Overweight and obesity. General principles of correction

Modern medicine considers obesity as a multifactorial chronic disease requiring a serious medical approach when it is corrected.

In today's world, 20-25% of the population suffers from obesity, and the more economically developed the country is, the higher this figure. Along with the aesthetic problems associated with obesity and arising primarily in women, obesity is one of the main causes of early disability and mortality of patients of working age.

The occurrence of obesity is due to age, sexual, occupational factors, as well as physiological states of the body - pregnancy, menopause. Regardless of the etiology of obesity, there are hypothalamic disorders of varying severity. The frequency of obesity in women over the past 20 years has doubled.  

By the type of distribution of adipose tissue in the body, the android, gynoid and mixed types of obesity are secreted.

The android type is characterized by the deposition of adipose tissue predominantly in the abdominal region (male type). The gynoid type of obesity is characterized by the accumulation of fat in the gluteo-femoral region, i.e. In the lower part of the body (female type). With a mixed version, the distribution of subcutaneous fat is relatively uniform.

The android type of obesity is combined with impaired glucose tolerance and diabetes, hypertension, hyperlipidemia in women. There are subtypes of abdominal obesity: subcutaneous-abdominal and visceral. Patients with a visceral type of obesity have the highest risk of complications.

Abdominal fat deposition can be estimated by measuring the waist circumference (OT). If this indicator in women is higher than 88 cm, the risk of cardiovascular diseases is very high, metabolic disturbances develop and the risk of developing type 2 diabetes mellitus is significantly increased. The distribution of fat tissue can be estimated from the circumference of the waist to the hip circumference (OT / OB). If this ratio is greater than 0.85, then there is an accumulation of adipose tissue in the abdominal region. In the diagnosis of obesity, an indicator such as the body mass index (BMI), which is equal to the ratio of body weight in kilograms to growth in square meters is taken into account.

The main mechanism of obesity is the energy imbalance between the energy inputs of an organism and the number of calories fed with food. Energy imbalance - a consequence of malnutrition and low physical activity. You can not neglect and hereditary-constitutional predisposition to obesity: in 1994, the obesity gene, coding for the production of lelthin, was identified. Leptin is produced primarily by fat cells and affects food intake and reproductive function.

The presence of obesity affects the health of women at any age, and with its increase, obesity tends to progress. A necessary method of treating obesity in women is to reduce body weight and maintain it at a constant level. The most effective is a gradual decrease in body weight - 0.5-0.8 kg per week, it is normally tolerated by the body and gives a steady result.

Treatment of obesity should be combined and includes limiting calories consumed from food, increasing physical exertion, applying hardware methods of cosmetology, in some cases - drug therapy (with BMI> 27). It is necessary to emphasize the importance of an integrated approach to correcting overweight and obesity.

Normalization of body weight with exercise

Correctly dosed and regularly received physical load is able not only to help maintain weight, but also to have a complex positive effect on the entire body as a whole. A sedentary lifestyle, on the contrary, provokes a rapid return of previously eliminated kilograms. Along with running, swimming, sports games in the past decade, fitness has become very popular as a type of motor activity, including: aerobics without jumps, aquasaycloning (imitation of an exercise bike in the water), powerball (aerobics using a rubber gymnastic ball); Pamp-aerobics (power aerobics), step aerobics (aerobics using the step-platform), tai-bo (aerobics using martial arts techniques), trekking (group jogging on simulators) and much more.

In order to seriously improve the figure, a simple set of exercises is not enough. It is necessary to choose a complex that not only makes the muscles work, but also provides food for the mind, that is, it will be interesting diverse. Let us dwell in more detail on two types of fitness - step aerobics and power-fitball.

Step aerobics is a kind of exercise with health-improving exercise using a step-platform.

Optimum in terms of treatment of excess weight are loads of low and medium intensity, but long-lasting, for example, walking or tonic exercises in the style of step aerobics or dance aerobics for 60 minutes per day. Under high-intensity loads, carbohydrates are consumed mainly in carbohydrates, and the resulting under-oxidized products (lactic acid) block the burning of fat. So, It was shown that women, doing aerobics for months, did not change their weight more than 0.5 kg. It was worth them to start using the diet as the weight started to decrease, and the rate of this decrease increased by about 20%.

Physical exertion has one more important feature: with the help of exercise it is possible to cause selective consumption of fat in places of its accumulation in the body. It is proved that the fat soon leaves the areas where the muscles are working intensively. With the accumulation of excess body weight, as a rule, fat is disproportionate: in some places it is more, in others less. Thus, in some women there is a disproportionate amount of fat on the buttocks and hips, in others - on the abdomen and waist. The distribution of fat in the body is controlled by hormones, and the subtle mechanisms of this process have not yet been fully explored. It is considered, for example, that fat on the buttocks and hips of women is the so-called strategic energy reserve. It is consumed only with breastfeeding and then only if at that time the usual diet is not enough. Physical stress prevents the consumption of fat-free mass during weight loss. However good the diet is, along with the fat tissue, the mass of muscles also decreases, which is undesirable. Physical loads of intensity, frequency and duration, corresponding to the usual training in step aerobics, can reduce the loss of muscle to a minimum. At the same time, up to 90% of fat burns in muscles, and the more muscle tissue a man has and the more active, the less likely that a person will get fat.

Step aerobics classes (like any other kind of physical culture) have a general physiological effect on the body: increase metabolism, which positively affects the cardiovascular, respiratory and digestive systems; develop strength, flexibility, speed, endurance, coordination of movements. In turn, the harmoniously developed muscles of the trunk are of primary importance in the formation of a correct posture.

The platform for step-aerobics, or step-platform, can be made from a variety of materials that are strong enough and do not have a negative effect on humans. On the platform, around it and through it, the so-called basic steps, jumps and jumps are performed, all movements can be stylized for any dance.

Musical accompaniment increases the emotionality of classes, positive emotions cause the desire to perform movements more vigorously, which enhances their effect on the body.

In describing exercises for health programs indicate the number of movements per minute (the frequency, which should be according to the number of accounts of clock intervals). For «Low impact» it is recommended to use musical accompaniment with a frequency of 120-130 beats per minute. And for "High impact" - from 130 to 160 (very rarely - more than J60) beats per minute; The study of biomechanical factors, manifested during the operation of the step-platform, allows you to evaluate the mechanical load, the effect on the body during training. The knowledge of the physiological, biomechanical processes occurring in the body of those engaged, and their results after training, helps to increase its effectiveness and safety. Forces that affect the body during training can have undesirable effects if they do not correspond to the physical capabilities of those involved (there is an increased risk of injury).

Energy consumption during step-training can be increased or decreased, changing the height of the platform. Thus, the average energy consumption in step-exercises at low altitude (10-15 cm) is approximately equal to that obtained with relatively fast walking in a horizontal area. During classes on a high platform (25-30 cm), the range of energy consumption is similar to the data obtained when jogging at a speed of 10-12 km / h. However, the indicators of energy consumption at such platform heights for different people do not coincide. This is due to the difference in the level of their overall preparedness and coordination training. The energy expenditure in training, as an indicator of the intensity of physical activity, can be determined in three ways:

1. Sensible tension is a subjective evaluation of muscle tension.
2. Heart rate - an estimate of energy expenditure based on the pulse cost of exercise.
3. Calculation of the maximum consumption of oxygen (MIC) - allows you to accurately determine the energy consumption and is based on monitoring the consumption of oxygen in the classroom.

To determine the energy expenditure in the step aerobics classes, it is sufficient to use one or the other methods that are most convenient for the coach, but the conditions for conducting the session must be taken into account. The following factors are relevant to the conditions of the meeting:

• age and sex involved;
• the level of their physical readiness;
• the degree of fatigue at the moment;
• platform height,
• Use in the lesson of choreographic elements and burdens on the hands or feet.

In aerobics step-by-step classes, you can change the intensity of the exercise, since it depends to a large extent on the rhythm of the music and the height of the platform.

The height of the platform is regulated and determined depending on the level of physical fitness of the practitioners, the skill of working on the step, the angle of bending the knee at full load in the process of lifting to the platform. The most commonly used platform height is 15-20 cm. The knee flexion when performing exercises should not exceed 90 ° , the optimal angle is not more than 60 °.

Hands can perform bilateral and one-sided, simultaneous and alternating, circular and with varying amplitude of motion. However, motor work with hands with a large amplitude significantly contributes to an increase in heart rate, so it is recommended to alternate movements with a large amplitude and low amplitude.

Jumps must be performed when climbing a step, and in no case when descending from it. Movement with ejection (jump) is recommended to be performed only by a sufficiently experienced person.

At step-steps up and down there is a tendency to maintain the position of the center of gravity over the leg in front to maintain equilibrium. This involuntarily causes an easy inclination of the trunk forward, which, when properly performed, does not adversely affect the spine.

The movements of a person coming down from the platform to the floor with their back to it always cause a more powerful support reaction than the steps down that are performed by the person to the platform or sideways to it.

To prevent various injuries associated with sports, it is important to observe the correct position of the body. In particular, with step-training you need:

1. Shoulders to expand, buttocks to strain, knees to relax;
2. avoid overextension of the knee joint;
3. avoid excessive back bending;
4. at a step to bend over the entire body (but do not tilt forward from the hip);
5. when lifting to the platform and lowering from the platform, always use a safe lifting method; standing facing the platform, climbing, working with his feet, and not with

Proper body movement mechanics increases the effectiveness of step-training and reduces the risk of injuries caused by excessive stress.

The main rule of safety for step-training is as follows:

1. Steps to perform in the center of the platform.
2. On the platform put the entire foot when lifting, and go down, putting the foot from the toe on the heel
3. When the knee is carrying a load, the joint should not be bent at an angle greater than 90 °. The height of the platform is selected in accordance with the growth.
4. Control the view platform.
5. Leaving the platform, stay close enough to it (do not deviate from the platform further than the length of the foot).
6. Do not start moving with your hands until you master the movements of your legs perfectly.
7. Do not climb and do not descend from the platform, standing with your back to it.
8. Taking a step is easy. Do not hit the platform with your foot.

Powerball, or fitball-gymnastics

Gymnastic balls can also be used for therapeutic and health gymnastics in order to form a beautiful posture and normalize body weight. A bright ball, musical accompaniment and a variety of exercises create a positive psycho-emotional mood for those involved. Positive emotions increase the tone of the tentral nervous system and stimulate various physiological mechanisms.

Gymnastics on the ball forces passive muscles to work, makes it possible to involve deep muscle groups in performing exercises, without exerting excessive strain on the spine. With the help of the ball, you can direct physical effects on individual muscle groups. For example, if you tend to stoop and round spin on the ball, you can make, lying on your stomach, sagging in the thoracic spine without affecting the lower parts; with a tendency to lordosis, lying on the abdomen, hyperlordosis is perfectly compensated and, consequently, exercises to strengthen the abdominal muscles become more effective.

Exercises on the ball suggest both a comprehensive and local impact on problem areas, which is especially effective in excess body weight. The possibility of local exposure is achieved in different positions. For example, from the initial position sitting on the ball, exercises are performed for the upper and lower extremities, the upper part of the trunk and the pelvis. At the same time, the correct posture is maintained. Or, lying on the abdomen, side or back, fixing the upper or lower parts of the trunk, or not fixing them. And also: lying on the back with the ball between the legs or in the hands; kicking on the ball; lying on his side with the ball in his hands or between his legs.

Fitball-gymnastics removes a number of limitations and difficulties in doing health gymnastics in people with excessive body weight, visceroptosis, circulatory inferiority of the lower extremities, problems with the functions of pelvic organs, due to the damping action of the ball, active strengthening of the pelvic floor muscles, elevated position of the lower extremities, lower parts of the trunk. Provides an excellent opportunity to strengthen the muscles of the upper and lower extremities in the unloading position, which has a beneficial effect on the joints, increasing their mobility, elasticity and flexibility.

Thus, fitball-gymnastics solves the following curative and preventive tasks:

1. The all-round development of all muscle groups, including, what is especially important, massive and deep.
2. Balance training.
3. Developing the skill of correct posture.
4. Increase the elasticity of the muscles and the amplitude of mobility in all joints.
5. Prevention of violations and normalization of the functions of the pelvic organs
6. Improving coordination skills.
7. Creating a positive psycho-emotional tone of the body.
8. Increase the efficiency of the heart, lungs, internal organs
9. Reduction of fatty deposits in problem areas.

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