The basic information of this laboratory test customer is as follows:

Mr. Zhang, 38 years old, 1.74 meters tall and 81 kilograms in weight, works as a copywriter in a company. Sitting activities (meetings, in front of computers and TVs, driving) for up to 6 to 8 hours a day, with little exercise and no dietary control. During a physical examination last year, it was found that blood triglycerides and cholesterol exceeded normal values, fasting blood sugar was high, and there was moderate fatty liver. The body fat accounted for 31% of the body weight. The doctor made the following diagnoses: diabetes, mild obesity, excessive body fat, mixed Hyperlipidemia, fatty liver, maximum oxygen uptake and low cardiac function within the normal range are high risk factors for coronary heart disease. Based on this case, a conditioning plan will be provided.

Conditioning plan:

1. Health risk review

Mr. Zhang is currently facing the following health risks:

1. BMI is overweight , body fat rate exceeds the standard, and is mildly obese

Mr. Zhang’s BMI has reached 26.8, which is in the overweight range, and is in the upper position of the overweight range. Calculated by height and weight, the obesity is mild. obesity. Being overweight is often accompanied by a high body fat rate. For example, Mr. Zhang's body fat rate has reached 31, while a normal male's body fat rate is around 15. This can easily lead to metabolic disorders of the three major energy-producing nutrients in the body. Mr. Zhang's loss of weight is closely related to elevated fasting blood sugar, blood triglycerides, total cholesterol and other indicators.

In addition, fat is part of the human endocrine system. High body fat can also cause disorders in the endocrine system, aggravate metabolic imbalances, and easily lead to a vicious cycle, allowing more fat to accumulate in visceral parts, increasing inflammation and imbalance of internal organs. For men, inflammation imbalance may also cause abnormal nucleic acid metabolism in the body and increase the risk of hyperuricemia.

If weight management is not carried out in time, obesity will continue to increase the burden on the cardiovascular system and cause serious health problems, such as coronary heart disease, hypertension, gout, etc. Obesity can also aggravate respiratory system inflammation and is closely related to snoring and sleep apnea syndrome. It can easily cause fatigue, headache, hypoxia and personality changes, and increase the probability of sudden death during sleep at night.

2. Metabolic abnormalities such as diabetes and hyperlipidemia

Mr. Zhang’s fasting blood sugar has reached 8.23mmol/L, which is higher than the 7.1mmol/L standard for diabetes, and diabetes can be diagnosed . Diabetes is very harmful. Currently, long-term diabetes will induce many complications, including chronic damage to the eyes, kidneys, cardiovascular, and nerves. In addition, diabetes itself is not just a problem of too much sugar. Another important factor is that the ability of normal cells to utilize sugar has declined. Insulin resistance, the predisposing factor of type 2 diabetes, will put cells in a state of hidden hunger. In this state, glucose cannot be used normally, resulting in excessive glucose accumulation in the blood, prompting more intense insulin secretion, and the pancreas is prone to failure due to overwork in the future.

Mr. Zhang’s triglycerides, total cholesterol, and low-density lipoprotein are all on the high side. He belongs to mixed hyperlipidemia. Abnormal blood lipid metabolism will cause excessive accumulation of fat in the blood and increase blood viscosity. The consistency blocks blood flow and increases the burden on the heart. In addition, the high level of low-density lipoprotein indicates that the amount of "bad" cholesterol in the blood is increasing, the blood cleaning ability cannot keep up, and the risk of atherosclerosis will also increase.

In addition, high blood sugar and high blood lipids can easily increase the pressure of blood on blood vessels, induce high blood pressure, and thus increase the risk of stroke.

3. Moderate fatty liver

Abnormal fat metabolism can also cause abnormal accumulation of fat in the liver. Mr. Zhang currently suffers from moderate fatty liver, that is, the fat content in the liver has More than 10, if Mr. Zhang does not drink too much on a daily basis, then the fatty liver belongs to non-alcoholic fatty liver, and moderate fatty liver will seriously affect liver function, and the liver is the most important material metabolism and detoxification center of the human body. Liver function The decline will seriously affect human health.

If fatty liver does not undergo intensive maintenance, it will gradually evolve into liver fibrosis, and then further evolve into cirrhosis in about 10 years. 50% of patients with cirrhosis will develop liver cancer. Liver cirrhosis itself is also prone to serious life-threatening complications such as hepatic ascites, massive gastrointestinal bleeding, liver failure, and hepatorenal syndrome.

In addition, impaired liver function also indicates that the gastrointestinal tract has been damaged. There is circulation and mutual cooperation between the liver and intestines. Mr. Zhang’s digestive system is not good enough and requires timely intervention and adjustment.

4. Uncontrolled diet

Diet is a very important factor in the development of chronic diseases. Uncontrolled diet can cause unbalanced nutritional intake, usually excessive intake of carbohydrates and fats. , and insufficient intake of trace elements and decreased digestive function will also cause the body's ability to digest and absorb protein to decrease. These will cause chronic inflammation in the body and ultimately aggravate the occurrence and development of chronic diseases.

5. Sedentary for a long time and little exercise, maximum oxygen uptake and cardiac function are at low levels within the normal range

Sedentary for a long time and little exercise, coupled with uncontrolled eating, it is easy to ingest If you consume too much energy but don't eat enough high-nutrient-dense foods, your body won't consume much. The calories you eat will be easily converted into fat, aggravating the problems of fatty liver and hyperlipidemia. Exercise can enhance the body's metabolism, reduce inflammation, and improve the ability of the cardiovascular system. However, Mr. Zhang's maximum oxygen uptake and heart function are already at a low level within the normal range, indicating that the cardiopulmonary function is not good enough, and the amount of exercise should be increased step by step.

In order to control the above health risks, Mr. Zhang needs the following health management goals:

1. Lose weight, reduce BMI to the normal range, and reduce body fat rate to the normal range

Losing weight can greatly assist Mr. Zhang in controlling or even reversing the development of chronic diseases, including

Mr. Zhang’s current BMI is 26.8. The first goal can be set at 25, and the second goal can be set at 25. It is within 24, reaching the normal range. Mr. Zhang can continue to work hard to optimize the BMI to reach the ideal body shape of about 22.

At present, Mr. Zhang’s body fat rate is 31, while the normal body fat rate for men is around 15. The first goal can reduce the body fat rate to less than 25, and the second goal can reduce the body fat rate. to below 20, and finally achieve a normal body fat rate within 15.

2. Manage blood sugar and keep fasting blood sugar below 7.1mmol/L

Diabetes is largely caused by what we eat, so managing blood sugar will require Mr. Zhang to carefully cooperate with dietary management The plan is to control blood sugar and keep fasting blood sugar below 7.1mmol/L. Of course, you also need to take medication as directed by your doctor during this period.

3. Manage blood lipids and reduce triglycerides and cholesterol indicators

Hyperlipidemia will bring about a higher incidence of cardiovascular disease, an increased risk of atherosclerosis, and coronary heart disease. The risk of heart disease is also very high. In order to reduce these health risks, Mr. Zhang needs to manage blood lipids and lower triglycerides and cholesterol indicators. During the management period, he can take medication as prescribed by his doctor and manage his diet at the same time.

The emergence of blood lipid problems is directly related to our diet. Our cholesterol is not only synthesized from fat in food, but also from carbohydrates (that is, sugars, including starch). Yes, when there is a lot of refined white rice and noodles in our diet, cholesterol production will also increase, and the cholesterol produced by refined carbohydrate staple foods such as white rice and white flour is more harmful to cardiovascular disease because the low-density lipoproteins they produce Cholesterol particles are relatively small, and when the body lacks the protection of antioxidant nutrients such as vitamin E, it is easily oxidized and deteriorated in the blood, which is a risk factor for inducing blood vessel plaques.

2. Diet management plan

1. Control the total amount of staple food, enrich the types of staple food, and focus on low-glycemic index staple food

Mr. Zhang’s daily diet Staple food should be controlled to about 1 fist per meal, which can ensure that the total daily raw weight of staple food is about 150g, which is a more suitable level.

At the same time, this fistful of staple food should be composed of whole grains, cereals, beans, and potatoes as much as possible, so as to better balance blood sugar after meals. In addition, the carbohydrate intake of diabetic patients is highly individualized. They need to carefully cooperate with the weighing of grams of staple food, as well as post-meal blood sugar testing, and look for patterns after recording.

Whole grain staple foods are what we often call whole grains, such as black rice, brown rice, oats, buckwheat, quinoa, etc. It should be noted that instant oatmeal is a highly processed cereal and has a high ability to raise blood sugar, so it is best to control the amount appropriately. It is best to buy cereal staple food in the form of rice grains. Such grains are rich in dietary fiber. Although they need to be soaked for a longer time to cook deliciously, they have the best ability to control blood sugar.

Miscellaneous beans include various red beans, mung beans, peas, and broad beans. These "snacks" that we think are healthy are actually staple foods. They can be used to replace white rice and flour in meals, and they also contain Part of plant protein is a very good dietary supplement. Miscellaneous grains include our common corn, lotus root and pumpkin. Usually, we think of them as "vegetables", but in fact they have more starch content, so they can provide more energy to the body. At the same time, they are rich in dietary fiber and B vitamins, which can provide a stronger feeling of fullness. Even a fist can be full. They are also more energetic and easier to concentrate because they can make blood sugar more stable. .

The last part of the staple food is called potatoes, which are tuber foods, such as potatoes, yams, sweet potatoes, etc. The staple food for each meal should be limited to the size of your fist. Considering that Mr. Zhang's gastrointestinal injury may be damaged, it is recommended to use half rice (generally white rice, half coarse grains) at the beginning. The grain porridge can be made thicker, as long as it is soft and rotten, to avoid the hard grain porridge after eating. Stomach upset.

Generally, the size of a bowl can be measured with your fist. A small bowl that just fits your fist is enough. You are guaranteed to have such a staple food at every meal. There is no need to deliberately skip the staple food. The key is to choose high-quality staple food. As long as it is rich in dietary fiber, the ability of the staple food to raise blood sugar will not be so high, the ability to stabilize blood sugar will be better, and it can maintain a feeling of satiety for a longer period of time.

A special reminder is that never use whole grains to beat into a paste, or make whole grain soy milk, and do not drink the whole grain juice sold on the market, because once the whole grains are made into this kind of pulp, Water and paste, the dietary fiber in it is interrupted, and the starch is dissolved in the water. It is digested very quickly and has a very high ability to raise blood sugar. It will also dilute the protein in soy milk and rice soup. The nutrients are equivalent and the nutritional value is reduced. Grains must be eaten so that the original appearance of the grains can be seen.

If you cannot accept the change of staple food in a short period of time, you can buy special rice noodles specially designed for diabetics. These rice noodles are specially made with high technology. Although they maintain the form of white rice and noodles, they have a lower impact on blood sugar. It has a strong management effect and can help Mr. Zhang manage blood sugar levels.

2. Increase the intake of high-quality protein and improve the feeling of fullness

High-quality protein food is an essential raw material for our body. Protein is needed for muscle growth and cell repair. , there is no life without protein. Muscle is the key for us to develop a lean physique. The raw materials for muscle repair can allow our body to maintain a high basal metabolic rate (basal metabolism is like the basic power consumption of a mobile phone when it is on standby. The higher the basal metabolism, the more food we eat) The easier it is to be consumed, the less likely it is for people to gain weight), allowing us to lose weight even while sitting.

Healthy weight loss requires more nutrition, of which protein is an essential component. Protein foods need to be added to all three meals. High-quality protein sources include fish, meat, eggs, milk, and beans (soybeans). The daily protein requirement for men is 65g, so the amount of protein food in each meal needs to reach 1 fist. Milk refers to all dairy products, but since milk has the effect of stimulating insulin secretion, Mr. Zhang was advised to eliminate it.

Fish includes all aquatic products and seafood.

Fish, shrimp, crab, shellfish, etc. These seafood are good sources of protein, and they will not gain weight. The meat is red and white lean meat from all poultry and livestock, such as chicken, duck, beef, sheep and pork. It should be noted that you must choose the lean part, such as chicken and duck meat, and remove the skin, because poultry has a lot of subcutaneous fat. You should also choose lean parts of beef, mutton, and pork. Pay special attention to pork, which has the highest fat content. It is best to choose tenderloin and rib parts.

Eggs refer to all eggs. Mr. Zhang does not need to dare to eat egg yolks because he is worried about the relationship between cholesterol and blood lipids. 1-2 eggs a day is no problem. Check the food types in the staple food section. Adjustment is more suitable for lowering blood lipids. The protein in eggs is easy to digest and is great for boiling eggs or making custard.

3. Increase the intake and variety of vegetables

Vegetables are high-density nutritious foods that many men tend to ignore. They can provide essential vitamins, minerals and many phytonutrients for the body. , and it has very low calories, making it very suitable for consumption during healthy weight loss.

The amount of vegetables in each meal should be allocated to two fists, and the types of vegetables need to be diversified. The simplest way is to judge by color. These two fists of vegetables should be eaten to form a rainbow, one The first fist is vegetables with dark green leaves, and the other fist is vegetables of various colors, such as eggplants, tomatoes, carrots, white radish, mushrooms, kelp, etc.

It should be noted that some vegetables actually mainly provide starch and belong to the staple food category. They must be excluded from these two fists and cannot be counted. The specific types are listed in the staple food section below. . In addition, vegetables must be included in breakfast, which is very helpful for Mr. Zhang to balance blood sugar and blood lipids.

4. Choose good oils instead of unhealthy fats

Fats are not all bad. Our bodies need fats, but they need high-quality fats, and fats can help the body. Anti-inflammatory. However, a large part of the oils we use in our daily kitchen are pro-inflammatory, including peanut oil, soybean oil, sunflower oil, corn oil, etc., while the other type of oils that help the body reduce inflammation are rarely eaten.

This type of oil is also an essential fatty acid for the body. They are relatively abundant in flaxseed, chia seed, quinoa and other crops. You can buy some flaxseed oil and perilla oil to eat in cold dishes. , Purple potatoes, sweet potatoes, babe pumpkin and other staple foods are very delicious dipped in flaxseed oil. You can also sprinkle a handful of chia seeds on it when drinking soy milk. High-quality fish oil is also rich in anti-inflammatory fats, so the fish must be steamed or steamed as much as possible. Cook lightly to avoid damaging the fish oil in it due to high heat.

These anti-inflammatory oils can not only help our body repair, but also increase the content of high-density lipoproteins in the blood. These high-density lipoproteins are scavengers of blood vessels. They remove unused cells from cells throughout the body. Cholesterol is recycled back to the liver and used for other purposes, rather than letting it go bad in the blood vessels, thereby reducing the risk of cardiovascular system problems.

During the healthy weight loss period, consuming these high-quality oils in moderation and reducing or temporarily stopping the economical oils we used to eat can help our bodies repair faster and better achieve health management goals.

5. Pay attention to cooking methods

During the health management period, fried and grilled foods should be shielded as much as possible, steaming and stir-frying should be used more often, and salt should be reduced and as much salt should be used as possible. Preserve the nutrients in food.

6. Optional nutritional intervention measures

Patients with type 2 diabetes have severe insulin resistance, accompanied by more serious nutritional deficiencies and malnutrition. In addition to conventional dietary management In addition, it is best to add special nutritional intervention measures to increase the supply of nutrients. You can usually choose a comprehensive vitamin and mineral supplement to improve basic nutrition, allow cells to eat more raw materials, and improve metabolism. At the same time, increase the intake of chromium, which is an important nutrient for glucose tolerance. It can help improve insulin sensitivity and help diabetic patients alleviate insulin resistance.

3. Life management plan

1. Exercise regularly and choose acceptable exercise methods

Exercise that suits your physical ability can reduce inflammation and promote blood circulation , increase cardiopulmonary function, increase muscles and promote metabolism. Since Mr. Zhang currently has a large weight base, he needs to pay attention to avoid damaging his knees during exercise. You can choose to wear a health bracelet, use walking or Tai Chi, or consult an experienced sports personal trainer. As long as you do moderate activities but not excessive, exercise is very helpful for your health, especially to reduce the poor blood circulation caused by sitting for a long time. Smooth, weakened cardiopulmonary function will be helpful. However, you must be careful not to cause yourself any sports injuries. For example, you must do a good warm-up exercise and pay more attention to nutritional intake.

2. Go to bed early and get up early, maintain a regular work and rest schedule

Relaxation and meditation can help our body reduce stress. Going to bed early and getting up early is in line with the law of the biological clock, and can help the gastrointestinal tract recuperate according to biological rhythms. , which is beneficial to the repair of the gastrointestinal tract. During health management, try not to stay up late.

3. Eat three meals at regular intervals, chew slowly and do not look at your mobile phone or work.

When eating, if you eat too fast, or if you are distracted by watching TV, scrolling on your mobile phone, or working, the secretion of gastric acid will be affected, which will reduce the digestive ability of the stomach. Without sufficient gastric acid, protein foods will be difficult to completely decompose and absorb, and the body will not receive sufficient nutrients. Therefore, when eating, you need to chew each bite 20 times and eat a meal for 30 minutes. The order of eating is also important when eating. Follow the order of soup-vegetables-meat-rice. First drink a small bowl of stomach-warming soup (if available), then eat vegetables, meat, and finally the staple food, so that you can eat both at the same time. It makes you feel full without eating too much staple food.

The above is the analysis and adjustment plan for Mr. Zhang’s physical examination report.