A nutritionist, a doctor of personalized medicine, professor of the Federal Medical and Biological Agency (FMBA) of Russia. She graduated with honors from the Medical Faculty of the First Moscow Medical Institute named after I. M. Sechenov, then - clinical residency in major "Cardiology". Candidate of Medical Science. She has been working in medicine for more than 25 years. She was the first in Russia who began to make individual comprehensive nutrition and body correction programs. She developed her own method of reducing and maintaining weight. Head and Chief Physician of the Margarita Koroleva Aesthetic Medicine Clinic.
Olga Bubnova, a TV BRICS correspondent, spoke with Margarita Koroleva.
Losing weight, a slim figure - this is some kind of endless number of magical fast diets. Half of Russian women either lose weight, or try to lose weight, or are going to lose weight ... Where is this dream of an unattainable slim figure in our subconscious from?
People want to lose weight, especially when the summer season begins, and everyone starts preparing for the summer season. Naturally, they understand that their clothes have become a bit tight, swimsuits are already impossible to try on, self-confidence is leaving. People are disappointed by their bright, but plumpy image. And they make a decision. They must lose weight for the season again.
In general, even though I am a nutritionist, I do not like the word expression “to lose weight”. Losing weight is something from the word "loss". That is, to lose something. Therefore, I always amend the lexicon of my patients and the people with whom I speak - “to slim”. Yes, to gain healthy harmony, right. But certainly - not to lose weight. Yes, people make decisions, keep some kind of extreme diet and lose weight quickly. And, as a rule, extreme diets do not change the model of eating behavior, do not teach a person how to keep this result afterward. And the person, having received it, does not hold it for too long.
Being on vacation, having a rest, he tastes and eats with pleasure everything that used to be available for him. Naturally, by the end of vocation he is gaining already lost kilograms, and ... Any kilogram lost during an extreme diet brings, as a rule, a couple of kilos back, and a person is disappointed - both from himself and from another weight loss technique, and as a result he, in fact, loses faith in himself.
And he realizes that, probably, that same dream - healthy harmony - is unattainable. Probably, genetics is somehow to blame, and it is enough to look at one's mother or aunt ... Perhaps, there are some problems, and it's better to look for them - the thyroid gland, metabolic disorders, problems with gynecology ... That is, people start searching for any problems, but they stop halfway in this regard, too, they let all this situation hang out.
And for the next summer season, people who gained a couple, three, five, or even ten kilograms, again and again make an attempt to lose those extra kilos. And so everything is in a circle. Why does this happen? Because people keep some short-term diets, strict ones, with the restriction of nutrients, with a state of hunger, malaise during this period. They get the desired numbers on the scales, then return the lost weight quickly due to the fact that you want to eat.
And a person compensates for something that he did not eat up during a nutrition program, limited himself to everything, or experienced hunger in the absence of any favorite foods. Feeling just frustrated that everybody can eat what they love, but he has to give up what pleases him. Therefore, of course, a person returns to his favorite foods, without changing eating behavior, and gains weight.
You called, it seems to me, one of the main mistakes in eating behavior, at least in our country, it is a huge number of short-term diets and an absolute refusal from regular, normal nutrition. What else are the main mistakes, the main misconceptions in our country, for example?
In fact, there are quite a lot of errors. Either really an abnormal eating behavior, or a general behavior, which leads to the weight gain. An anxious attitude to favorite products with salt, fat, and sugar. An excess of refined foods in the diet. Food is chaotic and disorderly, as a rule, many people come and say: “We eat even a little!” But rather chaotically. We have breakfast and a fairly heavy dinner. Why are kilos gained then, and so many - the question is open. Then I have to explain what the physiology of the process is, what the reasons for that are.
And it is enough for a person, in fact, to take a food diary and start taking notes step by step: what he eats, what mode he follows, what quantity, how he combines the components of food. Whether he has a physical activity, whether he drinks water. And a food diary, with which a person has to communicate one on one, helps to identify the root causes of overweight.
As a rule, a person analyzes and begins a correction work. He either appeals to the opinion and advice of a specialist who will help to create a step-by-step program, taking into account his individual characteristics, nature of work, rest, accumulated diseases, physical activity, sleep, number of stressful situations, ability to manage stress. That is, a combination of factors can lead to overweight. And the ability to manage these factors will allow a person once and for all to lose overweight and to maintain infact his beautiful, healthy, well-shaped physical form. To forget about diseases, problems and to be confident. To have a new level of energy, effective work of the brain, to be useful for relatives, profession that he studied. All this is possible.
You have said we have a lot of convictions, give a trite example. All the girls have probably heard the phrase: just do not eat after 6 p.m., and everything will be fine. And how to explain to a person that this will not help?
Many people understand that any diet or moving from one diet to another is a waste of time. Many of them were convinced of this. They need to change their lives. Once and forever. Just to change their meals, attitude to themselves and attitude to what they eat. To change the mode of eating, food quantity.
To rethink their meals in favor of natural products and dishes, with a gentle processing. To structure and plan meals. That is, we must learn to analyze our lives. We must take care of our bodies. To help them maintain their beauty and form. To avoid problems and diseases. Not to load it with overweight.
You know, once, when I was working for the "Health" program, on Channel 1, I often had groups of those wonderful stout people for whom I gave master classes. And one day I have such a young lady sitting at the table, and the whole group complained about her due to the fact that she did not have time to make notes.
She was very stout, with a very small height - 153 centimeters, she weighed about 160 plus kilograms. She couldn't reach the table, she couldn't put a piece of paper on the table. She located one A4 paper on her stomach and was writing quietly. She fell behind. Everybody complained, hurried her a little bit. And I set all the conditions so that she could remember the information.
And there was the last question, she raised her hand and asked me: "my knees hurt. Why, do you think?" I looked at my knees, at her knees and said: “We have exactly the same knees, you have just loaded yours like that. You don't like yours.”
And she said: "I've understood everything." So – a sign of self-dislike. This is the attitude when a person torments himself with various kinds of diets, hungry programs, while he feels bad, sometimes faints, and as a result he reaches the coveted kilograms, but cannot keep them again. Therefore, a system is required.
A systematic, integrated approach to a person, which will include a complete change in the nature of food, dishes that the person will eat for breakfast, lunch, and dinner. Useful snacks are to be present. The nature of physical activity is to be changed. One must learn to manage stress, environmental factors. That is, it is a system that really helps a person to change his life.
You talk about your clients, about your patients so pathetically, when I entered your office for the first time, I was a little surprised, I expected to see a slightly different office at one of the country's leading nutritionists. Explain why do you have such an interior design?
You know, one day a film crew came to me, and a reporter with a significant overweight, talking to her cameraman, said during their dialogue: “I can’t understand why there are so many plump girls here?” She said addressing me: “Why, why do you have so many of them? Oh, Vasya, Vasya, take a picture of me, please, here with this one! Oh, look, and this one is like me, like me! Well, and here with this too! No, I want to stand next to this one! Well, why, why do you have so many plump girls? ”
You know, this is a psychological moment. I told her. Sometimes a person who wants to enter the office is a little shy, with complexes. A person is stopped in front of this office with his accumulated complexes and self-indulgence, he comes in with hesitation, thinking that the doctor has a normal, healthy, slim shape, and, probably, hates fat people for a long time.
But when people come into this office, they see that I treat these charming plump girls favorably, it makes a good impression on them. They relax and trust me the most confidential things, and we talk with them for a long, long time, identifying the causal relationships that led to a body overweight. We are looking for solutions to the problem together. Allied, just like that. I form each person individually.
i am responsibile for the step by step solution of the problem. I give only a tool, and a person himself implements it, having an individual responsibility for implementation, punctual, disciplined implementation of all prescribed recommendations.
Very often, not even the delusions that we have already talked about serve as a barrier on the way to a slim figure, but some psychological, internal problems. Why does this happen? You have an example when a person seems to be all right, and the physiology is good, the way of life is normal, but he cannot lose weight, because some psychological barrier prevents him from doing so.
I think that psychological barriers are the lack of self-belief. When a person has played enough with all diets, and he is disappointed in the end. In the fact that diets do not work. Moving from one to the other is really a waste of time. And the continuation of the further diet will also not work for long.
And when serious problems really begin to manifest themselves, the level of pressure and sugar rises, then a person is forced for himself, for his health, in order to maintain the quality of life and in order not to become a burden for relatives and friends, to come to the doctor’s office, in order to solve the problem of overweight and already existing problems associated with it.
Only the task - to change his health - as a rule, motivates a person to make a decision to change his own and external image as well. But the most important motivation is health. As for beauty, disappointment and loss of self-belief still slow down a person.
A constant self-blame. He blames himself for any deviation from the intended program, and when we start talking with patients, I always say that they shouldn't blame themselves, they shouldn't beat themselves up.
Often people come and say the same, “I hate myself. I do not like me." I begin to explain that a human body is created in love. Not at all to become one day a proving ground for military actions. You must stop fighting with it. It can not be scolded. After all, self-flagellation is like the sharpest spears that the emotional, delicate, lively, and vulnerable human body receives from its holder. They are sharp, they hurt, sting, offend. And the human body - it begins to defend itself. From these sharp spears.
How? The psychoemotional component decreases. Down to depression. The person understands that he has already fallen into this state. And the metabolic rate is sharply reduced. And if yesterday, conditionally, an apple helped you to lose, progressively, some grams, extra kilos, today you will gain weight with this apple due to the fact that you started to treat yourself incorrectly. You began to scold, to blame yourself.
And I teach people to love themselves, accept themselves and start helping themselves. To become a manager of their own project "Change Your Body". You must learn to talk with it. To communicate. Then, hand in hand with your body, everything will be all right. You know, when my little, younger child, she was three years old, a girl, we sat with her in a restaurant, and they brought us chicken soup for lunch. There were many, many, many greens. Lisa sat looking at those greens, turned to me and said: “Margosha (this is my granddaughter, when she was three years old, she was very small) ... Margosha, they put so many greens here. Let's tell them to remove a half". I said: “Lizonka, your lashes will be even longer if you eat these greens!” - “Oh, let's tell them to put more of them!”
So it is necessary to communicate with the body, it is necessary to explain what is useful for it and what is harmful. You need to explain and accept this information, hear yourself, listen and help to the maximum. It is necessary to stop fighting, I must say: “Forgive me, beloved, dear, the only, huge thanks to you for being with me, still healthy, with emerging motivations, with goal setting. You want to be and become different, and you will succeed. Let `s do it together. We will succeed together."
It seems that you were not immediately ingaged in this big deal - to help people, you graduated with honors in major of cardiology, not dietology at all ...
I really was an excellent student, I liked all the practices, all the subjects I was engaged in, despite the fact that I had a little daughter at the same time. I gave birth in the third year, I did not take maternity leave, I did not take academic leave, I managed, it was very hard, but I managed to combine everything. And at the same time, I worked off all missed class time, of course. Working off was obligatory. My mother-in-law helped me. Quite a bit, due to the fact that she was also a working person.
At least, my relatives understood me, they helped me as much as possible. I did not gain weight after the first pregnancy and childbirth. But I have this nuance in life due to the fact that I am also inclined to stoutness, like many women in our country, I have such an inclination
to gain body overweight, and I had this problem after the birth of my second child, when I had the opportunity to be on maternity leave for a short time, and I, yes, was on maternity leave for eight months. I gained almost thirty kilos of overweight during pregnancy and lactation, it was a long time ago, it was the beginning of the nineties.
It was a sufficiently scarce time for the choice of food. We had the coupons for food, quite a difficult period of time. My husband brought all the scarce products with pleasure, and cooking was for me like art. I cooked and cooked. Well, naturally, two small children, I also had to eat up for them, and somehow, gradually, four months after giving birth, I realized that I had already gained thirty kilograms.
From that moment on, a really serious work on myself began. My husband saw me disappointed, in tears, when I was dissatisfied with myself, I also began to scold myself, he reassured me and said: “Well, I saw your mother.” My mother was stout, about ninety kilograms. That is, eating behavior, of course, is built in the family. And there was an inclination, partly it was genetically determined.
In fact, we can and should also change the work of our genes, and I am a vivid example of this. So, my husband said: “Yes, this is genetics, and you cannot change yourself, and I will not allow you to carry out any starving or half-starving programs. Due to the fact that you are a mother, first of all, you have two wonderful children, a wife, my beloved woman, I will just take control of this situation. ”
And, nevertheless, from that moment I was overwhelmed by a large amount of literature, endocrinology, the theory of obesity, and physiology, and gastroenterology. I was an excellent student at the university, and my husband was a doctor of medical sciences, that is, there was enough literature, and he brought a lot of translated literature. That is, I, as a subject to help, plus my medical knowledge and my experience allowed me, in fact, to lose overweight in a little more than eight months.
But this is a set of approaches again. I completely changed the contents of the refrigerator, my relatives became my allies, they also supported my healthy undertakings. Sausages, wieners and other refined products disappeared from the house. Sweet curd snacks moved to the children's shelf in the fridge. Some products were really only for children, some were definitely taboo. Regular and moderate physical activity, plus - a consistent change in meals made it possible to get a result that I have been keeping for almost thirty years.
If I return to the food from which I refused, I will very quickly gain those extra kilos, it does not cost me anything. Therefore, it is possible and real one day to lose overweight. And becoming one day another person, it is possible to maintain a healthy physical condition throughout your life. I weighed more than 85 kilograms, I know what it is, I know this weight, shortness of breath, increasing blood pressure, I will never return to that bright but stout image.
A hard period, isn't it?
Yes! I will never allow myself to be like that. I like another shape. I like what I am now. And I will always be in this shape. This is real for everyone.
You have said two very important things. You've said "genetics", and in the next sentence you've said "eating behavior". They say: "Look at your mother, she is also stout." Is it inherited in the tradition of family nutrition?
Of course, it happens that a person says that both his mother and his dog are stout, therefore the eating behavior is built at home. And often the whole family comes to me. And they are all so wonderful, about 150 kilograms. And a husband, and a wife, and a 16-year-old child - 130 kg, and a daughter - 120 kilograms. They are so wonderful. They have four refrigerators at home, and they make stocks, super stocks of their favorite products. They have family lunches and dinners, they have family weekends with barbecue, with visiting guests. They have such a food stereotype, a family food stereotype that has been formed.
Well, from our point of view, of course, it is anomalous. Whatever it was, but it led to the overeight of these gentlemen. It led to problems and illnesses. And this does not mean that it is genetics. Genetically, there is only an inclination. Groups of genes, a hundred of them, at least, that are responsible for weight gain, can lead to overweight. But each of the genes introduces only a small contribution in the form of inclination.
But it depends solely on the person himself whether it is realized or not.
What kind of food choices he makes, in favot of what kind of food he makes this choice, whether he is physically active or totally hypodynamic. He prefers refined products, chaotic food, goes to bed later than it could be. And, of course, he gains weight. He begins to complain that genetics is to blame. Even beloved Boxer, the dog, has also gained weight due to genetic reasons. That's it.
And what about water. Now, it seems to me, the world is divided into two halves. Some people go with bottles everywhere - they drink water, while others look at them and think: why do the first ones drink water all the time? For example, I always go with a bottle at work, my colleague once said: "Scientists have proven long ago that water will not help you". Is my colleague right or not?
Water is an important component of a healthy lifestyle. Water is our everything. We are 80% water. Water supports the rate of metabolic processes. It transmits nutrients and oxygen to each cell. The composition of cells, toxins are removed with the help of water. Unnecessary things that are collected in a cell. Slag, waste material. It supports lymphatic drainage, it maintains the body’s natural detoxification. Water is the turgor of each cell, it is the health of our skin, nails; this is, I repeat, the speed of metabolic processes.
And even if we are even thirsty for an iota, we must bear in mind that the metabolic rate has already decreased by 30%. Therefore, water must necessarily accompany our lives. And I focus on this aspect with my patients, with whom I build a nutrition program, and, of course, on a sufficient amount of fluid intake.
Mostly pure and non-carbonated water. A person should drink pure water of at least two liters. Well, and additionally two or three cups of green, weak tea or herbal tea, red tea, such as hibiscus - whatever you like. But it should be based on pure, non-carbonated water, which helps us.
Today they talk a lot about intuitive nutrition. What does that mean?
Almost every day patients come to me with their own intuitive nutrition. They are hungry and they eat. They think that this is an emotional component, an emotional hunger - that this is a physical hunger - and immediately they begin to eat: when they feel bad, when they are bored, when their emotions are not enough, to surprise themselves with something. And they immediately begin to eat.
And they eat, say, not sources of high-grade protein in combination with a useful vegetable side dish, but, as a rule, it is some kind of chocolate, ice cream, fast food, which is also attractive in taste and sets the conditions for pleasure. They eat intuitively, their body asked, and they gave it. That's what intuitive nutrition is.
Intuitive nutrition is when a person listens to his body, but, unfortunately, he often confuses physical hunger with emotional hunger. And he thinks, being on an intuitive diet, why he gains weight so quickly. And he confirms for himself that the intuitive nutrition does not work. It does not help maintain normal physical shape. And certainly it does not allow losing overweight.
You advise to follow the principles of reasonable nutrition based on the normal physiology of a person. And you state that you have been keeping this “diet”, as you call it in scare quotes, I emphasize, for more than a year, and all slender girls and women of the world have been keeping it for more than a thousand of years. This your idea is very much compliant with the Indian idea. Because, according to Ayurveda, you need to eat when the body requires, not to follow the “breakfast, lunch, dinner” rule; if you are hugnry, then eat, if you are not hungry, don't eat. If you are thirsty - drink. So are the Indians right about that?
Diet is some kind of a nutrition program limited in time, so that is the time frame. A person kept a diet and moved on to his so-called intuitive nutrition. This is not about diet. And I'm not on a diet. I just live like that. I love healthy food. I eat regularly, four to six times a day. I do it with pleasure. Intuitively, my body is already set to the next meal. It is waiting. The digestive system is ready to accept this amount of food. To digest, to assimilate.
I drink enough liquid, I have regular physical exersices, I love them, I miss them. This is the only factor in my very busy schedule that I lack, it is a sufficient amount of physical activity. I want to have a physical activity every day, but sometimes I finish work very, very late. After ten, after eleven o'clock in the evening, I can’t do any physical exercises. But, nevertheless, I use even some small timespans in my work schedule to get up on the treadmill or an ellipsoid-shaped gym machine in order to get a little shake on the vibration trainer. There is a fitness room in my clinic. That is, I give myself an opportunity and shake my muscles, reminding that I have not forgotten about them.
But regular nutrition is the foundation that helps me to think effectively, to be healthy, to avoid any problems that could potentially be associated with overweight or insufficient nutritional components. I am in harmony with myself, first of all, I love myself, I treat myself favorably, I feed myself in time, I will give myself enough water. I teach this to my patients. And therefore, I definitely eat in the presence of my patients and with their participation, together.
Sometimes a person has to be at the consultation for four to five hours. We have definitely have two meals together. And the portion of food that a person sees in front of him is also a lesson for him: what it consists of, how the components are combined in it.
As the amount of food for intake, at what speed it is necessary to use it, so I comment on all the meals that we eat together. This is also part of my consultation and part of the practice that I have as a way of life. I pass it on to my patients.
And I have a very high percentage of those patients who once lost their overweight and keep their result throughout their lives. Although, according to world statistics, there are few people keeping the result, between five and seven percent. I have more than 50% of people who keep their result, who once and forever changed with my participation.
Thank you very much, Margarita. You talk about your work so enthusiastically, I was very pleased to talk with you and hear the answers to many, many questions that are interesting not only for me.