the fact that before this we talked with andrei valerievich about cambodia, about how, how, how we acted there, and acted in such a way that we actually helped resolve the situation in indochina in general on a broad scale, and today vietnam does not forget this, despite the fact that he acts very skillfully maneuvers and develops relations with the united states and with us with...

who consider relations with the united states in a triangle or even in quadrangles of relations with china, with russia and the united states, they do not they are going to completely stand on our side, they don’t want to make a choice, they don’t want to make a choice, yes, it’s absolutely true, they don’t give in to american pressure not to deal with russia, but on the other hand, they want to maintain their own relations.

who was a very experienced business executive, as he is often perceived in history, but also a diplomat and politician who knew how to negotiate, including with chinese partners. and of course, that path, this four that you talked about, which was, well, if you like, forgotten for many years in moscow, that there was a revival of this kind. format or broader

formats, this is a new, very important direction of russian foreign policy, absolutely right, academician, thank you very much, it was an interesting conversation, and we are always grateful for your expertise for your time, i hope to see you again on our air very soon , thank you, it was a great game, we'll see you next week. hello, this is the podcast deception of substances, with you olesya nosova, editor-in-chief of komsomolskaya truth, and with me is my permanent presenter zukhra pavlova, a famous endocrinologist. today we will talk about eating disorders , and since this topic. which

is at the intersection of physiology and psychology, we invited a famous psychologist, candidate of psychological sciences, natalya fomicheva, to visit us. natalya, hello, hello, actually, the first question is, what is an eating disorder in general, can eating behavior be somehow upset, we can start with what normal eating behavior is, healthy, in general, our body is structured in such a way that we... we feel physiological hunger, we eat, feel full, stop eating, and this is the basis of healthy eating behavior, so all problems begin precisely from the place where a person either feels hunger, but ignores it, or does not feel hunger, or does not feel full and overeats, this is the basis of the disorders, this is precisely the failure of this perception of processes, sensations of hunger, the feeling of satiety. and here comes

the big story about the fact that somehow it is necessary look special, you need to somehow influence your own body, this can be done through food, so... i, for example, will limit myself in food, i will feel hunger, but ignore it, or i will use food to in order to regulate some emotions, then i will overeat, that is , this physiological basis is initially violated, uh-huh, natal, isn’t it normal to limit yourself in food, well, that is, you understand that you should look normal, it’s normal to feel, and for this you have to somehow not grab everything that’s at hand. in fact, to choose somehow, no, actually, saturation should work as a limiter, that is, i stop eating when i’m full, and i never ate a certain amount of calories, or i never started to worry that tomorrow this will affect scales, or never i looked at myself in

the mirror and said a bunch of nasty things to myself, that is, a limitation that comes from a feeling, it is essentially not a limitation, i i’ve eaten enough, i’ve had enough, that’s the limitation because... you need to look somehow, this is exactly the foundation that further leads to breakdowns, because people limit themselves, go on diets, and as we all know from research, 95% after 5 years of dieting, people weigh more than they started on this diet, this is the moment, if you eat very quickly, you will feel full when you have definitely overeaten than if you eat slowly and you will have time to eat less quantity. i would generally talk about awareness of the process of nutrition itself, that is , nutrition, the process of consuming food, in a good way, is a separate type of activity when we eat quickly because we are in a hurry, when we are simultaneously scrolling through something on the phone, arguing with household members and

doing a bunch of other things , of course we overeat, because satiety is a signal that needs to be caught, it needs to be felt, great, yes, this is from... the story about joke 33 times - this is exactly what i would say any artificial introduction of some numbers is redundantly, well, someone needs to live 33 times, someone 26, someone 48, but the question here is that we enjoy the process, we feel the taste, we feel how the food changes its taste, we are in contact with our own body, and this is all a separate process, yeah, but what if a person enjoys it. only if he receives a sweet bun, how can he live, is this also a disorder? the disorder begins, no, when we have diagnostic criteria by which we can already diagnose this disorder, sweet buns are not included, we, in principle, evolutionarily

prefer sweet food, because it is an energy-intensive food, we need this food - we need glucose for the muscles, for the brain, and this is a rare food. the main problem is that initially, where the sweet food was, there was sugar cane, go and chew it, go get this glucose from there, fruits, fruits, which still contain fiber, and there is a process of the pancreas responding to the glucose coming in, was much smoother, of course, now that we have industrial sweets, if you overeat exactly just sweets, or cakes, well... to some extent, this will not be very useful for the body, but this does not mean that you need to completely exclude it and sit, and then break down, again, yeah, people need some tangible things, why 33, not 48, not 26, because on average, to survive solid food, 33 is a sufficient

amount, 32 teeth, one tongue, and it’s easy to remember when there are some numbers, you can do a little train. as they say, then it becomes a reflex, and the person stops counting, but he gets used to the fact that food must be chewed, but you don’t know, this movement, when this food is pushed straight through, it’s a lump that is not chewed, not moistened with saliva, and naturally this food is of little use, because it cannot there is nothing to extract, just so that we don’t go too far, in the icd that same disorder, yes, eating disorder , is called, excuse me, the international classification.

we can say that we have an eating disorder, this is bulimia nervosa, anorexia nervosa syndrome overeating, where the preoccupation is precisely at the core of this... body experiences, i don’t like my body, and i’m trying to do something through food with my difficult emotions about the way i look, eating disorder is a completely different category , these are people who, for example, initially have a disturbed sense of hunger, they don’t feel it, they forget to eat, they have no idea to lose weight, they just don’t remember what to eat, they’re lucky, but i wouldn’t say such children... may experience developmental disorders due to lack of nutrients,

with slowing growth, in adulthood, these are people who understand that it is time to eat after they have lost consciousness from hunger, well, this is a common story, you want to say, it is still very difficult to talk about statistics, because only in 2013 this began to be discussed as a separate diagnostic category, research is still underway, so it is difficult to talk about any percentages. but in general i think that it will be approximately at the level of anorexia nervosa, somewhere around 1-5% of the population, this may have more to do with people with autism spectrum mental disorders, there are correlations, yes, we really, firstly, in people with autism and the autism spectrum we see an eating disorder, in the opposite direction we will also see autistic traits, but in general there are currently three...

they are quite happy with this, they eat little, not varied, and this is one group, the second group of people are people who seem to have very strongly developed papillae, that is, they are such natural tasters, from childhood they do not like the food that they have. for them vibrant flavor, and these are kids eating macaroni, mac and cheese, and cheese, that's it, i think, now. such children predominate, that is, they choose food that has a very neutral taste, very understandable, and

as a rule, these are carbohydrates, that is , here, on the contrary, we can see a situation when a person is overweight, because it is also very unbalanced nutrition, the third group are people who in childhood experienced some kind of, well, let’s say, trauma in their relationship with food, they choked very badly, got burned, got scared, poisoned, they have this experience, it seems to begin to change their eating behavior, that is, food begins to frighten and the child begins to avoid, he choked on soup, removes all liquid food, or choked on cutlets and stops eating meat, because it reminds him of it, and here, essentially, very different people can fall under the category of arfits, this is called avoidant restrictive food intake disorder, with very different such past experiences, but this can also be. harmless, for example, i have a child i know who doesn’t eat red food, he doesn’t eat strawberries, he does

n’t eat tomatoes, it depends on how limited the diet is, that is, if the diet is so limited that it already has certain health consequences, then this is dangerous, it’s good if a person simply doesn’t eat tomatoes, well, in the end, everyone has taste preferences, this is not yet an eating disorder , it has eased up, yes, thank you, that is not a disorder at all, that it is just some kind of well, that’s how you say it and how to distinguish it and how to distinguish it from a pathology from non-pathology? again there is diagnostic criteria are quite clear, if we are talking about avoidant eating disorder - this is a continuum, we have a food pyramid, there are complex carbohydrates, there are proteins, vegetables, fruits, fats, sugars and... with severe arfit, a person eats one or two of a product,

in principle, in lighter forms it is one or two products from each of this category, from each, from each layer of the pyramid. taste preferences are taste preferences. if it does not affect the functioning of the body, it is a preference. if the question arises about what it is impossible to change the nutritional structure; perhaps a person needs to add, for example. some nutritional supplements separately, sometimes they are directly prescribed these nutritional supplements, which are used functionally, yes, here we are talking about a violation. but are there any genetic predispositions, let’s say, they can be traced in the family, and we can say that these are genetically based? it is believed that there is, again, it is difficult to determine the genetic component for sure, but since we are talking about correlation with autism spectrum, yes, most likely it will be there, and some structural features of the same

taste buds, well, most likely yes, there is some kind of... genetic basis. alla prusa, these are hopes, these are some dreams, this is the whole life ahead, the palace square, the scenery of not yet fabulous st. petersburg. i ’ve wanted to perform on the scarlet sails for so long, it was great, the whole square sang with me, and the energy was really crazy, my task was to play asol, she was so young, the next stage was her meets.

podcast lab tomorrow on the first, we continue the podcast deception of substances, we are talking about eating disorders, this is olesya nosova, with me zukhra pavlova and natalya fomicheva, by the way, you said an interesting thing about the fact that some children, but this begins in childhood , prefer to eat macaroni, macaroni and cheese, sir, and so on, because they have a very strong. taste buds are developed, they are such potential, as you said, tasters, potential tasters, does this mean that if a person complete, if he likes macaroni and cheese, then the taster in him is dying, that he just needs to pump himself up a little, in fact we don’t rely on body mass index when

diagnosing an eating disorder or eating disorder, it may coincide, but again not everyone... people with anorexia nervosa are thin, because now , according to the new diagnostic criteria, we say that anorexia nervosa is weight loss, this is the dynamics of weight loss, at what weight a person entered there, it doesn’t matter, so here to say that you weigh so much, so this is too much of a simplification, but what kind of dynamics should there be for it to look like panic-nervous anorexia, 30% of the original weight in 6 months. this is a lot, well, that is, for a woman, 60 kg is 20 kg, loss of 20 kg, and almost up to 18, 20 kg, yeah, well, yes, significant, inpatient treatment for anorexia nervosa is always required, yes, this is very desirable, because in fact, this is a complex complex

disorder and it needs a team, it needs a psychologist who... people with anorexia nervosa, or rather no, people with such a genetic predisposition, do not feel hunger as discomfort, that is, they feel that they are hungry, but in general it gives them more activity, lightness, they even i like the experience of hunger to some extent, but if a girl with such a predisposition, as

a rule, it is the girls who decide that she needs to lose weight, she will lose weight as long as she loses weight, yes, that is, yeah. to a person who does not have such a predisposition, breakdowns will most likely begin there, restrictions will begin, a breakdown, maybe there bulimia nervosa will develop, here we go, we call it restrictive anorexia, when a very narrow corridor of calories is maintained, there are 500-600 calories per day, maybe this can be maintained for a long time only if you have a genetic predisposition to cope with hunger, there is - it's called the dutch eating behavior questionnaire, there are also separate questionnaires for bulimia, for orthorexia, there is

a body image questionnaire, because again we return to the fact that the root lies in this distorted perception of oneself, so yes, there are tests, you can pass, and what is orthorexia, so that our listeners simply understand what we are talking about, orthorexia nervosa is an eating disorder, which... is characterized by the fact that a person always eats only the right food, yes, i don’t eat the right food all the time, in fact, yes, this is such a relationship with food, where there is a lot of anxiety, and a person is always worried that if he eats some wrong food, things will happen some very serious consequences, so in general. nervous orthorexia will involve different types of eating behavior, where they will be united by precisely this experience of anxiety, an attempt

to regulate this anxiety through such structuring of food, excluding carbohydrates, excluding lactose, excluding fats, or vice versa, excluding carbohydrates, and i feel better on an emotional level , but food cannot regulate the psyche, it is another tool. therefore, in general, a raw food diet can also fall under the criterion of orthorexia nervosa, there is a roman scale for orthorexia nervosa, the same can be look, check, if they match, if the diagnostic criteria are suitable, then yes, and, again, sometimes vegetarianism can be classified as orthorexia nervosa, if this anxiety is the basis, and if this is a choice, for example, for some reason religious considerations, this does not apply to orthorexia, the core is there... this is the experience of anxiety that food seems to dirty my body, somehow has a very bad effect, perforates the intestines, that all this is still happening there, i yes, i'm trying

to regulate all this, essentially cope with my anxiety, uh-huh, well, i guess i should say that after passing all these tests, realizing that you have problems, you don’t need to treat yourself, pull yourself together, you need to go to a specialist, something else, yes , for example, in people with bulimia nervosa, in principle, this aversion to vomiting is reduced, because in general vomiting is an unpleasant story, but there are people who

genetically tolerate vomiting more easily, and there are factors associated with the psyche, there with anorexia nervosa, high perfectionism , you need to do everything perfectly, strong-willed people are very well developed qualities, there is a lot of anxiety, that is , there are also mental characteristics, there is an environment. and uh, i don’t remember exactly now, in my opinion, at fitje, it was recorded that when television appeared there, when beauty contests began to be broadcast, the curve of eating disorders immediately went up sharply , that is, the environment influences us, the idea that , that you need to keep yourself in some form, meet the standard and do this through dietary restriction, it can be contagious, of course, well, conditionally contagious. here it’s just that there is no genetics, most likely, yes,

by indicating that this is superficial and this is erroneous, you can return a person to a normal diet, or is this not so easy? in general, we can say that if a person comes out of an episode on his own, for example, anorexia nervosa or bulimia nervosa, most likely... there was no strong genetic predisposition, yeah, uh, we know such cases and there are patients who say that i am in at some point i realized that i was doing something wrong to myself, so i really stopped, i suffered there for a couple weeks, i talked myself into letting it go, most likely there was no genetic predisposition, but there are those that go one way, and even bring everything back, the mortality rate for anorexia nervosa is about 13-15%, yeah. this is a very high level for a mental disorder, but what is most effective in the family? let’s imagine that a person is somewhere far away and cannot

get to a psychologist.

same story, yeah, but is there a correlation by age? well, yes, most debuts are in adolescence, yeah, that is, puberty, entering puberty, accompanied by changes in the body, the appearance of adipose tissue, the appearance of some kind of emotional experiences about the fact that they didn’t love me, they rejected me, they didn’t take me here, and when all this collapses, this is the most typical story for adolescence, but there is practically no debut with... in adulthood, anorexia nervosa, yeah, there are much fewer of them, that is, yes, we have cases of anorexia nervosa that debut at 25, at 30, and even at 60, but there are significantly fewer of them . and with you again podcast deception of substances and its regular presenters, editor-in-chief of komsomolskaya pravda olesya nosova, endocrinologist pavlova. and with us today is a candidate

psychologically.

well, there, probably, the instinct of motherhood helps a lot to hold on, because it is most likely dominant. there is a separate eating disorder, prograxia, this is an eating disorder in pregnant women, at risk are those who had episodes of anorexia nervosa, bulimia nervosa in adolescence, but in general it can debut without it. yeah, that's how i am already as an endocrinologist i was interested in if there were only one boys, but by nine. this means there is some serious endocrinological basis here, estrogen somehow influences everything on this, since you’ve been involved in this, maybe you’ve come across some research on this matter? here, firstly, there is rather a social factor, because boys should not lose weight, in our country boys should still build more muscle mass, this should be about the message of society, and so there is

such a male option. it used to be even called bigorexia from the word big big, when men put a lot of effort into ensuring that they have these sculpted muscles, and their nutrition is also very distorted, because there is nutrition by the hour, a very strict diet, some of these supplements, in general there is content, it is also anorexic, my body should look only this way and not otherwise, all my mental activity is directed towards this.

goes in the other direction, yeah, interesting, i just think there are boys, but they meet, i saw patients, yeah, so interesting the thought sounded. that when beauty contests appeared, there was a sharp surge, and in general there are some statistics that earlier this disease was five times less common there, now it is five times more common, or they weren’t diagnosed then and didn’t think about it at all , that - this is something that is progressing, like obesity in the seventy-sixth year, now there are four times more people there, well, firstly - after all, they began to be diagnosed relatively recently, so for some part of the people they are just. didn’t get it, but from those descriptions, that we have, we often see a different content, that is, also a woman, there a girl refuses to eat, the weight decreases, but the content, for example, is some kind of religious

asceticism, uh-huh, why is this being done, but in general anorexia nervosa is not like that it has long been generally differentiated from schizophrenia, because it was considered one of the variants of simply schizophrenia. when it was identified as an independent disease, naturally our curve went up, because diagnostic criteria appeared, but cases of such voluntary refusal to eat with they met with a fatal outcome before, yeah, well, now, in principle, body positivity should help a little, after all, the criteria are not very much and it doesn’t help much; it was introduced in vain, that ’s for sure, no, it was introduced for a reason, but here. while the statistics are not optimistic, well, as for whether it will be positive, it’s a very difficult impression, i have a question about whether it will be positive, since olesya touched on it, when a person with morbid obesity, with any obesity, is told not

to be shy, not to worry about this, and most importantly , no need to worry, nothing to do, it’s tragic when a person doesn’t have a hand and they tell him: everything is fine, you’re no worse, but it happened, that’s good.

difficult, difficult, of course, a very, very question, because what you described is an ideal situation, ideal, and a person realizes at some point, and he wants to continue living healthy, and so on and so on and based on from this he most likely chooses something healthy, yes, but at first, again , a little sutrutically, but i just don’t need a person to call himself fat, there this or others called him that, and my task as a doctor is that i cannot force anyone. to become healthy, but i can’t help but explain to him what threatens him with everything that is now only in its infancy, if you are a doctor, then yes, but for some reason they think that we are fat people, that they need to convey that they are fat , every person passing by,

no, i don’t throw myself at everything that moves, no, i don’t doubt it, i mean that body positivity is also about the fact that in general a person has certain personal boundaries when everyone there, everyone there considers... it is his duty to inform him that there is something wrong with him, well, of course, this does not lead to mental balance even once, no, i asked this once when a fat man came into the office, i’ve been saying for a long time, sit down, yours complaints about being overweight, he said: “no, i’m okay with that, it was much more than 100 kg, since then i haven’t asked the question, are you overweight, why did you complain, but then, on in my opinion, it is still necessary to explain in such a way as not to frighten, but..." give a person an overall picture, and he could i would really like to understand, i would really like our listeners to understand today that an eating disorder is a problem, it cannot be treated with care, care needs to be treated, it will be very

useful in the family, everything else should be taken to a specialist, just let’s take overeating syndrome, associated with obesity, yes, that is, a person really, because a person can have overeating, but at the same time the body mass index is normal, here a person overeats, overeats, overeats, then he somehow weighs a lot, he comes to the doctor , the doctor says: you need limit yourself in nutrition, or in general, go to... you can’t just take it, take it away and give nothing in return, we see very frightening statistics, for example, suicides after bariatrics, depressive episodes, what is bariatrics, so that we don’t forget, these are various operations that are aimed at reducing.

who exactly has an increased body mass index as a result of overeating, then 90 there... 2 93% of them have a history of severe trauma, usually sexualized, no, rape, well, psychological, yes, yeah, and it’s theirs, well, that is, their overeating essentially develops as part of post-traumatic stress disorder, you can simply stop them from eating, well, in general, what can we do with ptsd, this is always an interdisciplinary problem, i also always resort to the help of a psychiatrist.

the gold standard is a combination of behavioral therapy with cognitive emotional therapy, that is, we work with food diaries, we work with identifying triggers that trigger episodes of overeating, we work with those emotions, we teach a person to regulate their emotions differently, not through food, we work with post-traumatic stress disorder, we work with hypnosis with everything - that would be great, but everyone really... wants to come once, it’s better not to come at all, yes, i’ll just

call the doctor on the phone, he ’ll tell me something, and i’ll magically stop eating, no, it doesn’t work like that, he’ll break the spell, yes, well, that’s a story for years, yes, well, let’s complete our , our wonderful program, with us was a candidate of psychological sciences, natalya fomicheva, and we we talked about eating disorders, natalya, thank you very much, thank you, thank you, thank you. hello, this is the badonbaden podcast and i am its host, professor severinov, our guest is dmitry alekseev, microbiologist, bioinformatician and candidate of biological sciences, dmitry, hello, konstantin, hello, what is this? it turned out that i was lucky that while studying

mathematics and physics, i suddenly appeared on the scientific arena when dna was deciphered and we learned how to load this information into a computer, so bioinformatics is about how bring this information in the computer to its meaning, to some kind of understanding, to deciphering it, to understand what living things can actually do from this code, and you are a part-time microbiologist, because you use bioinformatics to study microbes, bacteria, and what microbes are, so you said bacteria, microbes - these are probably viruses, probably, probably, some simple fungi of all sorts and others, but microbes were invented around the same time when levinguk began to look into a microscope, and this word simply meant.

the rest is such an evolutionary one, for example, yes, that bacteria, we believe, were one of the first to appear on the planet, changed the environment in which we are, the water, what do you mean, they changed the environment, the earth was hot, then cooled, bacteria did that they created oxygen, in fact, and thanks to oxygen, it became possible for larger organisms from a larger number of cells to exist, it became possible for the mitochondria of such small

power plants inside each cell to breathe with with the help of this oxygen, a very fundamental process on the planet, 1.5-2 billion years. microbes transformed the atmosphere so that we could use it all, it’s interesting, that is , just imagine what time range bacteria lived on this planet without everyone else, bacteria also appeared once, there is some point, before which there were no bacteria, but before that there were viruses, hypotheses about this, yes, how the first living thing appeared.

molecules, one of the latest discoveries is that these molecules or nucleotides, yes, the components of these molecules can be formed during space flights to an asteroid, yes, that is, due to the effects of radiation and then it’s all like the components of a good borscht, but suddenly the game appeared, on this everyone will always tell you that borscht needs a hostess to appear. somehow they often comment that it seems that without the hostess this cannot happen, and bacteria not only created the conditions for us to live, but then gave birth to us, this is such a way of looking at things, well, yes, yes, yes, we believe that somewhere

we all have a common ancestor, and he is as similar as possible to a bacterium, so we are related to them, yes, we are related to them, very, very much. yeah, now what functions are performed by, well, bacteria and viruses, fungi, all this, all this small fry that we don’t see, they live in, we call it homeostasis, but it’s a difficult word, but in general, balance, that is everyone is holding each other back, life, it seems to me, is always trying to grow, everyone has a task to give the maximum amount of space to their offspring, here at the crossroads of these various relatives and... different families, plants, fungi, microbes, bacteria and so on, they either fight or negotiate in such a way as to create entire ecosystems, that is, such niches, yes , for example, a forest or the ocean floor or our intestines, examples of such niches, within these niches, yes, they thrive,

yes, that is, they produce the maximum number of their own offspring, and where then do what are called pathogenic bacteria come from, obviously that there are a lot of not... things, diseases, it seems to me that from the moment such multicellular living beings arose, yes, from the moment the first intestines, the first creature arose, every microbe immediately realized that it was very good to live inside us, why it was very good, because it was warm there, warmer than in the environment, dark, that is, it does not interfere with sunlight and does not kill, someone else is constantly getting food, why kill, if that’s the case. and then there are different strategies for life in this environment, and like people, microbes, there are two directions, uh, in which what they can do is learn to be friends for survival, learn to conquer, win, fight for survival, as we see in both strategies.