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In conclusion, a few words about dietary supplements.

I am often asked a question about my attitude to the so-called dietary supplements. They are asked to evaluate this or that drug. I'll be honest. There are so many of them that I have never even met many of them.
Some of them are registered as medicinal forms and are successfully used for therapeutic purposes (for example, vitamins - Milgam, or herbs - Essentiale). However, their other (largest) group is represented directly in the form of various biologically active supplements (BAA), the attitude towards which among scientists and medical practitioners is ambiguous. The simplified registration mode, the absence of the need for clinical trials, the inability to control side effects and a number of other points represent only an incomplete list of pain points. So much so that some firms, in order to simplify the flow of their drugs into the pharmacy chain, register them as supplements.
A few years ago, the so-called dietary supplements gained incredible popularity in our country. I remember a time when many bought them with boxes. It does not matter how much they cost - dozens of rubles or hundreds of dollars, people acquired the hope of miraculous healing, and she did not feel sorry for her energy, time, and even less money. And if there is demand, there will be supply. And the rows of dietary supplements spread day by day. Already in 2004, more than 4,500 additives were officially registered, and nobody counted how many were spinning on the market illegally. And all of them, of course, were made from natural healing herbs that grow in the purest mountainous regions of China.
I think that after the production of so many of these additives, there is probably no grass in China at all!
In the meantime, the official Russian authorities realized it and finally began to wonder what they were doing so hard with excessively trusting citizens. And it turned out that everything is far from being so calm in the “BAA kingdom”, that some supplements not only do not benefit, but also significantly affect people's health. This began to actively write in the press and talk on television. Well, as usual, our gullible people immediately began to be vigilant. To replace jubilation came complete distrust and denial. It got to the point that the very word - BAA has acquired a certain nominal character. It has become synonymous with the word - deception, dummy, poison.
And indeed, quite a few additives turned out to be just sets of dried grass. And some dietary supplements even contained the most real drugs causing persistent dependence. How many of them were then withdrawn from implementation. Many violations were related to the inconsistency of the information put on the label with the information in registration certificates. Many of them did not have data on the date of production and contraindications to use. Nothing was said about the fact that dietary supplements - not a drug, but only a food product. More precisely a product that complements the diet.
Gennady Onishchenko, the head state health officer of Russia, in his commentary in Rossiyskaya Gazeta, made it clear that dietary supplements are not a medicine, and as a remedy, they cannot be used anywhere else. The people were lucidly explained: supplements are not medicines, but simply a combination of vitamins and minerals, which the body often does not get from regular food.
He stressed that we are not talking about the eradication of dietary supplements. Manufactured with observance of all technologies, correctly stored, correctly recommended to the consumer, they undoubtedly bring certain benefits. But these are not drugs, but food products, which should only correct the deficiencies of the dietary ration of a modern person.
In the modern world, most food products undergo tough processing, are subject to conservation, thermal effects, long-term storage, transportation, which negatively affects their quality and the content of biologically active substances in them. In this regard, today the question of the need for additional enrichment of food products and, in general, the diet of vital micronutrients, biologically active substances, is increasingly being raised.
Dietary supplements supply the body with those components that we need and which are not able to provide normal nutrition in sufficient quantities. Because they are, and they certainly will be more. But they must comply with their purpose, all hygienic standards. How to distinguish what is really useful, and what can cause irreparable harm to the body?
Probably, when buying any new unknown drug, first of all, pay attention to advertising. If the “next miracle” is heavily advertised, especially on television, it means that this is another deception, and you cannot buy it! But by the way, seriously speaking, never trust a beautiful, but to no name that speaks to you. If you already take responsibility and, without consulting a doctor, you acquire any medication, then, at a minimum, you should be aware of its mechanism of action. Know the indications and contraindications. As they say in one old joke: "Not all yogurts are equally useful!"
I would like, as an example, to cite the composition of one heavily advertised drug for weight loss in a dream. Let's try together from a scientific point of view to disassemble the practical effectiveness of its components. Let me just remind you that this drug is recommended to take at night!
1. Garcinia cambogia is a source of hydroxycitric acid, which slows down the conversion of excess carbohydrates to body fat and suppresses appetite.
Even if we take these words on trust, an involuntary question arises: “Why suppress the appetite at night?” After all, if someone wakes up at night in search of a refrigerator, what's wrong with that? After all, in fact, at night the human body is experiencing a kind of hunger strike of up to 12-14 hours! As a result, lipoprotein lipase enzyme is released, which contributes to the fact that all the fats eaten for breakfast are deposited in the subcutaneous fatty tissue.
2. Chitosan effectively binds fats and promotes their removal from the body. It really is! But the amount of this chitosan in one or two capsules of the supplement is so small that it is even difficult to imagine the amount of fat it can bind! Chitosan has a noticeable effect only when used in much larger quantities and even at the same time it is able to bind about 30% of the fat entering the intestine.
3. Linoleic acid inhibits the mechanism of formation of subcutaneous fat, stimulates thermogenesis (fat burning).
As I mentioned at the very beginning, fat can burn only in the mitochondria of muscle cells at a certain, strictly dosed, physical exertion!
4. L-carnitine transports fats into cellular mitochondria, where they are processed into energy.
It's true. But for this, the dosage of L-Carnitine must be at least 1000 - 1500 units. and besides, an involuntary question arises, who will perform serious and prolonged aerobic exercise at night? If only "lunatics" !?
5. Senna extract improves digestion, enhances the motor activity of the large intestine, has a mild laxative effect.
Even if a mild laxative effect, but at night !? In my opinion, this item does not need comments!
6. Extract of lemon balm stimulates digestion, has antispasmodic activity, has a calming effect.
Why stimulate digestion at night, when the body should rest?
7. Chromium picolinate maintains a normal physiological level of glucose in the blood, which in turn contributes to the suppression of sugar cravings and natural weight loss.
This is true, but only in those people who have impaired insulin tolerance, a hormone that regulates blood sugar levels. And if everything is all right with this tolerance, why introduce extra chromium into the body? In extreme cases, it can be taken during the day as a separate dietary supplement.
8. Vitamins of group B, E, zinc are involved in the metabolism of proteins, fats and carbohydrates.
The fact that vitamins are necessary for each of us, and especially for people who limit their diet, everyone now knows. All of them are certainly important for the normal functioning of the body. Each vitamin in a certain way affects the metabolism, but the effect of many vitamins is interrelated. Constant intake of one vitamin leads to a deficiency of another. So, taking vitamin B1 accelerates the loss of other B vitamins. Obviously, this pattern is not limited to B vitamins.
Of course, you remember that vitamins do not act alone, they work as a team! Acting as biocatalysts and regulators of metabolic processes, they act through a system of enzymes and hormones, which, in turn, are composed of proteins. The lack of one of the components of this balanced system will lead to the futility of all other elements. Vitamins are substances that interact with proteins, so they must be taken along with protein food for best absorption and functioning!
Conclusion - not a single component of this supplement has any effect on the process of losing weight! A waste of money, but the main thing is another disappointment and the formation of a sense of doom.
Despite significant advances in modern medicine, aimed at correcting the identified metabolic disorders, the question of the priority of using dietary supplements (dietary supplements) in the complex treatment of obesity is still controversial. Properly supplemented dietary supplements in the ration should, collectively, influence the main pathogenetic mechanisms of the onset and development of obesity, taking into account the developing concomitant pathology. The use of dietary supplements in preventive and therapeutic nutrition is primarily due to the possibility of fairly easily and quickly, without increasing the total caloric content of the diet, to eliminate the deficiency of minor nutrients, the need for which only increases in the process of treating obesity.
As for the question of tactics of therapeutic measures, I dare to say that it is impossible to preserve the biological usefulness of a limited diet without additional enrichment with its necessary micronutrients!
Of course, with obesity, as it may be, for no other disease, the system of properly and individually selected diet is one of the main methods of treatment.
However, after all, any restrictive diet is, first of all, a lack of vitamins, minerals and other substances in food, and the body's needs for them remain the same and even increase. Therefore, in any course of weight loss, it is necessary to take vitamin complexes, other additives, and, of course, it is desirable to do this under the supervision of a physician. After all, some vitamins, especially ascorbic acid and B vitamins, play a special role in the normalization of lipid metabolism. They are directly involved in the process of oxidation of fats.
But we can speak about the effectiveness of dietary supplements only with a properly planned diet. These funds can only contribute to the improvement of the final result, but there are neither drugs nor dietary supplements, which, without a corresponding correction of nutrition, would reliably restrain the increase in weight in persons prone to fullness!
A joint study conducted by the Wharton ^ Iag1; school of Business and the University of Pennsylvania School of Medicine showed that dietary supplements and pills designed to combat obesity, with independent, uncontrolled use, have quite the opposite effect. Even if these drugs are really effective, people taking them often do not lose weight.
The reason is that those who want to lose weight rely more on the products of pharmacists than on themselves. In particular, they do not give up bad eating habits, do not start to play sports, etc. Moreover, people who began to use such drugs, less responsibly approach to solving the problem of self-control.
The authors of the study claim that partly the producers of the miracle pills are guilty, who put in advertising and on the packaging of their products statements that in order to lose weight, it is enough to use their products. At the same time, consumers usually choose diet pills not on the basis of some objective scientific criteria, but on the basis of their personal faith in the effectiveness of these drugs. That is, the more active the advertisement, the greater the sale. The law of the market.
The main difficulty lies in the fact that a huge number of modern drugs, presented on the shelves of pharmacies, raise doubts about their correct selection, even among experienced doctors.
All dietary supplements are designed to regulate various functions of the body. The mechanisms of this action are very different for them, but in most cases the principle remains the same - the physiological necessary saturation of the body with micronutrients. However, doctors often do not take into account the fact that different people have different needs for these substances and different ability to perceive them. This may depend on the age and nutritional value, and even on the season. Therefore, a detailed selection of dietary supplements is necessary according to the criterion of their compliance with the requirements of the patient. Individual selection of dosages is the most important point in improving the efficiency of the correction of health.
Modern dietology, more than ever, needs to develop a single, sound concept of the use of biological active additives.
It can be said without exaggeration that medicines and non-medicinal products containing amino acids and peptides in different quantities and ratios, vitamins and vitamin-like substances, coenzymes and microelements are now actively used in all fields of medicine and for any reason. This popularity can obviously be explained both by their effectiveness in the treatment of various pathological conditions, and relative harmlessness. This combination of factors leads to the fact that the doctor is easier to prescribe a particular drug "just in case" than to understand the feasibility of such an appointment. As a result, due to thoughtless use, due to the lack of a methodological basis, the effectiveness of treatment suffers, which in turn often raises doubts about its fundamental effectiveness.
Such drugs as coenzyme Q10, carnitine, B vitamins and many other substances are widely used in modern medicine, although rational bases for their use are poorly developed. These drugs are used randomly, without sufficient knowledge of their capabilities, the features of their interaction, without planning treatment strategies from the standpoint of expediency.
The attending physician should have a clear idea of ​​which mechanisms underlie the effects of each drug, and which patients need it at a particular stage of treatment. Often, doctors try to solve these problems on their own, as a rule, based only on personal experience. But, unfortunately, it is not always enough to make the right decision.
Some public speeches of famous doctors in favor of one or another means of losing weight, clearly demonstrate that the financial benefit for someone means more professional honesty. But, thank God, there are still not very many such cases. Most of our doctors retain professional integrity and do not stoop to advertising dubious funds.
In my practice, I am always guided by the justified necessity of using a particular drug and always try to explain in detail to my patients the mechanism of its action and the goals pursued at different stages of the procedure. And although the word BAA itself can instill distrust and caution, but, in fact, vitamins, trace elements and amino acids, without which the human body cannot exist, can be attributed to the same dietary supplements.
It is necessary for the patient to understand the difference between an unknown overseas blend of herbs in a beautiful expensive package and a specific drug, the effect of which has long been studied and tested. In order for him to understand that there are no “pills for obesity” or “burning” fats, but at the same time, some drugs are simply necessary for the body in a difficult period of adjustment.
Separately, I would like to say about the need to be especially careful with such methods of losing weight as the use of laxatives or diuretics.
Unreasonable use of such drugs that stimulate the excretion of fluids from the body to “accelerate the process of losing weight” may ultimately cause a decrease in the ability to absorb food, vitamins and minerals contained in it, lead to an imbalance of the intestine and the general dehydration of the body.
Alas, the supplements that Americans and Japanese take are often very different from those on shelves in Russian pharmacies. According to unofficial data, today the number of not only useless, but also hazardous to health, dietary supplements reaches 50% of the total supplements market. Most of the questionable dietary supplements are made in China and Thailand, and they, unfortunately, are designed specifically to combat excess weight. At least, that’s what the manufacturers indicate on the labels.
Восточная, и в частности китайская, медицина сейчас очень популярна во всем мире. Кроме иглорефлексотерапии, прижиганий и травяных чаев для похудения, входят в моду различные комбинированные препараты и биодобавки с причудливыми названиями. Они продаются в аптеках, активно навязываются по телевидению, широко представлены в сети Интернет. И, как ни странно, желающие провести на себе эксперимент, находятся.
Между тем установлено, что несколько из этих препаратов содержали фенфлюрамин — вещество, не только подавляющее аппетит, но и нарушающее функции печени, а посему запрещенное к применению. Употребление этих средств вызывает серьезные нарушения работы печени, щитовидной железы и других жизненно важных органов.
Взять, к примеру, так популярные у нас «чудо-капсулы» для похудения. Проведенные экспертизы обнаружили в них сильнодействующие наркотические и психотропные вещества, хотя продавцы продолжают заявлять, что в этих препаратах ни диуретиков, ни психотропных веществ нет и в помине. К тому же, многие «сжигатели жира» устраняют вовсе не жир, а способствуют усиленному мочеотделению, то есть активно выводят из организма воду. И сброшенные за месяц 5—6 килограммов возвращаются к Вам, как только Вы перестаете принимать препарат. Только вдобавок к этому еще прибавляются проблемы с почками и обменом веществ. Так что сжигаете Вы, скорее всего, не жир, а прожигаете свое здоровье. Однако, вера во всемогущество восточной народной медицины еще очень сильна, и соблазн вогнать фигуру в «золотое сечение» с помощью чудесных средств велик особенно у женщин.
Конечно, не стоит валить все в одну кучу. На российском рынке есть БАДы, которые действительно полезны, а в некоторых случаях и незаменимы. Только вот неясно, как отделить хорошее от плохого. Если доверять нельзя ни рекомендации врача, ни надписи на упаковке, ни регистрации, то, может, вообще от греха подальше отказаться от всех БАДов?
Именно такая логика меня и пугает. На рынке биологических добавок нет порядка. От этого страдают, прежде всего, добросовестные производители. А они ведь есть! Просто меньше афишируют свою деятельность. Меньше навязчивой и многообещающей рекламы и больше реальной пользы. Если Вы хотите в этом разобраться, то обращайте внимание не на яркое название, а на страну изготовления и международный уровень классификации, присвоенный заводу производителю (стандарт GMP).
Вот общие правила применения биодобавок.
1. Приобретать биодобавки следует только по рекомендации врача и только в аптечной сети. Особенно осторожно следует относиться к применению БАДов людям пожилого возраста, детям, беременным женщинам, кормящим матерям.
2. Нельзя принимать два или более препарата одновременно, особенно если речь идет о многокомпонентных препаратах, содержащих смесь различных ингредиентов. Так как никогда нельзя точно прогнозировать каково будет их взаимодействие.
3. Не стоит рисковать и принимать БАДы в состав которых входят неизвестные или мало изученные экзотические компоненты. Поскольку точно неизвестно их влияние на организм человека в целом и на Ваш организм конкретно.
4. В случае возникновения любых побочных реакций необходимо сразу же прекратить прием БАДа и сообщить об этом своему лечащему врачу.
Для того что бы как-то систематизировать все данные о медицинских препаратах используемых при лечении ожирения, о многих из которых я уже упоминал на страницах этой книги я решил дать им повторно краткую характеристику в отдельной главе.
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В заключение несколько слов о БАДах.

  1. Несколько слов в заключение
    Yeremeev Yury Fedorovich tel. 434-4280 Zyabkin Viktor Borisovich Katunsky Mikhail Mikhailovich tel. 277-6324 Krasilnikov Alexey Alekseevich tel. 152-2372 Администрация Если обобщить все имеющиеся на сегодняшний день результаты отдельных исследований, проведенных в разных направлениях, можно сделать вывод о том, что рассеянный склероз является аутоиммунным заболеванием центральной нервной
  2. Несколько слов в защиту жира
    — Ничего соленого, ничего жареного. С утра — бассейн. На завтрак — овсянка на воде. Потом зеленый чай все время пью. Напротив меня сидит девушка весом под сто килограммов, хотя то, что она мне рассказывает, звучит как особая диетологическая симфония. — Теперь — ужин. Все готовлю только на пару, а перед сном, чтобы уснуть, пью полчашечки обезжиренного кефира и больше ни-ни! Девушка, мягко
    Экономисты подсчитали: человек, который изобретет эффективное средство от избыточного веса, станет миллиардером менее чем за полторы минуты. This proves, on the one hand, the ineffectiveness of most diets and preparations created for weight correction, and, on the other hand, the topicality of the problem. And here is another very significant statistical fact: after the invention of a cure for cancer
  4. A few words in defense of the burr
    And nevertheless, any speech is valuable not by the absence of defects, but by the presence of merits. Here are just a vice vice strife. The vices 1 ~ 15 of the previous chapter are criminal for speech, but what about burr? Моя школьная учительница географии очень сочно картавила, громко и раскатисто проговаривая неправильное «р-р-р». This not only did not interfere with her listening, but also gave her voice amazing brightness and recognizability.
  5. A few words about the action of anti-allergic drugs
    Сначала разберемся, что такое аллергия. Аллергия (от греч, olios — другой и ergon — действие), извращенная чувствительность или реактивность организма к тому или иному веществу, т.е. allergen. Allergens can be various substances - from the simplest to complex protein and non-protein. Allergens that enter the body from the external environment - exoallergens can be infectious
  6. A few words for fat people and fatties
    In the early days of the Program, do not limit yourself to food! You wanted a chop and flavored with condensed milk and peaches endless piece of biscuit - give yourself that! It is very likely that your Organism will be stunned in the full sense of the word from such happiness and allow itself to be weak. But, as soon as he realizes that the restrictions and punishments really ended and you do not intend to humiliate and offend him anymore, your
  7. Stages of the formation of the reading action. Phoneme analysis of words
    The question of sound analysis and its place in the system of teaching reading is one of the oldest and perhaps the most controversial. In C. D. Ushinsky's attention to the sound side of the language was associated with its basic principle of letter-reading. Yes, to write a consistent hearing of the sounds of a word is necessary. But is it really necessary to be able to analyze the sound composition of words for reading? In the modern method of sound
  8. But if words are not enough, what to add?
    The morning after the meeting, the head of the company called me, who had arranged an informal survey the day before. He asked me to come to an impromptu meeting. Entering the room, I saw six company leaders (who participated in yesterday’s seminar), who were engaged in drawing on flipcharts. I was handed a printout of Mike's speech, in which someone had already noted all four strategies. My
    If you have firmly decided to start a kitten in the house, first of all, worry about its safety: get rid of poisonous indoor plants (see section below), install grilles on windows (windows) or tighten the balcony with a metal grid so that the kitten cannot fall. A lot of dangers for cats conceals a kitchen (gas, oven, etc.), and it is better to make the animal happen there as much as possible
    Increase vitamin C intake. It is established that if the body lacks vitamin C (ascorbic acid), the sperm becomes viscous. And according to statistics, 16% of cases of infertility occur precisely for this reason. Vitamin C has an antioxidant effect, strengthens the cell membranes and generally has a positive effect on the process of sperm formation. The method of "fortification" male
  11. AV reciprocal PT with pre-excitation of the ventricles in patients with several PD
    According to N. Wellens (1986), half of patients suffering attacks of antidromic tachycardia have more than one PD. Of the 435 patients with electrocardiographic signs of WPW syndrome G. Bardy et al. (1984) found multiple D77 in 61 (14%). Only v 20 of 61 patients (32.7%) managed to cause an AV reciprocal PT. The average age of patients developed 27 ± 14 years (from 9 to 67 years). Соотношение
  12. Fetal period. Several types of food.
    In the embryonic period, the main type of food is histotrophic (after implantation of the blastocyte, the embryo feeds on elements of the uterine mucosa, and then on the yolk sac material). After the formation of the placenta (from the II-III months of intrauterine development) - hemotrophic type of nutrition follows (due to transplacental transport of nutrients from the mother to the fetus). Основой на этих первых
  13. Step 6: Meeting the cost of several million
    We were so heavily charged with clarity and simplicity of the schedule that we could not wait for the moment when we returned to Thomson and share our conclusions. Apparently, the representatives of Thomson felt about the same thing - just before the start of our presentation, Dick Harrington suddenly asked if he could attend the meeting. We brought with us a huge printout of graphics to
  14. Some significant remarks about metabolism and energy
    The main goal with which we eat food is to get energy. We absolutely need energy for any of our actions - maintaining metabolism, constant body temperature, breathing, heartbeats, muscular work, and so on; all these processes need a constant flow of energy that is contained in food. True, not all components of food have energy, but only three.
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