In its traditional form, a low-calorie diet (LVNK) refers to diets with daily daily calorie restriction up to 350-700 kcal, as reported by Pannochka, an online publication for girls and women from 14 to 35 years old.. net Recall that the physiological norm of energy consumption is about 2500-3500 kcal.

That is, DVNK contains energy no more than 15-25% of the usual daily caloric intake..

Another important feature of this method of treatment is that nutrition with a pronounced low-calorie diet is carried out using special nutritional mixtures (cocktails), the main nutrients in which are either pure proteins or proteins and carbohydrates in one or another proportion.. Fat content is usually negligible and does not exceed 3-4 grams per day.

This, as we noted above, corresponds to the modern principles of building diets for the treatment of obesity.. In addition to nutritional mixtures, patients receive multivitamin preparations, mineral supplements, w-3-polyunsaturated fatty acids and dietary fiber..

Perhaps the main advantage of DOHC is that this diet is effective in almost 100% of cases.. Weight loss with its use is achieved even in patients who are on strict bed rest.. This diet can be used on an outpatient basis, although most authors believe that a hospital regimen is desirable (Bryner R. et al. , 1999).

The average rate of weight loss, according to various authors, is 1.0-2.0 kg per week (Ryttig K. , Rossner S. , 1995; Pekkarinen T. et al. , 1996). However, there are reports of more pronounced results.. So, according to Hakala K. et al. (1996) in patients with severe obesity (body mass index (BMI) - an average of about 45.6 kg / m2), during a 6-week course of the diet, weight loss was observed by an average of 25.7 kg, that is, more than 4.

A number of studies have investigated the possibility of using a pronounced low-calorie diet in complicated obesity (Kansanen M. et al. , 1998; Williams K. et al, 1998). At the same time, it was noted that in the course of weight loss in patients there is an improvement in the control of diabetes mellitus (Wing R. , 1995; Williams K. et al. , 1998), reduction of plasma atherogenicity and reduction of high blood pressure (Bryson J. et al. , 1996; Ewbank P. et al. , 1995).

However, DVNK has a number of very significant shortcomings, namely:.

Poor diet tolerance due to monotonous, monotonous and low-calorie nutrition. It is known that a two-month course of diet therapy is able to complete no more than half of the patients who started treatment (Hoie L. , 1995).

Due to the adaptation of the body to a pronounced low-calorie diet, against the background of the use of FENC, a decrease in daily energy consumption is observed and, as a result, a slowdown in the rate of weight loss or even the cessation of weight loss (Valtuena S. et al. , 1995).

Of the side effects of a pronounced low-calorie diet, it should be noted a feeling of weakness, dizziness and a possible change in behavior in some patients associated with a lack of energy and a feeling of hunger.. These phenomena are usually observed in the first days of the use of DVNK and then may pass..

There are also side effects from the gastrointestinal tract - a possible exacerbation of chronic diseases (gastritis, pancreatitis, peptic ulcer). The literature describes several dozen cases of ventricular fibrillation and death of patients on the background of a course of a pronounced low-calorie diet..

Moreover, these cases were recorded in patients who did not have cardiac pathology before starting treatment.. The causes of ventricular fibrillation have not yet been precisely established..

It is believed that one of the possible causes is associated with a lack of polyunsaturated fatty acids and certain minerals in the diet.. In any case, in recent times, when minerals, vitamins, and polyunsaturated fatty acids are specifically added to the diet, the incidence of ventricular fibrillation has decreased dramatically (Seim H. et al. , 1995).

The diet does not lead to the formation of rational nutrition skills, therefore, after the cessation of treatment, recurrence of excess weight is observed with a frequency close to 100% (Pekkarinen T. et al. , 1996). For the application of the diet, hospital conditions are desirable. Its use on an outpatient basis for one reason or another can be difficult or dangerous..

It is clear that these shortcomings, despite the high efficiency of DVNK, prevent its wide application.. In general, in the practice of diet therapy for obesity, it must be taken into account that the tolerability of treatment and its safety are parameters no less important than its effectiveness..

In this regard, the question is relevant, but would a diet that does not imply any special restrictions on daily caloric content be effective Below we provide an overview of the experience, so far very small, of the use of this kind of diet..

Ginzburg M.

medbe. en.