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Д-р Николова, всички казват, че трябва да се отслабва постепенно. Защо не се препоръчва рязкото сваляне на килограми?
Защото не е физиологично, защото рязкото отслабване вероятно означава много сериозен калориен дефицит, който ще вкара организма в други микро или макро дефицити и съответно редуцирането на теглото няма да бъде трайно. Здравословният темп на отслабване е 0,5-1 кг. седмично, тоест от 2 до 4 кг месечно. Не знам дали си спомняте, че „кривата на запомняне е равна на кривата на забравяне“. Ще ви дам един пример: ако преди изпит Ви е много екстремно и бързо си натъпчете главата за 12 часа с половината учебник, вероятно със същата скорост в следващите 12 часа след изпита, ще забравите цялата информация. Ето защо трябва да се следи да има един адаптационен период, в който организмът да привикне и да създаде клетъчна памет, метаболитна памет, каквато искате памет я наречете. В общи линии човешкото тяло трябва да се адаптира към новото енергийно състояние, към новото метаболитно състояние и да ги възприеме като свои. В природата празно няма и всичко трябва да се случва бавно и постепенно и не толкова мъчително. Хората доста трудно толерират големи енергийни дефицити и когато драстично се намали обичайният хранителен прием, това не е физиологично и не е здравословно. Замисляли ли сте се къде отиват всички тези разпадни продукти? Ако например рязко отслабнете с 10 кг., това са мускули, това са мазнини, по какъв начин съответно те ще бъдат метаболизирани? Как трябва да работят черният дроб, бъбреците, отделителната система? Просто не е адекватно и не е правилно да се подхожда по този начин.
Това означава, че това е начинът да се избавим от "йо-йо" ефекта?
Категорично, защото когато си направите много висок енергиен дефицит, съответно много бързо ще ви падне нивото на лептина (това е хормона, който казва на мозъка: „стига си ял, защото имаш мастна маса“). Когато рязко се намали лептина, се обостря апетита на човек и той наистина се чувства гладен и се опитва да компенсира загубата на телесното тегло. Определено бързата редукция на теглото не е дългосрочна. Ако човек рязко е загубил 1-2 килограма, то най-вероятно се е дехидратирал или просто се е изпишкал и е загубил гликоген. Ако например сте 80 или 90 кг и сте загубили 1 или 2 кг гликоген и още 1 кг вода, това са общо 3 кг. Въпросът обаче е колко мазнини сте редуцирали! За мен това е признака за редукция. Тук стигаме и до много важна задача - запазване на постигнатите резултати. Стотици са препоръките, режимите и възможностите човек да редуцира телесното си тегло, но по–интересен е въпросът за запазването на килограмите. Защото много малка част, може би около 5-10 % от хората успяват да запазят в рамките на 5 години постигнатите резултати. Въпросите са многослойни: метаболитен слой, психосоматичен слой, съответно емоционален слой. Човек трябва да се отучи от емоционалното хранене, защото храната не е средство, с което той да се успокоява и да запълва разни празноти в живота и не може при всеки един проблем, да се обръща към висококалорийна мазнинна храна за успокоение. Много често първото нещо, което хората, постигнали резултат правят, е да увеличат порциите, след което включват храни, които не са приемали дълго време и в един момент пак се връщат към старото си неразнообразно и неблагоприятно свръх хранене, като в крайна сметка резултатът се разрушава. Кой е казал, че след като човек е отслабнал той може да яде всичко и да прави каквото си иска? Ако искате да ядете трябва да се движите: тоест увеличаването на хранителния прием и съответно разнообразието от храни е свъразно с повишаване на физическа активност. Даже мен са ме питали: „Вие като сте толкова слаба, защо идвате да тренирате?“ Моят отговор тогава е: „Защото искам да ям.“ Ако искате да ядете трябва да се движите. Няма как просто да постигнем някакъв резултат и щастливи и доволни да се върнем към старите си хранителни навици. Промяна в хранителните и двигателните навици не трябва да е стихийна за месец, 6 седмици, 10 дни, тя трябва да е до живот. Няма как човек да започне пак да пие по 3 литра бира, да пие по 500 мл концентрат, да изяжда по 3 шоколада, да яде само нощем и да запази килограмите си. И не трябва да ги има оправданията от типа „скоро е рождения ми ден“, защото след него ще дойде и рождения ден на детето Ви, на мъжа Ви, на комшийката, после ще дойде някой имен ден, Коледа, след нея еди какво си и така нататък. Защо въобще човек трябва да преяде на някакъв фамилен празник или на някакъв национален или религиозен празник? Нека има баланс и равновесие и затова тряба да наблегнем и на психологическия момент. Ако е нужно, може да поговорите и с психолог. Има една книга на психотерапевтът Стиван Грос, в която той споделя истории за негови пациенти и един от пациентите му казва: „Аз искам промяна без промяна.“ Окей искам да си ям, да си пия, да си лежа, нищо да не правя и искам да се променя. Няма как да се случи това. Ето едната страна-психотерапевтичния подход.
От друга страна, ако човек има някакъв метаболитен проблем той трябва да се контролира и да се обгрижва. Не всички състояния в медицината се лекуват, но почти всички могат да се контролират. И определено чрез храненето може много да си помогнете в тази посока – примерно инсулиновата резистентност да не стане диабет.
А защо с годините става все по-трудно да поддържаме теглото си?
Това е един много важен въпрос. С годините човек трябва все по – малко да яде и повече да се движи. Настъпва един естествен процес в организма на промяна на телесния състав наричащ се саркопения (тоест бавно, постепенно и естествено намаля мускулната маса и се покачва съдържанието на мазнини в организма) и не на последно място пада базалния метаболизъм (това е енергията която ни е необходима, за да сме живи грубо казано – да дишаме, да храносмиламе, да съществуваме). Когато падне съдържанието на мускули в организма естествено пада и нашия базален енергоразход. След 25-годишна възраст започва да намаля нашия базален метаболизъм и съответно се променя и храненето, ставаме все по–обездвижени в напреднала възраст. На около 35 години, започват да настръпват хормонални промени и метаболитни промени, може да се появяви инсулинова резистентност или хипотиреоидизъм. После се появява менопаузата и падат нивата на тестостерон при мъжете. Така се променя телесния състав при хората и те затлъстяват. Така, че трябва да има и медицински контрол.
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