nabadnikova, we are discussing madame bavari, the famous novel by gustov flaubert with oksana bondarenko, director of the moscow transport museum , an art critic, and alexandra rivenko, the most beautiful actress of our time, the most beautiful madame bavari, the most beautiful madame bavari. oksana, as an expert on french society, please tell me, here is emma bavari and her husband, charles bavari, who are they? is this average? class or what, they are rich, they are poor, it is difficult to understand from our point of view, because it seems that doctor, it seems that they have servants, they even have some kind of estate, which they secretly sell, uh, at the same time there they go on some kind of, well, relatively speaking, minibus, yes, she goes to rouen on this carriage, where everyone is crowded, well, this is our minibus, yes, or is there some kind of wooden shoes tied up there so that these heads can knock?

yes, and her mother-in-law scolds her for the fact that the upholstery of the chairs, two francs each, the material, 2 francs per meter - this is very expensive, it should be a maximum of 10 sous, only the the eldest member of the family, and a lot of armchairs - it’s too luxurious, new curtains are too luxurious, in general it’s strange, well, that is, i want to somehow correlate this with our reality, that is, what class do they belong to?

charles, this is such pettiness in the details of the same seller of cunning outfits for flaubert and the same charles, yes, that is, for flaubert, although he seems to be a doctor, for flaubert this is just a vivid description of the purely material mishchansky society or the established context of philistinism, in which...

which is already the apotheos of vulgarity, at the funeral of father charles, she comes in the most luxurious dress in our performance, well, it looks like emma, ​​it seems to me that this is a fairly accurate detail found by the director, that is, emma is also the fruit of its own - its own context , a revolution, this is a kind of revolution, as if rooted, yes, it violates the etiquette of adultery.

“we can, we can, just study music, stay, go to rouen, take lessons, and flaubert, when he says madame bavarie is me, you agree that he succeeded...” penetrate into female psychology, we believe emma and feel her, when we read a novel, it seems to me that when we generally pick up a book, then we are in one way or another the proposed circumstances, as they say in our theater, we are immersed in them and also become we believe that we are part of this story, of course, because we get used to the narrative style, to the language, we ourselves become part of the book that we read.

with great torment, but despite the fact that he was accused of immorality, and of some kind of vulgarity, today he is a flaubert, today flaubert - this is a classic of french literature, on a par with balzac, on a par with balzac, yes,

absolutely, the same subtle player on male and female emotions, and such a great specialist in the relations between men and women of that era and that time. well, i think that this novel will be useful for everyone to read, this was a must-read podcast, i’m glaina batnikova, today we discussed gustov’s novel flaubert madame bavari, the famous scandalous one with oksana bondarenko, director of the moscow transport museum, francophone, the most beautiful actress alexandra rivenko, who played the role of mrs. bavaria in the theater, and i will perform, i will perform, i will perform. you can find all must-read podcast episodes on the website of the first channel 1tv.ru.

hello, this is the podcast deception of substances, with you olesya nosova, editor-in-chief of komsomolskaya pravda, and a famous endocrinologist. zukhra, let's talk today about obesity, about types of obesity, because it turns out that this is not at all obvious to a non-specialist, all fat people look about the same, but it turns out there are different reasons for this obesity. in general, what, what is happening in the world, how big 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 a pandemic on one continent. on all continents, unfortunately, this pandemic is progressing, which is why we talk so much about obesity, because we cannot cope with it, the number of people is increasing, i read it here in komsomol pravda, not on the who website also, about the fact that we have

a billion obese people, not so long ago, 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 , yes, and the whole government is taking great measures, doctors, scientists, there is a huge amount of information propaganda going on in the media in a good sense, yes. an even bigger problem, because the earlier obesity begins, the more difficult it will be in adult life;

cope with this. yes, we have data that clearly demonstrates how the number of obese people is progressively increasing, and the most interesting thing is that not many years have passed, let’s say, from 1975 to 2014, and less than half a century, the number of people among women among men have increased two or three times, and pay attention: what was not the case, you can say, yes, yes, it is, there is such an interesting picture floating around on the internet, and the beach, a lot of people, people on the beach are undressed, in swimsuits, and it says find the complete one, but then some year 2000, the same beach, the surroundings have changed a little, the same rosettes and people, the sun is invisible, it is written, find the bad one, that’s how strong it is, this period is for physiology, for evolution.

list, thank god, not in first place, but there are such interesting statistics on

post-soviet countries, and there we differ, women are in second place after one of the baltic countries, and men are in sixth, in last place, according to -i think tajikistan is nineteenth, twentieth, i don’t remember, and among women among men, but maybe one gets the impression that the more economically developed a country is, the more people there are with regret, but now the trend is changing and in many countries, say, with less developed economies, the number of overweight people is increasing progressively, this is due to what products become available for everyone due to cheap food, yes, which, as a rule, is not physiological, not very good, yeah, well, what’s interesting is that all over the world, that in russia, women have a higher percentage of obese people, that’s it. this is because of what, this is not because women, well, in principle, yes,

they eat more, but because there are also hormonal characteristics, we have more estrogens, and estrogens inherently contribute more to the accumulation of adipose tissue, although it all depends on age, on the initial state, of course, on genetic factors, but with all this, if you pay attention to a woman of reproductive age, with a figure... yes, then this is just a woman with such good hips, with good mammary glands, that is, the subcutaneous fat layer prevails over the visceral one, over the one in the stomach, yes or on the stomach, and this a healthier state, therefore, a woman of reproductive age with a certain excess of adipose tissue mainly in the subcutaneous layer is a healthy woman who is reproductive, nature is very concerned that everything will be fine with her, because for nature the most important thing is that

a person lives in a warm place, well he potentially moves more and eats less fatty foods, which helps to warm up, yes, and where it’s cold, people spend a lot of time moving less, but you can’t go skiing or take a walk there at -30 or -20, well, frankly speaking, he is practically in hibernation in front of the tv, practically,

that’s why this is also one of the factors that must be taken into account, there is an interesting scientific observation that... people who began to actively engage in sports, well, as i understand it, these are the people who have never worked out 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 subtly believe that once i i tensed up in the gym, then 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 wrong, you can’t replace household chores with physical activity, i agree , if the question arises that you need to lose weight, then it means you need to add, and not replace, of course, yes, consumption needs to be increased, in this situation it would be great to also reduce the income, it turns out that where it is colder, there are more people dangers with

from the point of view of obesity, well, including, because remember in the summer... you want to eat a sandwich with butter and caviar, for example, much less or with cheese than in winter, when this food is more acceptable, you want this fatty, warm, hot, because you need to warm up, well, it’s cold, this is not the most important thing, but this also has its place, we 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 man's man, dialed it, went to get fat, he i gained twice as much weight in order to survive the winter, as it were, normal, 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, and so on, in general, he returned to his previous form, yes, this is also typical for many people, in the winter they gain weight, or even go to

the fryer in the winter, and in the summer they lose it, they lose it very actively, and this is often connected. with dachas, with vegetable gardens, but this is generally bad or acceptable, it’s almost such a natural move, unless it’s plus or minus 2-3 kg, when it comes to some big jumps, this is of course bad, there’s nothing good about it, and i often noted before in the clinic that in the summer practically patients with type 2 diabetes simply disappear, they almost never exist, they prescribed themselves more medications in advance so that they could go to the dacha in the summer, and the point is not only that they would...

the main mechanism for gaining adipose tissue, if we take it quite literally, then remembering our great compatriot lomanosov, who, together with lovo azi, discovered the law of conservation of mass, as much comes as remains, well, in a simple statement, then obesity is just about this: if a person eats 200 calories, he spends only 1,500 kilocalories along with physical activity and some basic needs, for the operation of the mechanism, then they spend 500 kilocalories will not go anywhere, they will be stored in adipose tissue, this is how our physiology works, because a person did not always have the opportunity to have a sufficient amount of food, well , by the way, yes zukhra, here i would like to 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 accumulates, yes, yes, this is this, this must be taken into account, it will be very... difficult to retrain it , because yes, it’s not necessary, well, god forbid, it’s a cold winter, well, now it’s true that the climate seems to be getting warmer, yes, yes, yes, again, climate changes, 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 owe consume, and what’s happening here, firstly, food has become very accessible, even in my childhood everything was a little different, now... it’s absolutely everywhere, not just at home at your table, well, just like that at every step, it changes a little in its balance, more fat, more. simple carbohydrates , all of this refined stuff, unfortunately , the phenomenon of sarcopenia is actively spreading in our country, sarcopenia is when muscle

tissue is replaced by fatty tissue and a person is a little veiny, he seems to be slim, but he does not have enough muscle mass, and this is practically the basis of our health, well -functioning and sufficient in volume, not only fat, but also muscle and, above all, probably muscle tissue... tissue, although that too we need to emphasize when there is little adipose 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 lot of high all sorts of unfavorable risks, for sure just like when a person has a lot of fatty tissue, the balance has changed, the regulations have changed, now very often people eat at night and late in the evening, because 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, 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 large the arrival of energy resources than consumption has a lot of features. we have such a classification, we won’t go into its subtleties, it’s professionally quite complicated, but so that everyone understands, there are two big divisions: primary, elementary, so-called obesity or exogenous-constitutional, it’s more complicated, so primary elementary symptomatic, this is the primary one, most often people encounter such pictures, obesity. obesity in the shape of a pear, here in the shape of a pear - this is when our lower part is larger 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 an abdominal form of obesity, it is just more typical for men, and there are mixed ones, both abdominal and pear-shaped, it happens when these are already very large kilograms, yes, 200-300, there is already a lot of everything everywhere. there may be an endocrine problem, but we often hear a patient say: there’s something wrong with my hormones, sometimes something with hormones actually contributes to the development of obesity, and the endocrinologist here must remove the main

reason to help the person get rid of it, but there will still be overeating, or we often hear such a statement, after covid or during covid, they gave me injections with some kind of hormone, and after that i gained a lot, and more often in total, this hormone is... thyroid hormone, dexsometosone, which actually saved a person’s life, but that’s how they saved a person, there was no time for any endocrine disorders, subsequent ones, it was necessary to save the person, they saved him, but what do they do the same glucocorticoids, 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. hormones that stimulate our appetite, and a person really wants to eat uncontrollably, it is very difficult to explain to him that there is no need to eat, he will not hear, will not understand, all his activities,

all thoughts about food, against this background it is easy to gain excess weight, so yes, there are such options, but there are also medicinal ones features, sometimes we take some kind of drug and notice that we have become constantly hungry, this has never happened before, yes, when we ... prescribe certain medications and know that such a situation will happen, without these medications there is no way - a particularly important story that needs to be overcome with the help of these medications. we say: you know, your appetite will increase, please try to limit such and such high-calorie foods so that this set is less than it can be, and so in this way, we will help the patient to gain a smaller amount for the period that he needs to take these medications, that is, here... the reasons are very different. this is a podcast deception of substances, we are talking about obesity, with me is zukhra pavlova, a famous endocrinologist,

and i am olesya nosova, editor-in-chief. it is difficult to avoid weight gain, but in the majority, in 95% of cases, when a person is overweight, these are so-called polymorphisms, these are predispositions, and to certain changes, and this is not a sentence at all, here a person should or can to know about this, now it is fashionable to make genetic passports, and there everything is defined, defined and suggested, well , zuhra, well, isn’t it not family habits

, including, now we’ll get to that. 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 same family habits, that’s how it is, that’s how it’s accepted, yes, when i say , for example, to your friend, you don’t need to piss on the onion, these are additional calories, these same end products of glazing, which we have talked about many times, it will be very tasty anyway if... olive on the new year's table should be with mayonnaise, i say, well, god bless him, once a year yes there won’t be a catastrophe, but if

you... but there was such an experiment in my family, once my relatives decided to make a conspiracy: they went to a fast food restaurant, and they wanted to be a little secret , eat something that they once thought was delicious, so they came, laughed, brought with them this is already, so to speak, with irrefutable evidence, and i was surprised what it was, they said: we went there, 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. this is how it works when you don’t eat it all for a long time, and you don’t understand why you liked it, yes, there is a lot of talk around how to define obesity, yes, what is obesity, what are the classical criteria for making such a diagnosis, well, there is the well-known body mass index is a calculated indicator the ratio of body weight, well, kilograms and height, that is, we divide body weight by height squared. we get the value, depending on the obtained value we understand that this is a deficiency of body weight, everything that is less than 18 is normal body weight, and up to 25 is overweight from 25 to 29, well, figuratively speaking, from 30, from thirty five units each is obesity of one degree or another , depending on it. zukhra, you thought like this:

seventh degree obesity, that is, 40-45, you got the seventh degree, yes, listen, and an unhappy person, of course, 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 period, in my opinion, it seems to me, is almost less than a month, yes passed, no, no, no, definitely more. you can’t lose it in a month, because it’s dangerous, it has its consequences, you need to lose weight gradually, the classic, classic step is 4 kg per month, but when we use certain medications, this step increases a little, because we we reduce risks those troubles that threaten people who quickly lose weight, so there is no

need to rush, remember, there are plenty. today's color is 500 and you will start losing weight by eating two sandwiches, but give up two sandwiches a day, the weight will begin to decrease , well, it all depends on what your initial weight is, and different things, but body mass index is the parameter that we need helps to establish obesity, the degree of obesity, calculate, let's say, cardiovascular risks, and so on and so forth, but not itself... it won't show, it will show that a person the body can

show absolutely normal weight or even underweight or underweight, and this criterion can lead us astray, or if you have a bodybuilder in front of you, yes, you don’t even need to take a bodybuilder, if you take nikolai voloev, but such a famous athlete of ours. is already a political figure, his body mass index also has a good degree of obesity, but the man has a lot of muscle mass, and he has absolutely no excess fatty tissue, in any case, i don’t know, i haven’t seen nikolai for a long time, i hope he has everything is fine, good health to him. so, if you have a person in front of you with a lot of muscle mass, the body mass index may show some degree of obesity, but his excess is not due to fat, but due to muscles, so there are several such onions. a more objective criterion, there are certain ethnic characteristics, here 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, they... . for men 102 cm, and for women 88, but if why is this objectively so or just say so, well, if you look at the american population, that’s why they are so surprised when they look at our video from the patriarch’s ponds, well, that is, these are such giveaways, but a little, but somehow they are, it seems to me that they are helping their citizens, because they themselves are slimmer, yes, so that at least some part is slimmer. because the same americans are mostly immigrants from europe, and at one time their descendants are already here , if you have a japanese or a japanese woman in front of you, then here other criteria, the japanese are the only nation whose waist circumference should be

less normal than that of women, for men it is 85, and for women 90, and this is according to 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 in the same way 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 dynammetry - this is the most objective gold standard in determining a body composition, but you won’t send a person to the ring every time to determine his body composition, for example, when we lose this weight - the analysis is carried out very often, we look at what we are losing, because a person can lose in the process like fat tissue , and muscle, every time going for an x-ray is not very good, therefore, a fairly objective method is bioimpedance

analysis of body composition, it does not have any such difficulties, the technical is simple, does not cause harm to the body, and is not expensive financially, but what is it based on? we use it so often, this name, everything is very simple, even if you think about it, understand the meaning, the name of the bioimpedance method, impedance in english is resistance, biobiological resistance, that is , a low- intensity current passes through the human body, it does not harm the person in any way, encountering resistance from various tissues, bone, muscle, fat, the apparatus calculates the volume of these tissues and fluid, by the way, in fact, it gives out this... picture in the form of beautiful tablets there exact parameters, we know how many kilograms of muscle and fat tissue, how many kilograms can be converted into liters of water in the body, as a percentage,

this percentage ratio is very important to us, because sometimes a person comes and says: oh, doctor, i got a wonderful one the result of bioimpedance, i say: yes, and what’s so wonderful about it, he says: i am 70% muscle. i say that you, that you, show me a nice one, apparently, it’s definitely not japanese, and so i slowly begin explain to the person what it is in principle. are impossible, that’s why we have diagnostic methods, they are objective, 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, well, 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. well, sometimes it’s so completely banal

a thing when a person stands on a platform like a scale, yes, well, that is, it’s like a built-in bioimpedance of some 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, the bioimpedance in this situation can only measure the condition of the legs, well, that is, where they measure the ratio of muscle fat tissue and 70% muscle, this is exactly the same. legs - legs, then mathematically the device completes what the whole body could look like if it were measured normally, yes, so right there, let’s say, bioimpedance, which is particularly objective, we conducted research, compared the data with densametry data from this gold standard x-ray study, and the data coincided, well, almost completely, so when we explain to the patient that you have lost weight remarkably in... 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 the recommendations that were given initially, this is how you balance your food, and not the way you want, yes, because a person sometimes, when, let’s say, there is a decrease in appetite due to medications, he begins to eat not so much healthy food, because he doesn’t really want to eat, but rather tasty food, well, that goes without saying, it’s understandable , if there are few calories to... eat, then why should they be spent on something useful, it’s better to eat something tasty, yes, due to this tasty thing, the fatty tissue leaves in smaller quantities, and the muscle tissue escapes, oh, oh-oh-oh, how, on the scales you can see it very significantly, the muscles are heavy, and i always say to the patient, please tell me what you see more, changes in numbers on the scales or your clothes are getting big, so if the patient says: no, not clothes, this is the second time i ’ve changed things there. this is a very good option, because adipose tissue is voluminous,

a decrease in size is a good indicator, even if there is not very much on the scale, it is important for us not to see the numbers, yes, they are 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 in men, up to 24% of normal body composition is needed, and in women up to 31%, and of course, a sufficient amount of muscle mass then. everything is perfect, this is the ratio, the balance, it’s priority is not so much the scales as the ratios, because then the person will be healthy, which means that in terms of diagnostics we talked about methods, and i would really like for certain parameters to be included in this diagnostics, i often hear, we won’t talk about what tests need to be taken, yes, because despite the fact that they... are largely repeated from the patient to the 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 give? a patient calls, let’s say, wants to come for an appointment, says: what should i give? and i always tell him: i will examine you first, interview you , then i will assign you the scope of the examination. so, and often... i hear from my colleagues when they say that it is pointless to define some parameters there, they mean nothing they say, well, for example, there is a hormone called leptin, when it was discovered in the last century, scientists had the feeling that a revolution had taken place, now we, with the help of this leptin and its analogues, will cure everyone of obesity, this is a satiety hormone, but it turned out this way, that when they gave laboratory animals during... this hormone, some actually

lost weight, and some did not react to it in any way, meaning, they simply did not want to eat, they felt full all the time, but this is really true it worked, there was no increased appetite, accordingly, rats and other animals lost weight, but some rats did not lose weight and even gained it, so in fact, this hormone, like insulin, is such an indicator of fat volume... that is, if you and i see an overweight person with what someone with a morbid degree of obesity, we already understand that he will have a lot of insulin or a lot of ptine, and what’s worse is that... resistance to this other hormone very often develops, tolerance, they cannot act, leptin can not tell the brain that there is enough food, there is no need to eat anymore, insulin also 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, but due to this resistance, there is a lot of glucose in the blood, a lot of insulin in the blood, a person is always hungry... you always want to eat, and up to three bitches, literally, especially in the evening, when the activity of the same insulin is at its highest, sometimes to show the patient what is happening in his body, this is not such a big expense, but when you show how high the same insulin is, you can not only calculate insulin resistance, but also explain, we have such a problem, it is fraught with something, overcome it with willful efforts, control yourself impossible in the hands.

obesity is like the sun, yes i have such a positive approach, no, yes, why not, yes, why should we scare without it, so i draw this sun in order to show that the basis of many diseases is obesity, the sun has what, rays, here one of the rays is cardiovascular diseases; in addition to obesity, a person will have carbohydrate disorders, prediabetes, there is increased glycemia on an empty stomach 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, followed by followed by

erectile dysfunction, reproductive function and so on, in women it is polycystic ovary syndrome, which very often develops against the background of excess weight. body or obesity, this is a disorder, you and i often discussed this at one time, 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 illness, this radiance... every year it will only increase , unfortunately, it does not illuminate a person’s life with health, on the contrary, so when we start like this, literally, as you know, in a rusty pipe from which there is flow on all sides , to close individual holes, this is of course a necessary measure, but initially we need to fight

obesity, if we remove this solar disk, everything else will crumble like a house of cards. well, zukhra, it was very interesting, thank you very much, there was a podcast about deception of substances, my name is olesya nosova, i am the editor-in-chief komsomol pravda, the famous endocrinologist was with me, zukhra pavlova. hello, the program is about the most notable events of this day. without support workers, repairs and deliveries, ukrainian losses from our attacks. the assembly of tanks and self-propelled flamethrowers in omsk was checked by sergei shaigu. a formula of deception, supposedly.