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2018 Issue No. 1

RMC magazin Weight loss is not just about looking good

What are

the benefits of losing weight? Questions for the from a

doctor doctor

Why can’t I lose weight?

Psychological pitfalls of weight loss

Weight loss before becoming pregnant? Why it’s a good idea

Recipes from our dietitian

Broccoli takes center stage


Dear Reader, Here at Rózsakert Medical Center, we believe that is it our job as doctors not only to treat patients, but also to help them stay healthy. The latter is the more difficult task. These days, we all face information overload. Searching for various symptoms on the internet

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brings up tens of thousands of diagnoses and remedies, many of which are out-dated, extreme or downright nonsense. In this day and age, I think everyone desires to live a healthy lifestyle, but rarely does that desire meet realistic preventive solutions. For example, it’s very rare for people to ask a doctor’s advice on how to live healthier. RMC advocates ‘evidence-based’ medical practice. We optimize treatment of our patients based on the latest scientific research. We use this approach for preventive care as well, and always try to emphasize the importance of getting advice from experts. This is exactly why we’ve created the RMC Magazine, to provide advice on preventive care advice based on professional expertise and scientific evidence. Each issue of our magazine will build on a central theme. With

the help of our experts, we aim to create a variety of helpful articles that will include recipes, infographics and a chance to get better acquainted with one of our experts in the given field. Our first issue is about weight loss. As health care providers, we believe it is vitally important to emphasize that ideal weight is not just about looking good, it is about being healthy in body and mind. This means sticking to healthy weight loss practices. We’ll provide helpful tips on how to achieve this. Wishing you a good read and good health! Sincerely, DR GYULA CSERMELY PH.D Obstetrician-Gynecologist Fetal Medicine Foundation Certified Ultrasound Specialist RMC Managing Director


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What illnesses are linked to being overweight?

5

If you’re hungry, should you drink a glass of water?

What does our obesitologist think?

6

What are the benefits of losing weight?

7

Miracle diets and bare-faced lies

8

Recipes from dietitian Emese Eszter Kudron

Broccoli takes center stage

10 Can being overweight lead to gestational diabetes? 11 Weight loss before becoming pregnant? Why it’s a good idea 12 A healthy diet during pregnancy 14 Questions for the doctor from a doctor 15 Mind and body - Why can’t I lose weight?

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What illnesses

are linked to being

OVERWEIGHT?

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CONDITIONS AND DISEASES ASSOCIATED WITH BEING OVERWEIGHT

CONDITIONS AND DISEASES WHICH CAN LEAD TO BEING OVERWEIGHT

• High blood pressure • Diabetes • Coronary artery disease • Cirrhosis of the liver • Stroke • Gallstones • Cancer • Polycystic ovary syndrome (PCOS)

• • •

Insulin resistance Thyroid disease Cortisol weight gain


If you’re hungry, should you drink a glass of WATER? What does our obesitologist think?

DR ÉVA BAJNOK obesitologist

Hunger and thirst are the signs of two strong but distinct biological needs, which is why the feeling and our awareness of the two are usually very different. In rare cases, however, (such as with infants, elderly dementia patients or people who have suffered disease or dam-

age to their central nervous system) some people can be unable to make the distinction and might confuse the two. But this is not a normal occurrence. Nevertheless, drinking a relatively large quantity of water before eating can temporarily fill your stomach up, causing the brain

to sense its fullness and leaving you feeling temporarily less hungry. In any case, many people forget to drink enough fluids, especially water, in the first place, which means that the idea isn’t completely without merit, even if the approach is not exactly the right one.

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What are

the benefits

of

LOSING WEIGHT?

DR ÉVA BAJNOK obesitologist

While everybody wishes they had a perfect body, weight loss is not all about having a flat stomach and a slender waist. Shedding excess weight also brings with it various benefits for your health. We have outlined these below with the help of our obesitologist, Dr Éva Bajnok. REDUCED PAIN, LESS ILLNESS Getting rid of excess weight reduces the risk of developing various conditions and diseases, including diabetes, heart and artery disease, high blood pressure and certain cancers. A reduction in weight lowers strain on the spine, legs and joints, which is why weight loss can also reduce or even completely eliminate leg pains, back problems and joint inflammations and disease. BALANCED SLEEP Snoring and sleep apnea frequently occur in people who are overweight. The latter is a sleep disorder characterized by pauses in breathing or shallow breathing, often causing you to wake up suddenly in the middle of the night to take a deep breath, and which can leave you feeling sleep-deprived and struggling to concentrate the next day. Eliminating excess weight can greatly ameliorate this problem, giving you more restful sleep and reducing feelings of fatigue the following day, making your waking hours more productive.

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SURGING VITALITY Losing weight can also do a lot to improve your general sense of well-being. If you lose weight in a healthy way, you will find it easier to exercise and wake up in the morning, and will also feel more energetic. Generally speaking, self-confidence also increases significantly: you will feel more open and find it easier to get to know new people and develop social relationships. You will also be less likely to experience anxiety and depression. DO IT IN A HEALTHY WAY In order to feel the benefits to your health that weight loss can bring, it’s important to follow a healthy diet. Forget about starving yourself and miracle cures; instead, eat healthily, exercise regularly, and do it all gradually. And if you feel like you’re doing everything you can to lose weight, but it’s still not working, speak to a medical specialist in order to make sure there are no underlying problems or illnesses.


Miracle diets

and

BARE-FACED LIES by Dr Kitti Farkas

DR KITTI FARKAS intensivist

For decades now, we’ve experienced a global explosion in fad diets, yet obesity is still a growing problem. Why is this? In my opinion, this is because the plethora of methods and products that are (or were) available don’t actually help weight loss. These products are in direct conflict with the way our bodies work. But those desperate to lose weight buy them because they are given a guarantee, or a great story about how successful has been

for a single person. But a failed diet hits back twice as hard. First of all, a bad diet will damage the metabolism, ultimately resulting in more weight being gained back than was initially lost. Second, the psychological impact of failure causes a loss of confidence and less enthusiasm for trying again. All the while, the problem is not with them, but with the diet itself. The biggest problem with ‘miracle diets’ is that an actual miracle would be needed for them to work. Even so, nine out of ten people still expect miracles instead of consulting a physician or dietitian. Those who have been through many failed diets start asking the question: “Why have I not had any success?” These are the men and women I meet with in the course of my work. Sometimes I feel like I’ve heard about every diet fad ever invented. I now brace myself to start each consultation by listing the reasons why their diets have failed.

Let’s take a look at some of the most common dieting myths I hear about every day: • Eat breakfast like a king, lunch like a prince and dinner like a pauper. • Eat heavier foods rich in carbohydrates for breakfast – be as naughty as you want, you’ll burn it all off during the course of the day. • Eat five times a day, or every 2-3 hours, to keep your metabolism ticking over. • Don’t eat carbohydrates, live on proteins. • Fast. • Take some special pill and you’ll be able to eat anything. • Eat special diet foods that have had one thing taken out of them and replaced it with something else. • Eat a lot of fat. • Don’t eat any fat. • Separate nutrients: sometimes eat just carbohydrates, sometimes just proteins. • Eat according to your blood type

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WHY IS BROCCOLI HEALTHY AND HOW CAN IT HELP WITH WEIGHT LOSS? • It is an excellent source of potassium, beta-carotene, folic acid, vitamins C, B1, B2 and B3, and also provides calcium, magnesium and dietary fiber • Broccoli contains compounds that help prevent cancer (e.g. sulforaphane, which is responsible for its characteristic ‘sulfurous’ aroma) • It enhances digestive health by providing prebiotics for gut bacteria, therefore sustaining a healthy gut microbiota, which can help reach and maintain healthy weight levels. • Its high fiber content increases the feeling of being full and is responsible for optimal intestinal health, parallel with proper fluid intake (2.5–3 liters/day)

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Recipes from dietitian Emese Eszter Kudron

Broccoli takes

CENTER STAGE

EMESE ESZTER KUDRON dietitian

BAKED BROCCOLI CROQUETTES WITH TWO TYPES OF SAUCE (4 SERVINGS) INGREDIENTS FOR THE CROQUETTES: • 500g fresh broccoli (steamed or cooked) • ½ a cooking onion • 100g cheese (original recipe: cheddar; diet: low-fat cheese) • 2 eggs • 3 level tablespoons of ground oats (or oat flour) • 1 level tablespoon of psyllium husk • 1 teaspoon of parsley leaves • 1 teaspoon of cilantro leaves (optional) • 1 garlic clove • Salt and pepper to taste SPICY YOGURT SAUCE: • 1 small pot of plain yogurt • 1 garlic clove (optional) • ½ teaspoon green peppercorns crushed in a mortar • Fresh herbs (or an herb mix e.g. Provence) • Salt to taste CURRY TOMATO SAUCE • 2/3 bottle of tomato passata (thick, Italian tomato purée) • 1 teaspoon basil

• 1 teaspoon oregano • ½ teaspoon coriander seed powder • ½ teaspoon curry powder • ½ tablespoon erythritol or other sugar alternative (¼ cap liquid sweetener) • Salt, pepper to taste Method: Preheat oven to 200°C. Wash broccoli well, separate into florets and steam. If you don’t have a steaming basket, a metal, or strong plastic colander over a matching-sized pot will do. When a fork goes through the broccoli easily, it is soft enough. Mash the broccoli with a fork or hand blender, then mix in the rest of the ingredients. Shape the croquettes with wet hands. Prepare a baking sheet with baking paper and brush on 1 teaspoon of oil. Place the croquettes on the baking paper and brush with another teaspoon of oil. Bake for 1520 minutes, until desired crispiness is reached. Serve with dipping sauces. This quantity of dipping sauce is sufficient for twice as many croquettes, so you can use the remaining sauce to dip fresh veggie sticks.

Nutrients in a single serving (six croquettes): 95 kcal, 5.5g protein, 3.6g fat, 11.2g carbohydrate – of which 2 grams is fiber; plus calories from the dipping sauces.

AVOCADO AND BROCCOLI SALAD WITH FARMER’S CHEESE DRESSING (4 SERVINGS) INGREDIENTS: • 800g broccoli • 800ml 0.1% plain yogurt or kefir • 120g low-fat farmer’s cheese • 60g leek • 50g sprouts (e.g. wheat, radish) • 1 bunch fresh parsley • 1 avocado • 1 lemon’s zest • Juice of half a lemon • Roughly ground mixed peppercorns • Salt to taste Method: Steam the broccoli, slice the leek into rings and dice the avocado (use a ceramic or plastic knife – not metal!) Mix the remaining ingredients to make the dressing and sprinkle the sprouts on at the end. Nutrients in one serving: 265 kcal, 21g protein, 10g fat, 24.5g carbohydrate – out of which 10.5g is fiber

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Can being overweight lead to gestational

DIABETES?

By Dr Viktor Vass

DR VIKTOR VASS diabetologist

WHAT ARE THE CHANCES OF DEVELOPING GESTATIONAL DIABETES IN VARIOUS BMI CATEGORIES? • Normal BMI (18.5-24.9): ~10% • Slightly higher BMI (25-30): ~17% - OVERWEIGHT • Moderately high BMI (31-40): ~35% - OBESE • Extremely high BMI (above 40): ~100% - EXTREMELY OBESE

WHY IS GESTATIONAL DIABETES DANGEROUS? If gestational diabetes develops and the mother’s BMI value stays high or continues to rise, the following risk factors apply: • The baby is up to 3.5 times likely

to be to large (macrosomia)

• The risk of shoulder dystocia

(baby’s shoulder gets stuck in

the pelvis) is doubled

• Preeclampsia (onset of very high

blood pressure from the 20th

week, accompanied by presence

of protein in the urine) is six times

more likely to develop

GESTATIONAL DIABETES ALSO HAS SERIOUS EFFECT ON THE BABY’S WEIGHT: • 20% chance of excessive

birth weight

• 17% chance of being

overweight by the age of 4-5

• Increase in BMI value measured

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in children aged 14


Weight loss before becoming pregnant? Why it’s a GOOD

IDEA

by Dr Nóra Gullai

Unfortunately, there is a range of health risks linked to being overweight both during pregnancy and in the periods before and after having a child. The good news, however, is that with a bit of determination and the help of specialist healthcare professionals you can lose that excess weight. Below, we take a look at why it’s worth putting your energy into reaching your optimal body weight.

DR NÓRA GULLAI Obstetrician-Gynecologist Fetal Medicine Foundation Certified Ultrasound Specialist • Difficulties with conceiving are

• Higher body weight increases

• Post-birth, there is a greater

more common if you’re overweight.

the risk of neural tube and con-

risk of thrombosis in overweight

• Being overweight increases the

genital heart defects, cleft lip, cleft

mothers, as well as various infec-

risk of various complications relat-

palate and limb deformities.

tions, independently of the birth

ed to pregnancy, from premature

• Complications when giving birth

method.

birth to gestational diabetes and

are more common in overweight

• The children of overweight or

high blood pressure.

patients. They are more likely to re-

obese parents are more likely to

are

quire a C-section, and in the process

experience asthma and obesi-

harder to carry out through a

of more technically difficult opera-

ty in childhood, which can have

thicker stomach wall, making it

tions, they are more likely to experi-

implications for both their phys-

more difficult to correctly identify

ence complications such as wound

ical health and psychological

the anatomy of the baby.

separation, infection or bleeding.

well-being.

• Ultrasound

examinations

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A heathy diet

during

PREGNANCY by Dr Viktor Vass

What is considered healthy weight gain during pregnancy? During a normal pregnancy (i.e. not twins), a woman with normal BMI (18.5-24.9) should gain between 9-12 kg. For thinner women, this can be more. However, for overweight women, the least weight gain possible is advisable. When is it necessary to diet? 1. If the mother is overweight or obese (their BMI is above 25). 2. If weight gain was above average in the first 12 weeks. In the first trimester 0.5 – 2 kg weight gain is the norm. If 4-5 kg has been gained by this point, this suggests high calorie intake so it is advisable to the mother to start paying attention to her eating habits. 3. If gestational diabetes develops. In this case, it is important to

keep blood sugar levels normal to protect mother and baby. How should pregnant women diet? • It is important to have a doctor or dietitian create a diet to avoid any nutrient deficiencies. • The diet should always be personalized. • Eat 4-5 smaller meals a day. • Eat nutrient-rich, low-calorie foods. Avoid processed sugars and empty calories. • Keep moving! Regular exercise during pregnancy is very important,

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DR VIKTOR VASS diabetologist

e.g. walking, swimming, and attending exercise and yoga classes for pregnant women. • If gestational diabetes develops, it is especially important to pay attention to carbohydrates. Instead of ‘diet’ products, stick to fresh, natural ingredients. Use natural sweeteners to replace refined sugar when baking at home. • Eating for two is a myth! It’s always quality over quantity. Even women in the normal weight category should pay attention to this.


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Questions

for the doctor – from a doctor Our intensivist Dr Kitti Farkas speaks to our obesitologist Dr Éva Bajnok. Why did you decide to specialize in obesitology? What do you like about it? I chose obesitology, or the science of obesity, because I thought that the rapid rise in obesity and the consequences it brings is one of the most important preventable health problems. In my opinion, by providing the right information and support, this process can be cost-effectively stopped and even reversed. Helping people to understand, learn and apply the

DR KITTI FARKAS intensivist

concept of moderation in order to save lives, improve health and, last but not least, to save our environment, seemed like the right challenge for me. How do you make sure your healthy lifestyle fits into your everyday life? Do you also try to involve your family? Having a healthy lifestyle has always been important to me. What I recommend to my patients, I also do myself. I eat a balanced, varied Mediterranean-style diet. Because I tend to put on weight easily, I count my calorie intake. I also fast regularly, though I don’t necessarily think that this is something that everybody should do. Exercise is also an integral part of my everyday life. Though I always love trying new things, my favorite activities are running, cycling, swimming and hiking. I always try to include my family in these activities, and most of the time I succeed. I believe in the power of teaching by setting an example and that I can easily reach and attain my goals if I have a healthy body.

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DR ÉVA BAJNOK obesitologist

How much time do you make for sports? In my opinion, sports are a kind of meditation, a form of relaxation; a tool that helps to align my mind, spirit and body. Which is why I always make time for it. On average I do at least an hour’s worth of exercise a day, a minimum of five times a week. What advice can you give to someone who is struggling with their weight? In a nutshell, they should dare to change and then stick to it, because it’s worth it in the end. I always say that hunger is a normal biological urge, and you don’t always need to try to get rid of it. If you only make a small change and maintain it, then it will make such a big difference to your sense of well-being and your self-esteem that the rest will follow. At the end of the day, we are all responsible for ourselves. I explain and teach about what you have to do and why, and then it is up to you to decide how much to change your life.


Mind and body

Why can’t I lose weight? The seven psychological pitfalls of weight loss

Do your dieting efforts always end in failure? Our psychologist Nedda Kántor describes the psychological factors that might be preventing you from reaching your goal. 3. LACK OF SELF-CONTROL You decide you want to lose weight. You start to do it, but those fleeting pleasures such as an unmissable dinner, drinking wine with friends or a mouth-watering pastry on the way home override everything else.

1. YOU DON’T REALLY WANT TO You can’t commit to losing weight because you don’t really want to, it’s just an expectation placed on you from outside: the media promotes an ideal body that you don’t identify with, or your family and friends are urging you or even forcing you to do it, or it’s a job requirement. 2. UNREALISTIC EXPECTATIONS Lose ten kilos in a week! – it’s not going to happen. If you don’t have realistic goals, you will easily lose faith and your motivation along with it.

4. YOU DON’T EAT BECAUSE YOU’RE HUNGRY You’ve confused hunger with craving. Maybe there’s some food at home that you really love. It pops into you head throughout the day, you think about it so much that when you get home you feel like you’re definitely hungry. Even if you only ate an hour ago.

NEDDA KÁNTOR psychologist

5. BONUS TREAT “I successfully finished a work project, so on the way home I popped into a pastry shop as a reward.” Or: “He didn’t write to me after our date, so now I’m going to wolf down a box of ice cream.” If you’ve gotten used to rewarding yourself with food when you are in a certain psychological state, you can easily become conditioned to this behavior, which is then hard to break from or overcome when dieting. 6. SURROUNDING PRESSURE Your friends or family are constantly asking you how the diet’s going. They always want to know how many kilos you’ve lost recently. This can cause you stress and prevent you from losing weight. 7. “DON’T DIET! A BIT OF PADDING SUITS YOU!” If you hear this all day long, it will be no surprise if you lose your motivation. These kind of opinions can be used as an excuse, which can easily lead you to fall behind in your goals.

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1000 m2 100 physicians 55 medical specialties

Rózsakert Bevásárlóközpont 1026 Budapest, Gábor Áron u. 74-78. (+36 1) 392 0505 www.rmc.hu


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