optimist orchestra in the swedish city of malmo. the composition consists of five figures. mr. kapustin, anastasia is wondering why there is a big break between the first and second. the answer is ready, alexey bakumenko answers. alexey bakumenko, please, the first figure symbolizes the thumb, so it is opposed to the rest. that's why she 's ahead. and now attention, the correct answer.

the sculptor specifically left a place in the group of musicians so that anyone could join the orchestra of optimists, look at the screen who wants to take a photo as a souvenir. 6:4 in favor of tv viewers. andrei kozlov's team is defeated, here are the names of the winners. 100 thousand rubles each were earned by irina gulyaeva from khim, a question about sun and shadow, nina andreeva from veliky novgorod, a question about handham, andrey kolesnikov from the city of livny, a question about a cult, elizaveta kozlova from novosibirsk, a question about stairs, irina staroverova from rybensk, a question about a prize oscar, finally anastasia shashkova from volgograd, a question about the optimist orchestra.

hello, this is the podcast deception of substances, with you alesya nosova, editor-in-chief of komsomolskaya pravda and famous endocrinologist zukhra pavlova. zukhra, let's talk today about obesity, about the types of obesity, because it turns out that this is not at all obvious, not to a specialist, all fat people look about the same, but it turns out that there are different reasons for this obesity. at all. what, what

's going on in the world, how big of a problem is this now? oh, a big problem, a pandemic, although vos called the 21st century the obesity epidemic, but in fact it is a pandemic, an epidemic is on ... the continent a pandemic is on all continents, unfortunately, this pandemic is progressing, that’s why we talk so much about obesity, because we can’t cope with it, the number of people is increasing, i read it here in komsomol pravda, not on the vos website yet, it wasn’t so long ago that we now have a billion obese people, two or three weeks ago at lectures on obesity , i said there are more than 700 million obese people, that’s... a billion, and this despite the fact that there are more and more ways to combat obesity, and even whole governments they are taking great measures, doctors, scientists, there is a huge amount of information propaganda in the media in a good sense, and they provide opportunities to independently balance

their diet, increase physical activity, and at the same time , the number of people is progressively increasing, unfortunately, unfortunately, among children , we used to know for sure that the children’s part is... the most slender part of people, well, they are active, they eat only when they want, like mothers don’t try, yes, yes, it was like that, now many children are overweight obesity, and that's it a big problem, because the earlier obesity begins, the more difficult it will be in adult life, and it will be more difficult to cope with it, yes, we have data that clearly demonstrates how the number of people with obesity is progressively increasing, and the most interesting thing is that it has not passed for so many years, let’s say, from the year seventy-five to 2014, and less than half a century, the number of people among women among men increased two or three times, and pay attention, in the seventy-fifth year there were practically no obese men it was, one might say, yes, yes, it is,

there is such an interesting picture floating around on the internet, a beach, a lot of people, people on the beach are undressed, in swimsuits, and it says find a fat one, and then... find a skinny one, that’s how strong it is , this gap is for physiology, for evolution, it’s not even a mix, it’s not a noticeable thing, that is, nothing has changed genetically, we understand that these are mainly external factors, external factors are nutrition, this is movement, circadian rhythms, by twenty fifth year about... obesity will be 33%, is it in our country or in the world in our russia in our country, there are general data, but the data varies greatly by

country, for example, north america and generally america and south america, there are significantly more obese and overweight people there than is acceptable. in southeast asia, that is, i don’t know, vietnam, laos, japan, in this regard, people are more structured, less complete than africa or america. we are on this list, thank god, not in first place, but there are such interesting statistics for post-soviet countries, and there we differ, women in our in second place after one of the baltic countries, and men in sixth, in... in last place, in my opinion, there are nineteenth, twentieth, i don’t remember, and among women among men tajikistan, but one might get the impression that what the more economically developed this country is, the more obese people there are, now trends are changing and in many countries, say, with less

developed economies, the number of overweight people is increasing progressively, this is due to what products are becoming available to everyone. adipose tissue, although it all depends on age, on the initial condition, of course, on genetic factors, but with all this, if you pay attention to a woman of reproductive age, someone with a guitar figure, yes, then this is just a woman with such good hips , with good mammary

glands, that is, the subcutaneous fat layer predominates over the visceral one, over the one in the abdomen, or on the abdomen, and this is a healthier state, therefore , reproductive age with a certain excess of adipose tissue mainly in the subcutaneous layer - this is a healthy woman who is reproductive, nature is very puzzled that everything will be fine with her, because... the most important thing for nature is reproduction. zukhra, you said that in 1930 there will be 30% of men, unfortunately, 33% - according to who data, these are the forecasts, what is their dynamics? unfortunately, it’s the same, there will be more of them, because there are already about so many of them now, we have dynamics, i also really like this information on our districts, we won’t present it here, it’s quite difficult to figure it out, but the point is that we have very different dynamics in different federal districts, minimal ones. the number of obese and overweight people in the north caucasus district, in the siberian

district, for example, is the largest number, and here there is such a very important factor that also needs to be taken into account, where a person lives in a warm place, well, he potentially moves more and eats less fatty foods food that helps you warm up, yes, but where it’s cold, people spend a lot of time moving less, but you can’t go skiing or. well of course, well, frankly speaking, he is practically in hibernation in front of the tv, yes practically, yes, so this is also one of the factors that must be taken into account. there is an interesting scientific observation that people who have started to play sports intensively, but as i understand it, these are people who have never exercised before. after some time, and maybe even very quickly, they stop doing household chores very intensively, at least on the same day, because they, apparently, secretly think that since i tensed up in hall, then, accordingly, at home, why should i

wash the floor there, i have already fulfilled my norms of physical activity and so on, so the scientists made an interesting conclusion that it turns out that this is absolutely false, but it is impossible to replace household chores with physical activity, i agree, if the question arises about the fact that you need to lose weight means you need to add, and not replace, of course, but consumption. it is necessary to increase, in this situation it would be great to reduce the income, it turns out that where it is colder, there people are in greater danger from the point of view obesity, yes, well, including, because - just remember, in the summer in the heat of eating a sandwich with butter, and with caviar, for example, you want much less or with cheese than in winter, when this food, it’s more acceptable, you want this fatty, warm, hot one, but because you need to warm up. well, it’s cold, this is not the most important thing, but this also has its place, you and i talked about timosha,

by the way, patients sometimes come and say: i’m timosha, timosha’s manul, let me remind you that - in the fall, in the fall timosha’s manul dialed and went to after fattening, he gained twice as much weight in order to survive the winter normally, but by the way, now timosha has lost weight, lost weight, and yes, he spent everything he saved up over the winter, and he is ready for spring, for active events. in the winter they gain, or even by winter they also begin to fatten, and in the summer they shed, they shed very actively, and often this is associated with dachas, with vegetable gardens, but this is generally bad or acceptable, it’s almost such a natural move, if only it’s plus or minus 2- 3 kg, when it comes to some big jumps, this is of course bad, nothing there is no good in this, and i often... noted before in the clinic that in the summer practically patients with type 2 diabetes simply

disappear, well, they almost never exist, they prescribed themselves more medications in advance so that they could go to the dacha in the summer, and that’s not only the fact that they were far from the clinic, they were much less worried about the problems there with sugar, because at this dacha there is constant activity, there is no time for sugar, and sugar does not bother him, he knows that the person is busy, he is active in everything good with weight gain. and the corresponding ones with sugars are also fine, if all other recommendations are followed, it would be good here, probably, when we talk about obesity, here i would really like to say what in general is the main mechanism for the accumulation of adipose tissue, if we take it quite literally simply, then remembering our great compatriot lomanosov, who, together with lovo azi, discovered the law of conservation of mass, as much comes... as much remains, well, in a simple statement, then obesity is just about this:

if a person eats 2,000 calories and spends only 1,500 calories together with physical activity and some basic needs, for the operation of the mechanism, then 500 kilocalories will not go anywhere, they will be stored in adipose tissue, this is how our physiology works, because a person has not always had the opportunity to have a sufficient amount of food, well, by the way, yes zukhra, here i wanted. put emphasis, let's still call it, well, some kind of favorable factor, in fact, this is cool, this is great, this is what saves us, what our body always saves, yes, yes, this, this, this must be taken into account. it will be very difficult to retrain him, because yes, it’s not necessary , well, god forbid, it’s a cold winter, but now the climate seems to be getting warmer, yes, we need climate changes again, but despite all this, we still have real frosts , and i would really like there to be a balance, that is, this is how much we spend, this is how much we should consume, and what

is happening here, firstly, food has become very affordable, even in my childhood everything was a little bit different to another. now she is absolutely everywhere, not just at home at your table, well, just at every step, and it changes a little in its balance, more fat, more simple carbohydrates, all this refined stuff, unfortunately , the phenomenon of sarcopenia is actively spreading in our country , sarcopine is when muscle tissue is replaced by fatty tissue and a person is a little jelly-like, he’s kind of... slender, but he doesn’t have enough muscle mass, and this is, well, practically the basis of our health, well functioning and sufficient in volume, and not only fat, but also muscle, and first of all, probably, muscle tissue, although we also need to emphasize when there is little fat tissue, it is not enough, it is in short supply, there will be no less problems, about the

same, they will be a little different , but it will also be a rather sick organism with a high mass. any adverse risks, just like when a person has a lot of fatty tissue, so the balance has changed, the regulations have changed, now very often people eat at night and late in the evening, because they they go to bed in the morning, yes, this factor makes its changes, and we are all hypodynamic, we sit here, we take the elevator up, we ride in the car, we are in a horizontal position in front of the tv, when we go to bed, activity has greatly decreased, even something so simple , like walking, so, despite the fact that such a basic mechanism is associated with a greater influx of energy resources than consumption, there are a lot of features, we have such a classification, we won’t go into its subtleties, it’s professional it’s quite complicated, but so that it’s

clear to everyone, there are two big divisions, primary, elemental, the so-called... here’s the primary, most often people come across such pictures, obesity in the shape of an apple , obesity in the shape of a pear, here in the shape of a pear - this is when our lower part is so dense, it is typical for women, obesity, which is abdominal, is more typical for men, but this does not mean that a woman cannot have...

one division is elemental and symptomatic, there may be endocrine, no one writes anything anymore, so this is what we often hear a patient say: i have something with my hormones, sometimes something with hormones really contributes to the development of obesity, and the endocrinologist here must remove the main cause to help the person get rid of, but there will still be overeating. or we often hear the following statement: after covid or during covid, they gave me injections with some kind of hormone, and after that i gained a lot. yes, most often this hormone is a glucorticoid hormone, dexsomizone, which, in fact, saved a life, saved a person , yes, so they saved a person, there was no time for any endocrine disorders that followed,

it was necessary to save a person, they saved him, but what do those same glucocorticoids do? they increase the level of the main hunger hormone, they often talk about it now, grillin, it even has a name, you can feel that it is very powerful, this grillin, and it causes an increase in receptors for hormones that stimulate our appetite, and a person really wants to eat uncontrollably , it’s very difficult to explain to him that he doesn’t need to eat, he won’t hear, won’t understand, all his activities, all thoughts about food, against this background it’s easy... to gain excess weight, so yes, there are such options, but there are also medicinal features, sometimes we drink some kind of drug and note that we became constantly hungry, this has never happened before. yes, when we prescribe certain medications and we know that there will be such a situation, without these medications there is no way, some special important story that needs

to be overcome with the help of these medications. we say, you know, you will improve appetite, please try to limit such and such high-calorie foods so that this set is less than it can be, and in this way we will help the patient for the period that is required to take these medications for... bruno kall i learned a lot from volgo schäubli as his patron. war is always a battle of propaganda. this is nothing new, we just need to be more

decisive and take the lead. is he playing his own behind-the-scenes game? russia is primarily concerned about the phenomenon of war to the western world. 12.00 german troops are involved in these exercises, which are taking place near our borders. they are preparing for the start of hostilities. that's why bruno kahl went there. bruno kahl and that says it all. dolls of the heir tutti. tomorrow on the first. zavali semyon nikolaevich. here's the thing, alexey. alexey, this is the first time you’ve called me by name, it’s not good. do you have a partner? no, i work alone. see you tonight? i can’t, i have another night at night, sorry. are you serious? karubin? don’t sleep, what is this, now you’ll find out, a taxi is under

cover, premiere, tomorrow, after the program , time, as the chairman of the jury i feel out of place, perhaps all the most famous actors and directors in the world were sitting at this table, i would like to have lunch.

say that you like my hat, you don’t have a hat, i would like to say in the future that i did everything i could in my life, this is a podcast deception of substances, we are talking about obesity, with me is zukhra pavlova, a famous doctor- endocrinologist and i olesya. editor-in-chief of komsomolskaya pravda, another such, such a frequent statement that we we hear from friends, from patients, we have such genetics: my mother, grandmother, everyone was overweight and i have no chance of getting rid of it, in such situations we need to figure it out, well , there is such a thing as monogenic, that is, when there is a gene mutation, there, in fact , everything is clear and so, look at a person, it won’t just be obesity, there will also be specific factors and... here it’s really extremely difficult to avoid weight gain, but in the majority, in 95% of cases, when a person has overweight, that's right called polymorphisms, these

are predispositions to certain changes, and this is not a sentence at all, here a person should or can know about it, now it is fashionable to make genetic passports, and even there everything is defined, defined and suggested, well, zukhra, well, isn't that just family habits? now let’s get to this, so there are predispositions, they are not a death sentence, an informed person knows this about himself and simply, well, let’s say, monitors his diet more closely, and sometimes under the guise of genetics those the most family habits, it’s so accepted, it’s so accepted, yes, when i tell, say, my friend, there’s no need to piss on the onion, these are additional calories, these same end products of glycation, which we have talked about many times, it will be much worse anyway. ..

i know, my relatives are the same, yes, yes, we are also rich in culinary traditions, yes, yes, yes, yes, yes, that’s why, when people say, olivier on the new year’s table should be with mayonnaise, i i say, well, god bless him, once a year, yes, no disaster will happen, but if you regularly eat like this, it will definitely have negative consequences, so as an exclusive, maintaining family traditions, once a year for health, yeah. you’ll even feel certain things that you haven’t felt before, figuratively speaking, the cleansed receptors of the tongue, they’ll immediately give you a clear understanding of everything, it will seem tastier, no, well, of course, everyone will react in their own way, most likely, but there was such an experiment me in the family, once my relatives decided to make a conspiracy and went to fast food restaurant, and they wanted

to keep it a little secret, eat something that once seemed delicious, so they came, laughed, brought it with them, so to speak, with irrefutable evidence, and i was surprised what it was, they said: we let's go, we wanted to, as they say, quietly eat up, have a blast, but it turned out to be not as tasty as it was before, that's why sometimes it works like that, when you haven't eaten it all for a long time, you don't understand why you liked it, yes, very much there is a lot of talk around how to determine obesity, yes, what is it? obesity, according to what classical criteria do we make such a diagnosis, well, there is a well-known body mass index, this is a calculated indicator of the ratio of body weight, well, kilograms and height, that is , we divide body weight by height squared, we get a value depending on we understand the resulting value to be underweight; anything less than eighteen is

normal body weight. up to 25 is excess body weight from 25 to 29, well, figuratively speaking from 30, from thirty to five units is obesity of one degree or another, depending on that is, zukhra, you considered seventh degree obesity, that is, 40-45, you got the seventh degree, and listen, and of course you are an unhappy person. yes, but this person i can already say, he has already lost 18 kg, we started not so long ago, and well, the normal, normal period of time for this is over what period, in my opinion, it seems to me, almost less than a month, yes it’s passed, no , no, no, you definitely can’t lose more than 18 kg in a month, because it’s dangerous, it has its consequences, the weight needs to be lost gradually,

classic, such a step is 4 kg per month, but when we use certain medications, this step increases a little, because we reduce the risks of those troubles that threaten people who quickly lose weight, so there is no need to rush, remember? no, well, zuhra, there are a lot of women who cannot lose 3 kg all their lives, there are such women, of course, but in order to start losing weight, we will talk about this in another program, well, just briefly looking ahead. subtract 500 from your today's coloring and you'll start lose weight, yes, give up two sandwiches a day, the weight will begin to decrease, well, it all depends on what the initial and weight is, well, different things, but body mass index is the parameter that helps us establish obesity , degree of obesity, calculate, let’s say, cardiovascular risks, and so on and so forth.

will not show, it will show that a person is of absolutely normal weight, or even underweight or underweight can show, and this criterion can lead us astray, or if in front of you is a bodybuilder, yes, you don’t even need to take a bodybuilder, if you take nikolai voloev, and such a famous one... the athlete is already a political figure, his body mass index also has a good degree of obesity, but the person has a large muscle mass, and he has absolutely no excess fat tissue , in any case, i don’t know, i haven’t seen nikolai for a long time, i hope everything is fine with him and he has good health, so if in front of you is a person with a lot of muscle mass, the body mass index may show some degree of obesity, but he is overweight not due to fat, but due to muscles, therefore...

this is a somewhat crafty indicator, a parameter, but there is, but there is a more objective one, we can determine the waist circumference, but the waist circumference is a more objective criterion. there are certain ethnic characteristics, for russia, for europe, there are certain criteria: for men the circumferential steel should be less than 94 cm, and for women less than eighty, but this is not the case everywhere, the americans have different criteria, for men they have 102 cm, and women have 88, but if and why is this objectively so or just say that?

this is the only nation whose waist circumference should be smaller, normal, than that of women, for men it is 85, and for women 90, and this is based on some criteria, it is clear that with our own eyes we can understand, yes, that a person is overweight, but waist circumference will not always help us just as much as body mass index if we have a person with arcopenic obesity. and here only bioimpedance analysis of body composition comes to the rescue, or denstometry - this is the most objective gold standard in determining a composition of the body, but you won’t send a person for an x-ray every time to determine his body composition, for example, when we

lose weight, this analysis is carried out very often, we look at what we are losing, because a person can lose in the process both fat tissue and muscle, going for an x-ray every time is not very good. therefore , a fairly objective method is bioimpedance analysis of body composition, it does not have any such difficulties, it is technically simple, does not cause harm to the body, and is not financially expensive, but what is it all about? based, we use it so often, this name, everything is very simple, even if you think about it, understand the meaning of the name of the bioimpedan method. this is resistance, biobiological resistance, that is , a low-intensity current passes through the human body, it does not harm the person in any way, and when faced with the resistance of various tissues, bone, muscle, fat, the apparatus calculates the volume of these tissues and liquid, by the way,

in fact, it gives out such a a picture in the form of tablets of beautiful exact parameters there, we know how many kilograms of muscle fat fabric, how many kilograms, well, you can translate. in liters of water in the body as a percentage , this percentage ratio is very important for us, because sometimes a person comes and says: oh, doctor, i got such a wonderful result of bioimpedances, i say, and what’s so wonderful about it, he says: i i’m 70% muscle, i say, what are you, what are you, show me, american, judging by everything, not japanese, and so little by little i begin to explain. person that this is impossible in principle, that ’s why we have diagnostic methods, they objective kiev propagandists distorted bulgakov’s biography so much that they instantly turned him into an enemy of ukraine. since kiev is the mother of russian cities, these crazy

people will abandon kiev. the sharikovs gave birth to offspring, now they are taking revenge on bulgakov. now he has been declared a ukrainophobe and rightly so, of course, because they have finally started reading books. and also exclusive. in our studio there are fighters who have won trophies. german marder, outdated equipment, sent here as a write-off, given to the ukronazis and the tale of how ukrainian civilization emerged in the second millennium bc. antifake, premiere, tomorrow on the first. this is my friend alyosha. just recently his arm was completely paralyzed and did not work, but now? and now i can move it in different ways, and the kids at school love it. like this, of course, now in all directions, a unique development of russian scientists, exoskeletons, and not only in the program, life is great, tomorrow is the first, we are again

together with those who love good music with all their souls, lilac fog, volodya, well me you hooked me so much that i swam. singing swing in russian is another task, you know, the gears don’t always match, you were still a boss. everything is there, three chords, a new season from

april 14 on the first, the deception of substances podcast is with you again, we are talking today about the causes of obesity, in the studio the editor-in-chief of komsomolskaya pravda olesya nosova, and i am an endocrinologist zuhra pavlova. zukhra, let’s talk a little more about bioimpedance, what does it mean, it’s simple - poorly calibrated devices or they’re not devices at all, well, if when... a person gets these 70% of muscles, but sometimes it’s such a completely banal thing when a person stands on a platform like a scale, yes, well, that is, it’s like built-in bioimpedance devices, and this is a projection of the legs , but the legs are very different in composition from the composition of the rest of the body, that is , bioimpedance in this situation can only measure the condition of the legs, well, that is, where the muscle ratio is measured. tissue and 70% of muscles - these are definitely just legs, legs, then

the mathematical device completes the construction as best it could the whole body would look like if it were measured normally, yes, so the same, say, bioimpedance, which is particularly objective, we conducted research, compared the data with denstometry data from this gold standard of x-ray research, and the data coincided, well, almost completely, therefore, when we explain to the patient that... you have lost weight remarkably, in your opinion, but unfortunately you have lost the most valuable thing, you have lost muscle mass and water, so let us still return to those recommendations, which were given initially, you balance the food this way, and not the way you want, yes, because a person sometimes, when , let’s say, there is a decrease in appetite against the background of medications, he begins to eat something that is not so healthy, because he doesn’t i really want to eat, how much is delicious, well, it goes without saying, it’s clear that if you need

to eat few calories, then you need to spend them in a healthy way, it’s better to eat something tasty, yes, due to this tasty thing, fatty tissue is lost in smaller quantities, and muscular it runs away, oh, oh-oh-oh, how you can see it very significantly on the scales, the muscles are heavy, and i always tell the patient, please tell me that you see more changes in the numbers on the scales, or your clothes become big, so if the patient says: no od... this is the second time i’ve changed things there, this is a very good option, the fact that adipose tissue is voluminous, a decrease in size is a good indicator, even if there isn’t very much on the scale, it’s important for us not to see the numbers, yes, they also of course important, but not a priority, it is important for us that body composition has become physiological, so that there is as much fat as needed, by the way, as much as needed in men is up to 24% of normal body composition, and in women up to 31%. and naturally a sufficient amount of muscle mass, then everything is ideal, this

is the ratio, the balance, it is a priority, not so much the scales, but the ratios, because then the person will be healthy, which means that in terms of diagnostics we talked about the methods, but i would really like so that certain parameters are also included in this diagnosis, i often hear, we will not say which ones tests need to be taken, yes, because... despite the fact that they are largely repeated from patient to patient, each patient has his own characteristics, when the doctor examines the patient, he sees certain signs of certain diseases or conditions, and will add something else, so when they say: what should i hand over? a patient calls, let’s say, wants to come for an appointment, says, what should i give? and i always tell him: i’ll examine you first, interview you, then i’ll prescribe... examinations, so, and often i hear from my colleagues when they

they say that it is pointless to determine some parameters there, they don’t say anything, well, for example, there is such a hormone leptin, when it was discovered in the last century, scientists had the feeling that a revolution had taken place, now we are using this leptin, its analogues , we will cure everyone of this obesity, this is a satiety hormone, but it turned out that when they gave... laboratory animals were injected with this hormone, some actually lost weight, and some did not react to it at all, meaning, they simply did not want to eat, they felt themselves all the time. well-fed yes, for some it really worked like that, there was no increased appetite, so the rats and other animals lost weight, and some of the rats did not lose weight and even gained it, so, in fact, this hormone, like insulin, is such an indicator of volume adipose tissue,

that is, if you and i see an overweight person with some kind of morbid degree of obesity, we already understand that he will have a lot of insulin or a lot of liptin. and the worst thing is that this hormone is very often combined resistance develops, sustainability, they cannot act, leptin cannot tell the brain that there is enough food, there is no need to eat more, insulin in the same way cannot ensure the passage of glucose into the cell, saturate this cell and give the hunger centers and other substances there a signal: stop , we no longer need to eat, and due to this resistance, there is a lot of glucose in the blood, insulin... a lot in the blood, a person is hungry, forever, wants to eat all the time, up to three bitches, literally, especially in the evening, when the activity is the same insulin is as high as possible, sometimes, to show the patient what is happening in his body, this is not such a big expense, but when you show how much the

same insulin is, you can not only calculate insulin resistance, but also explain, we have such a problem, it’s fraught with something, it’s impossible to overcome it... it’s impossible to control yourself with effort, sometimes it’s possible to show this in medicine, there’s even one on anatomy exams to show this part, you have to show, for the patient this visual the image is very sobering, it defines such a boundary, now it’s like this, and if you take another step in the same direction, it will be even worse, there will be diabetes, there will be cardiovascular pathologies, and so on. and the like, i generally draw obesity as a sun, but i have such a positive approach, no, yes, why not, yes, why bother anyway, so i draw this sun in order to show that the basis of many diseases is precisely obesity, the sun has rays, one of the rays is

cardiovascular diseases, except an obese person will have carbohydrate disorders, prediabetes, and there will be increased fasting glycemia. or after eating , diabetes itself and some other troubles, this will be a violation of the lipid cholesterol profile, and our fats are in the wrong balance, and this will contribute to atherosclerosis, again, cardiovascular diseases, this is an imbalance of sex hormones, androgen deficiency, it will be followed by erectile dysfunction, reproductive dysfunction, and so on, in women it is polycystic ovary syndrome, which is very... often develops against the background of overweight or obesity, this is a disorder, you and i often discussed this at one time, of purine metabolism, that same gout, yes, hyperuricemia, high levels of uric acid, usually against the background of fatty degeneration of the liver, is now raging, this disease is progressing,

hepatosis, non-alcoholic fatty liver disease and there is this very high uric acid, followed by arthritis, arthrosis, urolithiasis... this radiance, it will only increase every year unfortunately, it’s not possible to illuminate a person’s life with health, on the contrary, therefore, when we start like this, literally, as you know, in a rusty pipe, from which there is a leak on all sides , to close individual holes, this is of course a necessary measure, but initially we need to fight obesity, let’s remove this disk sunny everything else will fall apart like a house of cards, well, zukhra was very... interesting, thank you very much, you had a podcast with you about deception of substances. my name is olesya nosova, i am the editor-in-chief of komsomolskaya pravda, the famous endocrinologist doctor was with me, zukhra pavlova.