Obesity treatment method

FIELD: endocrinology.

SUBSTANCE: abnormally corpulent persons are treated by reduced-caloricity diet with limited content of carbohydrate-containing components and fats. In particular, caloricity of meal is reduced to 1200 kcal, including carbohydrate-containing components with glycemic index below 40. When initial weight is reduced by 5% and the weight is stabilized for 3 months, caloricity is increased to a specified value, calculated in terms of formula for daily caloricity recommended by World Health Organization taking into account sex, age, weight, and physical activity, glycemic index of carbohydrate-containing components ranging from 40 to 69 until the weight is lowered to desired level.

EFFECT: achieved stable and long-term reduction of weight owing to lowered insulin resistance of organism.

3 tbl

 

The invention relates to medicine and can be used in the correction of body weight.

The main cause of obesity is a positive energy balance, when for a long period of time, the flow of energy in the body exceeds its consumption. The energy coming into the body is a calorie consumption of food and beverages. Therefore, the basis of rational therapy of obesity is the limit daily calories.

To reduce the caloric content of the diet of overweight patients, traditionally, in addition to reducing fat, changes and carbohydrate food component. It is known that excessive intake of carbohydrates from food is the cause of the onset and progression of obesity. In Russia in recent years, the share of carbohydrates in the dietary patterns of the majority of the population has increased, so optimizing the intake of carbohydrates is one of the greatest problems in the treatment and prevention of overweight.

At the same time in dietetics only quantitative characteristics of dietary carbohydrates. The consumption of carbohydrates, in addition to the quantitative side (chemical composition)has a qualitative aspect that is associated with the peculiarities of adsorption and, first of all, the speed of their absorption and assimilation. It is known that due to the peculiarities of digestion at the bottom and the same composition, the amount of nutrients and calories, body weight may remain unchanged or increase.

There is a method of reducing body weight through dietary intervention. So Avepa, Vdien propose to limit the amount of food to 1300-1500 ml per day with the exception of energy-dense foods within 2-3 months (Patent 7 And 61 M 21/00; TPMF No. 21, 2000, patent No. 2153362, S).

However, this approach even when conducting parallel psychotherapy does not take into account absorption of carbohydrates, does not specify the number of calories in the daily diet and therefore weight loss even after psychotherapeutic correction is not conducive to a long and lasting weight loss.

In another method of weight loss lies a low-calorie diet during weight reduction with subsequent transition to euchlorine diet on the step of maintaining body weight. The authors major role in the diet of obesity attach fats and therefore recommendations are limited to the restriction of fat intake (up to 8-10% of total fat) and legkousvaivaemyh carbohydrates, but without regard to their glycemic index (Butrova S.A. Bad A.A. Treatment of obesity: modern aspects. - English medical journal, 2001, volume 9, No. 24, - c.1140-1146).

This approach to diet therapy in the treatment of obesity, as the experience of practice is mental work, leads to a slight decrease in weight, since it is not considered pathogenic role of insulin in the onset and progression of obesity and its complications.

As the prototype is considered a method of treating alimentary obesity, which on the basis of the principles of nutrition to achieve reduction of body weight (Starostin EVGENIY Principles of nutrition in the treatment of obesity / Cardiology, 2001, No. 5, S-99).

The basis of this approach is quantitative and qualitative restructuring of power. The author proposes to reduce the source of the calories by 500 kcal. However, as practice shows, the original calorie diet in a patient with obesity may initially be very high (2800-4000). In this regard, even after a small decrease in calories (in this case 500 kcal) remaining calories will stay relatively high and therefore will not have much to contribute to the improvement of metabolic processes in obesity.

Proposed a qualitative change in the composition of the diet affects the reduction of fats, alcohol and carbohydrates. It is proposed to increase the intake of carbohydrates at the expense of products containing slowly absorbable carbohydrates (i.e. at the expense of vegetables and fruits).

However, this does not take into account the glycemic index uglevodosoderjati the th products which may exert pressure on the insular apparatus, to contribute to an increased release of insulin into the blood when eating foods with high glycemic index. The more that foods with a high glycemic index, are very common and popular in Russia and vegetables (potatoes, carrots, beets, bananas, raisins, and others). As a rule, doctors ' recommendations to increase in the diet of obese patients, the quantity of these vegetables and fruits do not take into account their glycemic index. And so these vegetables and fruits are the same as white bread, sugary drinks and confectionery, not only to increase the level of insulin in the blood, but also taking into account the peculiarities of the metabolism of insulin, not to provide a long-lasting feeling of satiety and contribute to overeating and, consequently, weight gain.

The present invention is to achieve a stable and lasting weight loss by making the diet, taking into account the insular pathogenetic link in the development of obesity and selection of carbohydrate-containing foods with a particular glycemic index.

This object is achieved in that prescribe a reduced calorie diet with restriction of starches and fats. Caloric intake designate 1200 kcal, and in the diet include uglevodsoderzhashchie roducti with a glycemic index of less than 40. At lower initial body weight by 5% and stabilization of weight within 3 months of dietary energy consumption raise to the calculated value determined for the patient according to the formula of calculation of daily calories recommended by the who. In the diet enter uglevodsoderzhashchie foods with glycemic index 40-69 to reduce weight to a specified level.

The novelty of the method. 1. When making diet nutritionist prepared diet reduced calorie 1200 kcal recommended by who as the minimum numbers of calories with which to begin the treatment of obesity. Lowering calorie intake is ensured by limiting foods that contain fats and carbohydrates.

2. The basis of the diet are uglevodsoderzhashchie foods with a low glycemic index of less than 40. Moreover, the inclusion in the diet of starches is carried out depending on the glycemic index carbohydrate-containing foods.

Mono - and disaccharides (glucose, fructose, sucrose) can be quickly absorbed in the gastrointestinal tract, contributing to a sharp increase in the release of insulin and increase blood sugar after 10 minutes after ingestion. These foods have no fiber, they are small, poorly satisfy your appetite after a short time after their admission occurs hunger and people overeat.

Polish the IDA (starch) and other polymer fragments on the basis of hydrolyzed sugars over a long time and cause a slow rise in blood glucose. From the moment of their acquisition to increase the blood sugar level goes 30 minutes.

Accounting for the effects of products on insulin secretion is required, as in the pathogenesis of obesity huge role of tissue insulin resistance and compensatory hyperinsulinism. Therefore, reducing the load on the insular apparatus attained by diet therapy, it is extremely important in the treatment of obesity.

Used in food, uglevodsoderzhashchie foods with a low GI, which are based on fiber and vegetable fiber found in vegetables, herbs, fruits and berries, as well as in cereals and products made of wheat flour. Cellulose is practically not absorbed by the body, but, filling the stomach, creates a feeling of satiety. These fiber-rich foods contain both vitamins, and water that has no calories and fills the stomach. Therefore, we achieve lasting weight reduction due to the fact that foods with a low glycemic index do not have a severe load on the insular apparatus due to the high content in its composition of dietary fiber, provide greater fullness of the stomach, which in turn helps reduce and normalize appetite.

The modern level of development of nutrition requires clear guidance on the number and quality of those or ins is carbohydrate-containing foods, differing in the rate of absorption. Carbohydrates, which promote the rapid development of insulin and in a short period of time, called vysokogermetichnymi carbohydrates. On the contrary, nitroglicerina carbohydrates contribute to the progressive development of this hormone and for a long period of time, which ensures the emergence of a sense of satiety, reduces the load on insular apparatus and prevents the development of obesity.

These considerations consider the power only patients with diabetes mellitus, although given the rate of absorption of carbohydrates is important for prevention and therapy of diseases of the cardiovascular system, obesity and other diseases. This is especially important, as was shown the positive impact of products and dishes with a different GUY, not only on carbohydrate metabolism, but also on other types of metabolism, including lipid metabolism.

It is now known that one of the reasons for the emergence and development of obesity and its complications (hypertension, diabetes 2, and others) is insulin resistance and hyperinsulinism. Insulin resistance is a decrease in the sensitivity of tissues to insulin action. This leads to the excess fat in the body. Proven by many researchers that obesity decreases insulin-dependent transport of glucose and times is by hyperinsulinism (M. Zanella, Kohlmann O.Jr., Ribeiro A. Treatment of obesity hypertension and diabetes syndrome // Hypertension. - 2001. - V. Sep.38, No.(3 Pt2). - P.705-8). This process depends on the amount of fat (Ginzburg M.M., Catupecu G.S., Sergeev O.V. Relationship of insulin and blood pressure in obesity in women // problems of endocrinology. - 1996, V.42, №4. - S-27). In obese patients revealed increased levels of insulin in the blood (immunoreactive insulin) (Ginsburg M.M., hooks NN. The obesity. M. - Malpractice, 2002. - Pagination 126).

Increasing the amount of fat in the body increase the size of fat cells. The more fat cells, the less it is sensitive to insulin. Therefore, there is a decrease in the restraining influence of insulin on the processes of disintegration of fat. The result has been the increased level of fatty acids in the blood, which are captured in the muscle cells and liver cells for further oxidation. This switches the metabolism of the main target tissues for preferential consumption and fatty acid oxidation. And insulin transport glucose into the cells will be reduced. Develops insulin resistance. To compensate for these disturbances (increased levels of glucose in the blood) pancreas increases insulin production and is developing hyperinsulinism (Zimin J.V. hypertension in diabetes mellitus: pathogenesis and treatment (review) // T is R. archive. - 1998, No. 10. - P.15-20. Kobalava RAILWAY hypertension and obesity: random Association or causation? // Clinical pharmacology and therapeutics. - 2000. No. 3, V.9, - c.35-39).

Given this mechanism, a modern approach to the treatment of obesity is based on the reduction of the manifestations of insulin resistance. To improve the sensitivity of tissues to insulin by using a diet that is low in fat, and reduce the burden on insular apparatus using uglevodsoderzhashchie foods with low glycemic index. This pathogenetic approach provides a stable and long-term weight loss.

3. When you reduce body weight by 5% or more from baseline, which is considered by the who experts as a good result, and stabilization of weight within 3 months of dietary energy consumption raise to the calculated value recommended by the who, determined for the patient according to the formula of calculation of daily energy corresponding to the normal needs of the body for nutrients and energy, taking into account gender, age, height, weight and physical activity:

for women:

18-30 years=(0,0621×the real body weight (kg)+2,0357)×240×k,

31-60 years=(0,0342×the real body weight (kg)+3,5377)×240×k,

over 60 years=(0,0377×the real body weight (kg)+2,7545)×240×k;

for men:

18-30 years=(0,0630×the real body weight (kg)+2,8957× 240×k,

31-60 years=(0,0484×the real body weight (kg)+3,6534)×240×k,

over 60 years=(0,0491×the real body weight (kg)+2,4587)×240×k;

where k is a correction factor to random motor activity, equal=1,1 for persons with low physical activity level, k=1,3 for persons with moderate levels of physical activity, k=1,3 for persons with a high level of physical activity.

In the diet enter uglevodsoderzhashchie products with a medium glycemic index 40-69 to reduce weight to a specified level (World Health Organisation. Prevention and management of the global epidemic of obesity. Report of the WHO consultation on obesity. The World Health Organisation. Geneva 1998). The specified level is determined based on the formula of body mass index: body mass index=weight (in kg)/height2(cm). From this formula we determine the required rate of weight gain which will seek the patient: weight=body mass index (equal to 25, because this value corresponds to the normal body weight)×growth2(cm) (World Health Organisation. Prevention and management of the global epidemic of obesity. Report of the WHO consultation on obesity. The World Health Organisation. Geneva 1998). Inclusion in the diet of foods with a medium glycemic index provides the patient with a greater choice of food and thereby contributes to the expansion of food and makes the diet more varied. With the observed main pathogenetic principle of Le is to be placed, which will facilitate the patient endure the necessary dietary restrictions and, in General, increases its commitment to the diet.

As a result of use in the treatment of obesity proposed method of diet in 23 patients apart from reducing body weight decreased basal and stimulated glucose level of immunoreactive insulin in the blood.

The method is as follows. When handling patient complaints overweight, after a conversation with the patient and clarify the history of the disease is made diet therapy. The main goal of the diet is to reduce the consumption of the diet of the patient. This is achieved by reducing total fat and carbohydrates. The proportion of fats in the diet should be 25%, the amount of carbohydrates 55% of daily calories. The doctor prescribes a diet reduced calorie 1200 kcal. Selection of carbohydrate-containing foods is dependent on the glycemic index products. Uglevodsoderzhashchie products (typically mono - and disaccharides), resulting in rapid absorption increases plasma insulin, have a high glycemic index is from 70 to 100 (table 1). This nutritionist explains unwanted role of Smoking products on carbohydrate metabolism and provides a complete list of these Smoking etc the products dietitian limits in the diet of the patient uglevodsoderzhashchie products having a high glycemic index, and treatment of the patient assigns a diet, which is based on uglevodsoderzhashchie products (polysaccharides and cellulose), slightly increase the plasma insulin as a result of their slow suction and having low - less than 40 - glycemic index, and gives the patient a list of these products (table 2). As the sample is about the daily diet. The doctor asks the patient to come in a month.

At lower initial body weight by 5% and stabilization of weight within 3 months of dietary energy consumption raise to the calculated value determined for the patient according to the formula of calculation of daily energy corresponding to the normal needs of the body for nutrients and energy, taking into account gender, age, height, weight and physical activity recommended by the who for women: 18-30 years=(0,0621×the real body weight (kg)+2,0357)×240×k; 31-60 years=(0,0342×real weight (kg)+3,5377)×240×k; older than 60 years=(0,037×the real body weight (kg)+2,7545)×240×k. For men: 18-30 years=(0,0630×the real body weight (kg)+2,8957)×240×k; 31-60 years=(0,0484×the real body weight (kg)+3,6534)×240×k, over 60 years=(0,0491×the real body weight (kg)+2,4587)×240×k; where k is a correction factor to random motor activity equal=1,1 for persons with low physical the activity, k=1,3 for persons with moderate levels of physical activity, k=1,3 for persons with a high level of physical activity.

In the diet enter uglevodsoderzhashchie foods with glycemic index 40-69 (table 3) until the weight loss up to a specified level. The specified level is determined based on the formula of body mass index: body mass index=weight (in kg)/height2(cm). From this formula we determine the required rate of weight gain which will seek the patient: weight=body mass index (equal to 25, because this value corresponds to the normal body weight)×growth2(cm).

Example. Patient G-VA EL, 43, accountant. Asked for help concerning the excess weight. In addition complains of fatigue, weakness and irritability, decreased performance, periodic headaches associated with high blood pressure. With the growth of 165 cm weight 79 kg Increase in weight notes for 9 years, when after the child's birth and cessation of breastfeeding weight began to increase. The work of "sedentary" and is not related to physical exertion. The weight was gradually increased. Independently tried to lose weight in different ways: starvation, fasting days, various low-calorie diets. Weight was down for a short time (2-3 months), anakapalle stop dieting weight came back again to the previous figures. In the last year never tried to lose weight and says that she was forced to go to the doctor because of poor health. The patient was asked to undergo an examination, the results of which were revealed elevated levels of cholesterol (5.9 mmol/l) and triglycerides in the blood (2.21 mmol/l)and increased basal (18,1 mked/ml) and stimulated glucose (60 min - 79,8 mked/ml after 120 min - 51,3 mked/ml) level of immunoreactive insulin in the blood. Define the required level of weight loss formula: weight=body mass index (equal to 25, because this value corresponds to the normal body weight)×growth2(cm). The required weight is equal to: 25×1,652=67,5 kg

The dietitian explained the proposed method of diet on the proposed method and explained the unique feature of carbohydrate-containing foods on metabolism in obesity. While the dietitian explained the negative role of Smoking products on carbohydrate metabolism and have provided a full list of these prohibited products (see table 1). In addition, the dietitian in the quality of information provided to the patient a list of carbohydrate-containing foods with a low glycemic index less than 40 (see table 2) and as the sample was a sample daily diet. The calorie intake of 1200 kcal, 25% of the diet was fat, 55% carbohydrates. In the Ah was asked to come to the patient through the month.

After treatment by the method of diet the patient without significant efforts complied with the recommended diet. She completely refused from carbohydrate-containing foods with a high glycemic index. Within 1 month weight decreased by 4 kg (5% of initial weight), which was seen as a good result, and the patient did not experience difficulties that arose after the previous methods of diet obesity. After stabilization of the weight of the patient was expanded food diet due to the inclusion of eating carbohydrate-containing foods with a medium glycemic index 40-69. Caloric intake increased to the calculated value of the formula for calculating daily energy corresponding to the normal needs of the body for nutrients and energy, taking into account gender, age, height, weight and physical activity recommended by the who: first calculate theoretical speed of the main exchange by gender, age and actual body mass of the patient (actual body weight after weight loss of 4 kg was 79-4=75 kg: 0,0342×the real body weight (in kg)+3,5377=0,0342×75+3,5377=6,1027. The result is measured in megajoules; for translation in more familiar calories you need to multiply by 240:6,1027×240=1464,6. Next, calculate theoretical total daily energy expenditure, which received near the banks of basal metabolic rate multiplied by the ratio of motor activity. Since the patient by profession an accountant and her work is not associated with physical activity, this ratio equal to 1.1. Taking into account this factor received 1,464,6×1,1=1611,1 kcal. So, the calorie daily diet for the patient amounted to 1600 kcal.

Complaints the patient is not present, continued to respect the prescribed diet. After 6 months, weight was 70 kg During this time, the patient notes that formed certain stereotypes in its power at any time to start the meal with a vegetable salad, a full Breakfast in the morning, the complete elimination "of snacks and teas at work replacing their lunch in the cafeteria, replacing sugary refined foods (sugar, cakes, candies, sodas and juices) fruit and mineral water. Potatoes, beets and carrots consumed in small quantities and mostly in soups. The weight is within 69-70 kg during the year. Given the level of weight reduction is reached. The patient notes that after eating remains a feeling of fullness for a longer period of time than before the treatment.

Control blood examination revealed a normalization of all lipid parameters (cholesterol of 5.0 mmol/l, triglycerides of 0.95 mmol/l) and a significant decrease in basal and stimulated glucose level of immunoreactive insulin (basal, Ural branch of the Yan - 9.3 mked/ml) and stimulated glucose (60 min - 38,6 mked/ml after 120 min - 17.3 mked/ml) level of immunoreactive insulin in the blood.

Existing algorithms diet obesity excluding pathogenetic aspects are not sufficiently effective, because it does not provide as main objective the reduction of insulin resistance and hyperinsulinism and as a consequence, the normalization of weight. No reduction of calories of food consumed from fat or reduced calorie of food consumed only at the expense of carbohydrates by themselves may not provide a positive treatment outcome. Only pathogenetic approach, including the restriction of fats and accounting values of the glycemic index carbohydrates, is a reliable method with which it is possible to achieve stable and long-term weight loss, it increases the sensitivity of tissues to insulin and normal insulin production by the pancreas.

This method of treating obesity was applied in 21 patients who underwent treatment and observation in School correction of excess weight in the Municipal center, preventive medicine and in endocrinology clinic at MPB No. 1, Novokuznetsk.

As a result of this treatment reduces the load on the insular apparatus increases the sensitivity of tissues to insul the well. Patients faster comes a feeling of fullness, which persists for a longer period of time, helping to reduce and normalize appetite and, as a consequence, reduction of body weight.

Table 1

Foods containing carbohydrates with a high glycemic index (70-100)
Product groupName of ProductGIThe portion containing 12 g of carbohydrates












Pastry
In gramsMeasures
Wheat bread flour95251 piece
Wheat bread flour 1 and 2 grade80-85251 piece
Bakery products (bread, rolls), except sweet80-85251 piece
Bread wheat75102 pieces
Wheat flour (grade)70152 tsp
Toasted wheat bread b/C7020
Pancakes7075 ≈1-2 pieces
The cheese curd70120≈2 pieces
Pancakes70≈1 piece
The polished rice, semolina70152 tsp
Corn flakes, sticks70-8512≈2 Stoll
Cereals millet70152 tsp
Muesli7020
FruitWatermelon, without rind70135≈1 piece
Pineapple70100
Raisins70201 Stoll






Vegetables
Baked potato95-9850
Fried potatoes9540
Mashed potatoes901 Stoll
Potatoes crispy chips9530
Carrots85 170
Beets70140
Corn (grain)7020
Potatoes (instant)7080
Boiled potatoes*7075




Various products
Glucose10012
Caramel candy8015
Caramel with chocolate and nut additives7015
Honey75-90152 tsp
Chocolate "Mars"701/5 PCs
Ice cream milk7060

Table 2

Foods containing carbohydrates with low glycemic index (less than 40)
Product groupName of ProductGIThe portion containing 12 g of carbohydrates
Ȋ < / br>
















Fruit
in gramsMeasures
Apple30-35120-130≈1 piece
Pear33-3590-130≈1 piece
White currant30130-1501 Cup
Raspberry30145-2101 Cup
Black currant30120-1651 Cup
Red currant30150-1801 Cup
Cherry, cherry2590-100≈15 pieces
Dates (dried)4020
Peaches29120-1301 piece
Blueberry28150|≈1 Cup
Plum blue25100≈3-4 pieces
Plum red25100≈2-3 pieces
Grapefruit without the peel of the Grapefruit with peel25 25130 200≈1/2 pieces
Cranberries231501 Cup
Cranberry201502.5 Cup
Lemons20400-600≈4 pieces
Dried fruits:
The dried apples30201.5 table. L.
Apricots, dried pears30151 table. L.
Drain dried25201 table. L.




Bean
Dried beans, lentils30-4025
Dry peas3525
Green beans40140
Young peas3595
Black beans3025
Beans30400
Beans30190
Soybeans1550
&x0200A; < / br>


Dairy products
Yogurt sweet (fruit low-fat)351502/3 Cup
Milk (whole)>302501 Cup
Milk (skimmed)<302501 Cup
Kefir and other calomel. product.152501 Cup
Yogurt low-fat, no sugar152501 Cup


Various products
Milk chocolate, cream and milk, with additions, chocolates35-4520-25
Chocolate without additions (with a cocoa content of more than 60%)2520-25
The different nuts15-3080-100
Pumpkin seeds15300
The soy flour, whole15803 Stoll
Soy bread151 piece
Bran1540-50
FRU the Tosa 20
Vegetables:0-15
Tomatoes315≈3 pc.
Spinach600
Turnip green225
Zucchini245
Zucchini200
Cauliflower265-300
Cabbage200-255
Broccoli600
Kohlrabi180
Brussels sprouts205
Cucumbers600≈6 PCs
Pumpkin285
Leek185
Radish185&x0200A;
Radish315
Asparagus375
Rhubarb400
Eggplant220
The scallops200
Sorrel600
Peppers225-300
MushroomsMushrooms (champignons, mushrooms)10400
Fresh white mushrooms1090

Table 3

Foods containing carbohydrates with a medium glycemic index (40-70)
Product groupName of productGIThe portion containing 12 g of carbohydrates






Pastry
in gramsmeasures
Dumplings50-55≈4 pieces
Vareniki with cottage cheese55≈2 pieces
Meat pie50-5535-40≈1/2 pieces
Cottage cheese (sweet)5550
Pasta6015
Noodles (vermicelli) fast food6515
Noodles from flour4525








Bakery products. Cereals
Bread from a mixture of rye and wheat flour (rye, Ukrainian and others)55-6520-30
Rye bread5025-301 piece
Wheat bread whole wheat55251 piece
Wheat bread with bran5025-301 piece
Doughnuts products (bagels, drying)5015-20
Rusks products, wheat5015-20
Ed is Leah butter and puff 5520-25
Products from dough5525
Brown rice55201 table. L.
Wheat grains, in addition to manna45201 table. L.
Barley45201 table. L.
CerealOat flakes (rolled oats)4520
Buckwheat4025
Oatmeal cereal40502 table. L.


Pastry
Biscuits, cakes, waffles55-6015-20
Biscuits SOC50≈4 pieces
Oatmeal cookies55201 piece
Cake, cake, cake with a high-fat50-6020
VegetablesGreen peas45951/2 Cup






Fruit
Bananas with peel6090½ pieces
Mango5080
Kiwi501001 piece
Mandarins(without skin)

Tangerine peel
40

40
120

180
Oranges (skin removed) Oranges with peel40

40
120

180
Melon (without skin)451301 piece
Strawberries, strawberries40190≈1 Cup
Gooseberry401203/4 Cup






Various products
Cutlet40≈1 piece
Beer452501 Cup
Kvas452501 Cup
Sucrose6012
Jam, jam55152 tsp
Bars "bounty", "Snickers"55-60 20
Sundae ice cream, cream, chocolate, ice-cream (high fat)6060
Condensed milk with sugar55-6020
Cream condensed50-5525




Juices canned
Apple, pear, black and red currants, gooseberries40801/3 Cup
Pineapple40901/2 Cup
Plum40701/3 Cup
Grapefruit401402/3 Cup
Orange451101/2 Cup
Cherry40901/2 Cup
Tangerine401301/2 Cup
Strawberry401603/4 Cup
Crimson401702/3 Cup

The method of treatment of obesity, including diet therapy on irennoj caloric restriction starches and fats, characterized in that the caloric intake is prescribed 1200 calories in the diet include uglevodsoderzhashchie foods with a glycemic index of less than 40 and at lower initial body weight by 5% and stabilization of weight within 3 months of dietary energy consumption raise to the calculated value determined for the patient according to the formula of calculation of daily calories recommended by the who with regard to sex, age, height, weight and physical activity, diet enter uglevodsoderzhashchie foods with glycemic index 40-69 to reduce weight to a specified level.



 

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5 cl, 4 ex, 2 tbl

FIELD: organic chemistry, medicine.

SUBSTANCE: invention represents ligands MC-4 and/or MC-3 of the formula (I): , wherein X means hydrogen atom, -OR1, -NR1R1' and -CHR1R1' wherein R1 and R1' are taken among the group: hydrogen atom, (C1-C6)-alkyl and acyl; (1) each R2 is taken independently among the group: hydrogen atom, (C1-C6)-alkyl; or (2) (a) R2 bound with carbon atom that is bound with X and Z1 and substitute R5 can be optionally bound to form carbocyclic or heterocyclic ring that is condensed with phenyl ring J; or (b) R2 bound with carbon atom that is bound with ring Ar can be bound with R7 to form ring condensed with ring Ar; each among Z1, Z2 and Z3 is taken independently from the following groups: -N(R3e)C(R3)(R3a)-, -C(R3)(R3a)N(R3e)-, -C(O)N(R3d)-, -N(R3d)C(O)-, -C(R3)(R3a)C(R3b)(R3c)-, -SO2N(R3d)- and -N(R3d)SO2- wherein each among R3, R3a, R3b and R3c, R3d, R3e when presents is taken independently among hydrogen atom and (C1-C6)-alkyl; p is a whole number from 0 to 5 wherein when p above 0 then R4 and R4' are taken among hydrogen atom, (C1-C6)-alkyl and aryl; R5 represents 5 substitutes in phenyl ring J wherein each R5 is taken among hydrogen atom, hydroxy-, halogen atom, thiol, -OR12, -N(R12)(R12'), (C1-C6)-alkyl, nitro-, aryl wherein R12 and R12' are taken among hydrogen atom and (C1-C6)-alkyl; or two substitutes R5 can be bound optionally to form carbocyclic or heterocyclic ring that is condensed with phenyl ring J; q = 0, 1, 2, 3, 4 or 5 wherein when q above 0 then R6 and R6' are taken among hydrogen atom and (C1-C6)-alkyl; Ar is taken among the group consisting of phenyl, thiophene, furan, oxazole, thiazole, pyrrole and pyridine; R7 are substitutes at ring Ar wherein each R7 is taken among hydrogen, halogen atom, -NR13R13', (C1-C6)-alkyl and nitro- wherein R13 and R13' are taken among hydrogen atom and (C1-C6)-alkyl; r is a whole number from 0 to 7 wherein when r is above 0 then R8 and R8' are taken among hydrogen atom and (C1-C6)-alkyl; B is taken among -N(R14)C(=NR15)NR16R17, -NR20R21, heteroaryl ring and heterocycloalkyl ring wherein R14-R17, R20 and R21 are taken independently among hydrogen atom and (C1-C6)-alkyl; s = 0, 1, 2, 3, 4 or 5 wherein when s is above 0 then R and R9' are taken among hydrogen atom and (C1-C6)-alkyl; R10 is taken among the group consisting of optionally substituted bicyclic aryl ring and optionally substituted bicyclic heteroaryl ring; D is taken among hydrogen atom, amino- and -C(O)R11 wherein R11 is taken among the following group: hydroxy-, alkoxy-, amino-, alkylamino-, -N(R19)CH2C(O)NH2 wherein R19 represents (C1-C6)-alkyl, -NHCH2CH2OH and -N(CH3)CH2CH2OH, or its isomers, salts, hydrates or biohydrolysable ester, amide or imide.

EFFECT: valuable medicinal properties of compounds.

18 cl, 107 ex

FIELD: improved method for oil production.

SUBSTANCE: target oil, enriched in HODE, or esters thereof is obtained by controlled oxidation of linoleic acid and/or linolenic acid or esters thereof in presence of oxidation catalyst. Oxidation is stopped when total HODE or ester content is more than 5 %, and/or content of isomeric 9-hydroxy-10,12-octadecadienic acid (9-HODE) or esters thereof is more than 1,5 %; and hydroperoxides formed in oxidation process are reduced with reducing agent in presence of antioxidant. Invention is also relates to oil enriched in 9-HODE or esters or salts thereof having an lipolytic action; to drug or food additive for obesity treatment; cosmetic for local treatment of cellulite. Compound for controlling of adipocyte lipolytic activity and hydrolysis of triglycerides accumulated in adipocytes is also disclosed.

EFFECT: novel pharmaceutical composition for obesity treatment.

11 cl, 1 ex

FIELD: organic chemistry, biochemistry, medicine.

SUBSTANCE: invention describes a method for prophylaxis or treatment of states that involves inhibition of activity of enzyme that catalyzes hydrolysis of ester functional groups and wherein indicated state represents obesity or accompanying disorder, and wherein compound of the formula (1):

is prescribed, or its pharmaceutically acceptable salt, ester, amide or a precursor. Also, invention relates to a method for manufacturing the medicinal preparation used for prophylaxis or treatment of states wherein inhibition of activity of enzyme is required wherein indicated enzyme catalyzes hydrolysis of ester functional groups. In the formula (1) A means a 6-membered aromatic or heteroaromatic ring; R1 means a branched or unbranched alkyl (its carbon chain can be broken by one or more oxygen atoms), alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, reduced arylalkyl, arylalkenyl, heteroaryl, heteroarylalkyl, heteroarylalkenyl, reduced aryl, reduced heteroaryl, reduced heteroarylalkyl or their substituted derivative wherein a substitute is taken independently among the following group: halogen atom, alkyl, alkyl substituted with halogen atom, aryl, arylalkyl, heteroaryl, reduced heteroaryl, reduced heteroarylalkyl, arylalkoxy-, cyano-, nitro-group, -C(O)R4, -CO2R4, -SOR4, -SO2R4, -NR6R7, -OR6, -SR6, -C(O)CX1X2NR6R7, -C(O)NR4R5, -C(O)N(OR5)R6, -NR6C(O)R4, -CR6(NH2)CO2R6, -NCX1X2CO2R6, -N(OH)C(O)NR6R7, -N(OH)C(O)R4, -NHC(O)NR6R7, -C(O)NHNR6R7, -C(O)N(OR5)R6 or lipid, or steroid (natural or synthetic) under condition that any substituting heteroatom in R1 or R2 must be separated from exocyclic nitrogen atom by at least two carbon atoms (preferably, saturated atoms), and wherein R4 represents hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, reduced heteroaryl or reduced heteroarylalkyl, OR6, NHCX1X2CO2R6 or NR6R7; R5 represents hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, reduced heteroaryl or reduced heteroarylalkyl; R6 and R7 are taken independently among hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, reduced heteroaryl, heteroarylalkyl, reduced heteroarylalkyl or -(CH2)n(OR5)m wherein n = from 1 to 12, preferably, from 2 to 10; m = from 1 to 3; R5 means preferably (C2-C10)-alkyl; X1 and X2 represent independently hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, reduced heteroaryl, heteroarylalkyl or reduced heteroarylalkyl. Also, invention describes compound of formulae (II), (IIa) and (IIb) given in the description and a method for preparing compound of formulae (II), (IIa) and (IIb), pharmaceutical composition used for prophylaxis or treatment of obesity and/or accompanying disorder, nutrition product, a method for prophylaxis or treatment of obesity or accompanying disorders, a method for inhibition of activity of enzymes, a method for reducing fat content in animals, a cosmetic method for maintaining this weight and a new intermediate compound of the formula (IV) indicated in the description. Invention discloses the possibility for prophylaxis or treatment of obesity or accompanying disorders.

EFFECT: valuable medicinal properties of compounds.

33 cl, 1 dwg, 2 tbl, 5 ex

FIELD: organic chemistry, biochemistry, medicine.

SUBSTANCE: invention describes a method for prophylaxis or treatment of states wherein inhibition of enzyme activity is required wherein this enzyme catalyzes hydrolysis reaction of ester functional groups and wherein indicated disorder represents obesity or accompanying disease. Method involves prescribing compound of the formula (1):

or its pharmaceutically acceptable salt, ester, amide or precursor wherein in the formula (1) a means six-membered aromatic or heteroaromatic ring; R1 means a branched or unbranched alkyl (its carbon chain can be broken possibly by one or more oxygen atoms), alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, reduced arylalkyl, arylalkenyl, heteroaryl, heteroarylalkyl, heteroarylalkenyl, reduced aryl, reduced heteroaryl, reduced heteroarylalkyl or their substituted derivative wherein a substitute represents one or more group taken independently among the following group: halogen atom, alkyl, halogen-substituted alkyl, aryl, arylalkyl, heteroaryl, reduced heteroaryl, reduced heteroarylalkyl, arylalkoxy-, cyano-, -C(O)R4, -CO2R4, -SOR4, -SO2R4, -NR6R7, -OR6, -SR6, -C(O)CX1X2NR6R7, -C(O)NR4R5, -C(O)N(OR5)R6, -NR6C(O)R4, -CR6(NH2)CO2R6, -NCX1X2CO2R6, -N(OH)C(O)NR6R7, -N(OH)C(O)R4, -NHC(O)NR6R7, -C(O)NHNR6R7, -C(O)N(OR5)R6, or lipid or steroid (natural or synthetic one) under condition that any substituting heteroatom in R1 or R2 must be segregated from nitrogen exocyclic atom by at least two carbon atoms (preferably, saturated ones); R2 means hydrogen atom or group, such as determined for R1 and wherein R4 represents hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, reduced heteroaryl or reduced heteroarylalkyl, OR6, NHCX1X2CO2R6 or NR6R7; R5 represents hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, reduced heteroaryl or reduced heteroarylalkyl; R6 and R7 are taken independently among hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, reduced heteroaryl, heteroarylakyl, reduced heteroarylalkyl or -(CH2)n(OR5)m wherein n = from 1 to 12 but preferably from 2 to 10; m = from 1 to 3; for R5 (C2-C10)-alkyl is preferable; X1 and X2 represent independently hydrogen atom, alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, aryl, arylalkyl, heteroaryl, reduced heteroaryl, heteroarylalkyl or reduced heteroarylalkyl. Also, invention describes compounds of formulas (II), (IIa), (IIb) given in the invention description, method for preparing compound of the formula (II), pharmaceutical composition used for prophylaxis or treatment of obesity or accompanying disorder, the nutrition foodstuff, method for prophylaxis or treatment of obesity or accompanying disorders, method for inhibition of enzymes activity, method for reducing the fat content in animals, cosmetic method for maintaining this weight of animals. Invention discloses the possibility for prophylaxis or treatment of obesity or accompanying disorders.

EFFECT: valuable medicinal properties of compounds.

30 cl, 1 dwg, 2 tbl, 5 ex

The invention relates to the pharmaceutical industry, in particular the production of medicines used for colds, relieving headaches and neuralgia

The invention relates to medicine, namely to medicines affecting the immune system, as well as chemical and pharmaceutical production of these medicines

The invention relates to the field of chemical and pharmaceutical production, namely for compositions intended for the production of first-aid medicines on the basis of nitroglycerin

The invention relates to a method for improved compressed products, providing the agglomerating their components

FIELD: endocrinology.

SUBSTANCE: abnormally corpulent persons are treated by reduced-caloricity diet with limited content of carbohydrate-containing components and fats. In particular, caloricity of meal is reduced to 1200 kcal, including carbohydrate-containing components with glycemic index below 40. When initial weight is reduced by 5% and the weight is stabilized for 3 months, caloricity is increased to a specified value, calculated in terms of formula for daily caloricity recommended by World Health Organization taking into account sex, age, weight, and physical activity, glycemic index of carbohydrate-containing components ranging from 40 to 69 until the weight is lowered to desired level.

EFFECT: achieved stable and long-term reduction of weight owing to lowered insulin resistance of organism.

3 tbl

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