Dietary requirements for obesity complicated by kidney disease, constipation, anorectal diseases, and coronary heart disease
Characteristics and dietary requirements of obese individuals with kidney disease
Obese people are more susceptible to infection and have a higher chance of developing streptococcal glomerulonephritis. Obesity and hyperlipidemia can also affect the kidneys.
In 1923, Prebich reported that 40% of obese people had abnormal levels of proteinuria, serum creatinine, and blood urea nitrogen, and many patients had renal insufficiency.
Kidney disease in obese individuals is a major problem affecting their quality of life.
Medical literature does not discuss kidney disease in obese individuals in great detail. In recent years, animal experiments have revealed that the amount of urine excreted per unit time is significantly reduced, and the renal blood flow (RPF) and glomerular filtration rate (GFR) are also reduced. Morphological changes caused by obesity-induced kidney damage result in increased fat content, weight, and volume in the kidneys. Histological examination reveals that there are often obvious fat droplets deposited on the basement membrane of the renal tubules and glomeruli, and the glomeruli also become hypertrophic.
Because obese people often have arteriosclerosis and diabetes, their incidence of focal glomerulosclerosis is significantly higher than that of normal people, which may be related to the development of latent diabetes.
In addition, obese people also have water metabolism disorders, proteinuria, polyuria, and edema, which are almost common symptoms.
Water load tests often reveal hypothalamic disorders, while the Volhavdt test often shows water retention, with some of the excess being resolved through excretion.
In most obese individuals, water retention and proteinuria will significantly improve after weight loss through diuretics and weight-loss therapy.
Kidney disease has strict dietary requirements. When obesity is combined with kidney disease, the kidney's urinary function is affected to a certain extent. Therefore, the basic point of dietary treatment is to ensure normal urination function.
From a weight loss perspective, diuretics should be used appropriately for patients with kidney disease, as some weight loss drugs achieve weight loss through urination.
Any diet should be consumed in a way that does not impair kidney function; this is a fundamental requirement for dietary therapy for obesity complicated by kidney disease.
Secondly, treatment of kidney disease should be prioritized over weight loss treatment. Thirdly, traditional Chinese medicine treatment should be the first choice.
Severe cases should be treated with a combination of traditional Chinese and Western medicine.
What are the characteristics of obesity combined with constipation, and what kind of diet should be chosen?
Among the patients treated at our obesity clinic, nearly 50%-80% of obese people suffer from habitual constipation, and some even develop anal fissures and hemorrhoids due to severe constipation.
From a weight loss perspective, promoting bowel movements can reduce fat deposits on the intestinal wall, which is beneficial for fat conversion.
Therefore, the application of spleen-strengthening and dampness-resolving formulas is a major characteristic of traditional Chinese medicine for weight loss.
We often use the following prescription: 10g of apricot kernel, 12g of white cardamom kernel, 15g of coix seed, 15g of magnolia bark, 12g of stir-fried atractylodes macrocephala, 10g of kelp, 10g of seaweed, 6g of soapberry, 12g of hemp seed, 10g of cistanche, 15g of codonopsis, and 10g of immature bitter orange peel. Decocted in water and taken orally.
Take 1-3 doses every 3-5 days for better bowel movement.
Combining acupuncture at points such as Zusanli, Zhongwan, and Xuehai can further promote bowel movements.
The effects of obesity are systemic.
The proportion of adipose tissue increases, and the water content of adipose tissue is less than that of other tissues. Fat cells that previously contained a certain amount of water also become like taut balloons. There is also a lot of fat deposits on the mesentery of obese people. Excessive fat deposits affect the absorption function of intestinal villi, weaken intestinal peristalsis, and make it difficult to excrete digested food, thus causing constipation.
For obesity combined with constipation, a diet that promotes bowel movements should be chosen. This diet can also lower blood lipids, moisturize the intestines, and not cause trouble for normal life.
Based on our observations, foods that promote obesity and constipation should be mainly high in fiber and relatively low in sugar, such as mung bean cakes and rice, with vegetables such as celery, radish, spinach, cabbage, and kale as the main choices.
For beverages, use hawthorn juice, almond milk, coconut juice, etc., which are good for digestion. You can also drink senna leaves soaked in water regularly.
Another option is medicinal porridge: Crush 30 grams of pine nuts into a paste, add 50 grams of glutinous rice and an appropriate amount of water to cook porridge together, add an appropriate amount of honey, and take it on an empty stomach in the morning or before going to bed at night.
What are the characteristics of obesity complicated by anorectal diseases, and what dietary precautions should be taken?
It is very common for obese people to suffer from anorectal diseases, which are mostly related to difficulty in defecation and excessive secretion of oil.
Prolonged constipation prolongs the time that carcinogens remain in the intestines, and the accumulation of fat in the intestinal wall weakens the activity of the aggregated lymph nodes in the intestines, reducing the immune substances in the intestines, making it easy to develop rectal cancer or colon cancer.
Difficulty in defecation can impair the contraction function of the anal sphincter. When hard stools pass through the anus, they can abrade the intestinal mucosa and blood vessels around the sphincter, resulting in anal fissures.
Excessive secretion of oil makes the area too moist, which makes it prone to infection. Therefore, patients with anal abscesses are often seen in obese people.
Poor blood circulation around the anus is a major reason why obese people are prone to hemorrhoids.
Although anorectal diseases in obese people are relatively minor compared to other complications caused by obesity, the consequences can still be very serious if left untreated.
Obesity combined with anorectal diseases requires attention to dietary structure. When hemorrhoids or anal fissures are accompanied by bleeding, spicy foods should be avoided, while some cold foods can be eaten to promote bowel movements.
For example, you can use hawthorn cake, hawthorn leather, or fresh pear juice.
After surgery, you should strictly follow your doctor's instructions regarding beverage choices.
What are the characteristics and dietary therapy for obesity complicated by coronary heart disease?
Long-term clinical medical research has confirmed that obese people are more prone to coronary heart disease.
Some research data indicate that the incidence of coronary heart disease in obese people is 5:1 compared to people of normal weight, and the mortality rate of coronary heart disease in obese people can reach 30%-40%.
Obese people are prone to coronary heart disease. Obesity is only one of the many factors that contribute to the development of coronary heart disease. Whether or not a person develops coronary heart disease is mainly related to serum cholesterol levels and elevated systolic blood pressure.
In obese individuals, coronary heart disease occurs through hypertension as an intermediate medium; obesity itself does not affect the short-term or long-term mortality rate of acute myocardial infarction.
If obese patients prefer a diet high in fat and cholesterol, it will cause an increase in blood cholesterol and triglycerides. Excessive deposition of blood lipids on the blood vessel walls will lead to atherosclerosis.
In particular, when the coronary arteries harden, the lumen narrows, blood flow decreases, and the heart itself receives insufficient blood supply, which can lead to coronary heart disease.
Obesity combined with high blood lipids and diabetes is also an important factor in the development of coronary heart disease.
In addition, obese patients have less physical activity, weakened coronary artery circulation, reduced reserve capacity, and increased burden on the heart, making it easier for obese people with coronary heart disease to suddenly worsen their condition.
What are the characteristics of coronary heart disease in obese people?
The discovery of coronary heart disease in obese individuals is often accompanied by hypertension, and the electrocardiogram shows both the electrocardiographic changes associated with hypertension and the deviation of the cardiac axis. Obese patients with coronary heart disease often have high blood lipids. When performing cardiac auscultation on obese patients with coronary heart disease, the auscultation is often blurred due to the accumulation of fat in the chest.
Obese patients with coronary heart disease often have significantly abnormal cardiac impedance maps, and the symptoms of angina and myocardial infarction are atypical, sometimes mistaken for undigested food.
Dyspnea caused by poor ventilation in obese individuals can sometimes be difficult to distinguish from cardiac dyspnea.
Even more dangerous is that the difficulty in defecation for obese people can cause sudden death due to excessive straining during defecation.
Obese individuals who also have coronary heart disease often indicate that their obesity has reached a very serious level, and that they also have severe arteriosclerosis.
Therefore, when using weight loss drugs (mainly traditional Chinese medicine), some drugs that soften blood vessels should be added to the drugs, such as danshen, leeches, and earthworms; Western medicines can be used in combination with vitamin E, vitamin C, and prosperidone.
The key issue is to control it through diet.
For obese individuals with coronary heart disease, a suitable diet includes rice porridge and soy milk for breakfast; vegetables and low-sugar foods for lunch; and a low-fat diet for dinner, with a small amount of staple food allowed. Severely obese individuals with coronary heart disease should primarily consume vegetarian food, and should especially avoid eating before bedtime.
When obese patients with severe coronary heart disease require hospitalization, they should eat the meals provided by the hospital's nutrition canteen and avoid eating at will, especially overeating.