low-fat diet alone simply is that they are often high in carbohydrate, especially from rapidly digested sources, such as white bread and white rice. And diets high in carb foods increase the risk of weight gain.

Another reason is the quality of fat in the food you consume. Increased consumption of unhealthy fats- especially trans- fat and saturated fats are linked to weight gain, but increased consumption of healthy fats-monounsaturated and polyunsaturated fat-in moderate amount do not cause weight gain.

·        Medical causes of obesity  

       Hormonal causes

a] an underactive thyroid gland (hypothyroidism) – where your thyroid gland does not produce enough hormones and eventually it may cause obesity as  hypothyroidism slows down the metabolism.

b] Cushing's syndrome – a rare disorder that causes the over-production of steroid hormones

Drugs

·        Certain medicines, including some corticosteroids, medications for epilepsy and diabetes, and some medications used to treat mental illness – including antidepressants and medicines for schizophrenia – can contribute to weight gain.

How do proteins & carbohydrates impact obesity? 

Proteins

 Eating protein rich foods provide more satiety or people tend to feel fuller, on fewer calories, after eating proteins than they do after eating carbohydrate or fat. Easy satiety or full feeling can limit further intake of food.

It takes more energy to metabolize and store protein and this may help people increase the energy they burn each day. 

Protein seems to help people hang on to lean muscle during weight loss.

Higher protein, lower carbohydrate diets improve blood lipid profiles and other metabolic markers, preventing the chances of occurrence of heart disease and diabetes.   That means adequate  intake of protein is beneficial to your body.

However, choose proteins wisely as the types of food rich in protein is associated with some other health risks. Some high protein foods are healthier than others while other foods add to the risk of non-communicable diseases such as heart attack and stroke. That is, High intakes of red meat and processed meat are associated with an increased risk of heart disease, diabetes, and colon cancer.

Replacing red and processed meat with nuts, beans or plant proteins, fish, or poultry help to lower the risk of heart disease and diabetes. Lower carbohydrate, higher protein diets may have some weight loss advantages in the short term.

Carbohydrates

 While considering   prevention of weight gain and occurrence of chronic diseases, carbohydrate quality is much more important than carbohydrate quantity.

High glycaemic index carbs are  not good

Milled, refined grains and the foods made with them-white rice, white bread, white pasta, processed breakfast cereals, and the like-are rich in rapidly digested carbohydrates.  Potatoes and sugary drinks belong to the same category of foods. The scientific term for this is that they have a" high glycemic index and glycemic load."   Such foods cause rapid increase in blood sugar and insulin levels that, in the short term, can cause hunger to spike and can lead to overeating.

  In the long run high glycemic foods increase the risk of weight gain, diabetes, and heart disease.

The weight control evidence is stronger for whole grains than it is for fruits and vegetables owing to high fiber content. Therefore include whole grains into your diet.

·        Sugar-Sweetened Beverages and Weight gain:

There is irrefutable research evidence that sugary drinks increase the risk of weight gain, obesity, diabetes and heart disease.

·        Fruit juices with sweeteners and obesity:

Fruits lose its good fiber content on grinding and added sugars enhance the risk of obesity. Even the100 percent fruit juice, with no added sugar- is as high in sugar and calories as sweetened drinks.

Grades of obesity 

Health science classifies obesity into class types based on body mass index [BMI] and its intensity. If your BMI is between 25.0 and 29.9 kg/m², you are in the overweight category.  But here are three general classes of obesity that healthcare providers use to evaluate the grade of obesity to decide obesity management protocols and it is strictly individualized. They include:

Class I obesity: BMI 30 to <35 kg/m².

Class II obesity: BMI 35 to <40 kg/m².

Class III obesity: BMI 40+ kg/m².

BMI [Body mass index]: 

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.   Body Mass Index (BMI) is a person’s weight in kilograms (or pounds) divided by the square of height in meters (or feet). A high BMI can indicate high body fatness. BMI screens for weight categories that may lead to health problems, but it does not diagnose the body fatness or health of an individual.

A body mass index (BMI) over 25 is considered overweight, and over 30 is obese.

According to world health organization [data of 2022] more than 1 billion people worldwide are obese – 650 million adults, 340 million adolescents and 39 million children. This number is still increasing in a rapid pace everywhere on the globe.

 Obesity affects the vital organs like heart, liver, kidneys, joints, and reproductive system. It may lead to a range of non-communicable diseases (NCDs), such as type 2 diabetes, cardiovascular disease, hypertension and stroke, various types of cancers, and  mental health issues.

General tips to manage obesity

Reduce carbohydrate to moderate amount and the quantity as well as quality of food you take is important.

Include moderate amount of healthy mono and polyunsaturated fat into your diet.

Avoid sugary sweetened beverages.

Reduce alcohol intake. The scientific data available till date do not strictly restrict alcohol intake considering it as a major cause of obesity. Even though most alcoholic beverages have more calories per ounce than sugar-sweetened beverages, there’s no clear-cut evidence that moderate drinking contributes to weight gain. While the recent diet and lifestyle change study found that people who increased their alcohol intake gained more weight over time, the findings varied by type of alcohol.

Yogurt - A study from the Harvard School of Public Health, which found that people who increased their yogurt intake gained less weight. Increases in milk and cheese intake, however, did not appear to promote weight loss or gain. More research is needed in this area.

Nuts are rich in protein and fiber, both of which may help people feel fuller and less hungry.

People who regularly eat nuts are less likely to have heart attacks or die from heart disease than those who rarely eat them, which is another reason to include nuts in a healthy diet.

 Whole grains-The weight control evidence is stronger for whole grains than it is for fruits and vegetables.

 Proteins- some proteins are good for weight loss. Replacing red and processed meat with nuts, beans, fish, or poultry seems to lower obesity and the risk of heart disease and diabetes.

Fibers- since fibers slow down digestion, they help to curb hunger. Many fruits and vegetables are rich in fibers.

Lower carbohydrate, higher protein diets may have some weight loss advantages in the short term.

Reduce stress and stress related hormonal imbalances which may lead to obesity

Treat medical conditions like hypothyroidism and Cushing’s syndrome which are diseases contributing to obesity.

Promote physical activity through exercise programs and games.

Mediterranean diet for weight loss/ obesity management

What is  Mediterranean diet?

 Mediterranean diet is a way of eating that focuses on the traditional diet patterns.  Currently , Mediterranean diet is a universally accepted diet by health professionals. It was Ancel Keys, an American scientist who first noticed the relationship between the low incidence of heart diseases in some traditional Mediterranean communities and their specific dietary habits.

Mediterranean cuisines mean food choices of people of countries that border the Mediterranean Sea. They choose chiefly foods from plant kingdom, such as whole grains, vegetables, legumes, fruits, nuts, seeds, herbs and spices etc. as the foundation foods of their diet.

Olive oil is the main source of added fat. Mediterranean diet is adapted from this.

Fish, seafood, dairy and poultry are included in moderation in Mediterranean diet infrequently. Red meat and sweets are eaten only occasionally.

Later research studies confirmed that Mediterranean-derived diet plans are not only beneficial in the prevention of cardiovascular diseases, but also in the management of obesity, type 2 diabetes, metabolic syndrome, cancer or neurodegenerative diseases.

 What are the major ingredients of Mediterranean diet?

  The diet focuses mainly on vegetables, fruits, whole grains, pulses, nuts and seeds. Healthy fats such as avocados, olive oil etc. are preferred.

Olive oil is the main fat used in the Mediterranean diet and it is a great source of healthy, monounsaturated fat, which lowers total cholesterol and low-density lipoproteins [bad cholesterol] levels.

Nuts and seeds also provide monounsaturated fat and are good for health if consumed in moderation.

The  preferred animal protein is fish and seafood.

Oily fish, such as mackerel, herring, sardines, tuna and salmon, are rich in omega-3 fatty acids. Omega-3 fatty acids also help decrease triglycerides and lower the risk of stroke and heart failure. It is also anti-inflammatory in function.

Wine is also a component of  Mediterranean diet allowed in moderation.

How can you include Mediterranean diet in your dietary choices?

·        Include more vegetables, beans and whole grains.

·        Eat oily fish at least twice a week.

·        Use olive oil instead of butter, ghee, excessive amount of cheese etc.

·        Serve fruits in your breakfast or in dinner dessert.

·        Include adequate amount of nuts and seeds in your snacks

·        Include yoghurt everyday

·        Choosing water as the main daily beverage & some wine

·        Avoid red meat, added sugars and junk foods.

The  Mediterranean Diet is flexible, and you can tailor it to your needs.

 Health benefits of Mediterranean diet

Research studies show that  Mediterranean Diet can lower your risk of cardiovascular diseases, obesity, diabetes and life style diseases. A dietitian can help you customize the diet to suit your individual needs. SIAHMSR wellness wellness consultants & nutritionist recommend Mediterranean diet for :

           ·        Lowering your risk of cardiovascular diseases like heart attack, stroke etc.

·        Help you maintain a healthy body weight.

·        Help reduce blood sugar, type 2 diabetes, blood pressure and cholesterol.

·        Lowering your risk of metabolic syndrome-[ high blood pressure, obesity and bad cholesterols ]

·        Supporting a healthy balance of gut microbiota [healthy bacteriae of gut]

·        Lowering your risk for certain types of cancers [ prostate, colon cancers]

·        Slowing down the age related decline of brain functions ; that is helping to slow down the cognitive decline and dementia or memory loss.

·        Improve longevity

·        Mediterranean diet favors foods high in fiber and antioxidants. The fiber  helps to keep waste moving through your large intestine and improves gut health.

    Antioxidants protect your against cancer and other grave diseases by fighting against free radicals.

    High fiber content help reduce bad cholesterol and it also reduces the risk for colorectal cancers.

    Antioxidants also helps to slow down ageing preventing oxidative stress to skin and vital organs.

 For further reading :

https://siahmsrwellness.in/mediterranean-diet-for-obesity 

Pranayama for de- stressing & weight loss

    Obesity is closely connected with many kinds of hormonal imbalances and which in turn stem from acute as well as chronic stress. Therefore, in the management of obesity de-stressing also plays a crucial role as it is the root cause of obesity in many cases.  Pranayamas are one of the best yogic breathhing exercises for destressing and relaxing your mind. There are various types of pranayama to relieve your stress,anxiety and depression and bring happiness and calmness .

 For further details on Pranayama procedures and various types of this yogic practice please follow the link below.

https://siahmsrwellness.in/pranayama-for-de-stressing#

Apart from pranayama various yoga poses also helps in reducing obesity. Consistent practice of yoga poses or yogasana may help you get rid of the excess fat.

A few yoga poses reccommended by SIAHMSR Wellness  doctors for managing obesity are listed below. Please follow the links for details of  benefits of these yoga poses.

.  Paschimottanasana
. Adho Mukha Svanasana

. Bhujangasana  [ cobra stretch ]

.  Vrikshasana

Wish you good luck in your weigh loss journey .  This comprehensive obesity management  tool may definitely will help you achieve  optimum weight with consistent practice. For  addressing medical causes of obesity  you need to consult with a healthcare provider or doctor

 References 

https://www.who.int/health-topics/obesity#tab=tab_1
https://www.nhs.uk/conditions/obesity/causes/#:~:text=Obesity%20is%20generally%20caused%20by,by%20the%20body%20as%20fat.
https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

https://siahmsrwellness.in/fitness-yoga/list/yoga 

https://siahmsrwellness.in/fitness-yoga/list/mind-relaxation-yoga 

https://siahmsrwellness.in/diabetes-type2-diabetes

https://siahmsrwellness.in/mediterranean-diet-for-obesity