Dr. Emilia Doncheva: In Metabolic Syndrome, Nutrition Is Balanced, Not Scarce
Author: Victoria Aly
Time for reading: ~8
minutes
Last Updated:
August 08, 2022
Dr. Emilia Doncheva recommends a balanced diet for metabolic syndrome. You can learn more about the right foods from the interview ...
what is metabolic syndrome?
Metabolic syndrome is a combination of the following five diseases: hypertension; diabetes (diabetes) or impaired carbohydrate tolerance; dyslipidemia - a disorder of fat metabolism; hyperuricemia or gout - a disorder of purine metabolism; and overweight or obesity, which in Western countries is now considered not only a cosmetic problem but also a disease.
In the presence of at least three of the listed diseases in the same patient, we have every reason to diagnose and accept metabolic syndrome.
Depending on the number of identified diseases in the same patient, the metabolic syndrome can be - incomplete and complete (unfolded), when all five of these components are present. Modern medical science pays great attention to the metabolic syndrome due to the risks of serious complications for health and life. These are mainly cardiovascular diseases, the most severe of which are heart attack, stroke and generalized atherosclerosis. That is why the prevention and timely adequate treatment of the metabolic syndrome are extremely important! The timely inclusion of complex therapy, even in cases where the patient has only three of the five components listed, is essential in the fight against complications.
- What are the basic dietary guidelines for these patients?
The approach is different for each patient, depending on his health condition and the judgment of the nutritionist. In some cases, a well-structured and balanced diet or recommendations for adjustments in eating and drinking behavior made by a specialist are sufficient. In other cases, in addition to the diet, it is necessary to include additional medications to control the relevant metabolic disorder. It is important that patients have a high health culture, to be properly informed which foods and beverages are recommended and which are contraindicated for their health! In addition to treating and correcting metabolic disorders, diet is also important for weight reduction in overweight and obese patients.
In disorders of fat metabolism - the so-called dyslipidemia, it is advisable to limit the consumption of all high-fat foods, mainly of animal origin - fatty meats, all types of high-fat and full-fat fresh and yogurts, high-fat cheeses and yellow cheese, cream. Egg yolk and chicken skin, canned meats, sausages and animal by-products should also be limited. These foods not only bring calories into the body, but also increase the level of lipids (total cholesterol, LDL-cholesterol, or so-called bad cholesterol, which damages the vascular wall) and uric acid in the blood serum.
The second important recommendation is to limit the group of carbohydrate foods - fast-absorbing, which have the highest and fastest effect on blood sugar levels. These are white refined crystal sugar and all kinds of foods that contain it. The restriction applies most to patients with impaired carbohydrate tolerance or proven diabetes, as well as to all patients who are overweight or obese.
The other group of high-risk foods are white refined flour and all types of pasta made from it. In patients with proven hypertension (high blood pressure), the recommendation to limit salt intake is well known. It is believed that white salt is the third so-called "white poison" after sugar and flour, because one molecule of salt retains about nine molecules of water in the body and leads to an increase in total circulating fluid in the bloodstream, respectively - to increase arterial pressure. White salt (sodium chloride) can be successfully replaced with Tibetan, Himalayan or even sea salt, which, among other benefits, has the property to alkalize the body. On a daily basis, I advise patients to withdraw the so-called "hidden" salt in olives and cheese,
If a patient has proven gout or hyperuricemia, usually combined with oxalate kidney stones, it is best to avoid red meat, animal offal and red wine, which increase the level of uric acid in the blood serum. From plant foods it is desirable to limit as much as possible the amount consumed spinach, sorrel, dock, broccoli, beans, mushrooms, etc., which have the same effect on purine metabolism.
All types of carbonated alcoholic and non-alcoholic beverages, as well as the so-called "energy drinks" are also high-risk and high-energy. The reasons are their high caloric value, high sugar content, artificial sweeteners, colors, flavors.
- What foods can people with metabolic syndrome consume?
It is desirable to have more fruits and vegetables in the daily menu. It is best to be fresh and raw and in an amount between 350 and 450 grams, but provided that the patient has no gastritis, enteritis, enterocolitis, colitis, gastric and duodenal ulcers. The fiber and fiber contained in vegetables and fruits accelerate metabolic processes and increase intestinal motility. Thanks to this, weight reduction is achieved.
Detoxifying, or unloading, days have a very good effect. It is good for each patient to choose one day of the week in which to remove toxins from their body for 24 hours. The options for detoxification are different, but in my opinion the best effect is the vegetable or fruit version. This means consuming 1-1.5 kg of fruits or vegetables only for 24 hours with a liter and a half of water. In the summer months, water consumption can be up to 2-2.5 liters. These detoxifiers help the body get rid of toxins and improve to an extremely high degree all the indicators of the body, which until then were outside the accepted reference values. The surest evidence is the laboratory blood tests, which I periodically monitor in patients.
- Are these unloading days suitable for all patients?
The recommendations are extremely individual for each patient and are based on precise medical assessment of many factors: thorough history, objective condition at the moment, family history, allergies to food and medication, intolerance to certain foods, harmful habits such as smoking, alcohol use, hypodynamia, etc.
Provided that at the time of the consultation the person does not have any serious contraindications from the digestive system, he can consume fruits and vegetables in fresh, raw form or in the form of vegetable salads without added salt, or in the form of fruit salads without any additional cream toppings, sugar or other flavorings. This is the best option for a detox day, as it creates a feeling of volume in the stomach for a long time, and calorie intake is low. Fruits and vegetables can also be taken in the form of juices, fresh juices or smoothies, but due to their faster passage and increased intestinal peristalsis, the feeling of satiety will be shorter. And this is associated with a certain discomfort for the whole body and the need for more frequent consumption.
Vegetables and fruits have a perfect detoxifying effect - the safest way to remove toxins from the body. The effect of a detoxifying day is equal to the effect of 10 days of strict diet or strict fasting, which are more stressful and difficult to tolerate.
- What will a daily menu of a person with metabolic syndrome look like outside of unloading days?
It is healthiest to have a diet structured in five meals a day. Three main - breakfast, lunch and dinner, with two snacks. I share the opinion of my fellow nutritionists: "You lose weight not through starvation, but through a balanced diet." Breakfast should be between 7 and 8 am, lunch between 12 and 1 pm, and dinner no later than 8 pm. basic nutrition.
The options for the main breakfast in patients with severe metabolic syndrome are very different. I personally recommend oatmeal for breakfast. Well-cooked oatmeal (200-250 grams) with 50-70 grams of unsalted cheese or cottage cheese added to them, and the sweet version of the porridge is with a grated apple, a pinch of cinnamon to slightly lower blood pressure and detoxify plus a teaspoon of natural bee honey of proven origin. The next snack can be either juice or smoothie - 150-200 ml, or fresh fruit or vegetables.
Lunch should include 150-200 ml of tarator, it can be a light vegetable soup without salt and without extra fat. The main dish - 100-150 g of roasted meat or fish with 250-300 g of lettuce.
The afternoon breakfast depends on the personal preferences of the patient. It is best to have fresh fruit or 4-5 raw nuts (maximum 25-30 grams) or 25-50 g of natural chocolate.
For dinner, I recommend fish (at least once or preferably twice a week) with a portion of fresh salad, or roast meat with salad. Lean dinners are also recommended at least twice a week: zucchini with rice heated with potatoes, etc.
- Can a patient with metabolic syndrome consume bread?
Yes, but only certain species and in limited quantities! I do not recommend bread made from refined white flour, because among the huge variety of modern wheat varieties there are extremely many genetically modified. The white flour consumed today differs significantly from the flour a few decades ago. This is a real reason for additional serious diseases, because the cell genome has been completely changed. A special part of the science of nutrition and dietetics - nutrigenomics - deals with this huge modern problem. I do not recommend white bread because of its high caloric value. It is good for diabetics to stop eating this type of bread and replace it with either wholemeal bread or einkorn bread, which has not yet been genetically modified. Rye and barley bread are also good alternatives. Wholemeal bread is an important carrier for the body of B vitamins, as well as many valuable minerals. In moderation (100-150 grams per day) wholemeal bread is without risk to health.
- What mistakes do patients usually make when eating?
The main mistake is in the diet model. Recently, an unhealthy eating pattern has been widely practiced - one meal a day, and only in the evening, and in the late hours, which consumes unjustifiably many and unnecessary calories. Sometimes this diet is accompanied by alcohol intake, which is an additional calorie intake. One-time intake of food and energy burdens not only the digestive system but also the nervous system. This is a serious reason for sleeping at night. In many patients with metabolic syndrome, and especially in those with overweight and obesity, an additional disorder is increasingly observed - sleep apnea. My most important recommendation to patients with metabolic syndrome is to eat sensibly, balanced and healthy! And so that there is no risk to their health,
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