Dr. Sorina Ispas, specialist in diabetes and nutrition, the truth about weakening dietary supplements: how effective they are and what risks they hide

In a hurried world, in which fast solutions seem more attractive than habits built over time, supplements are often presented as shortcuts to energy, immunity or longevity. The advertisements exploit our desire to have effortless results, promising spectacular benefits, without reminding the importance of balanced nutrition, movement or rest. Thus, a tension is created between the image produced by marketing and the scientific reality: supplements can be useful in certain contexts, but they cannot replace the foundations of a healthy lifestyle.

Dr. Sorina Ispas Personal Archive

Dr. Sorina Ispas, a specialist doctor diabetes, nutrition and metabolic diseases, explained for “Weekend Adevărul” what is the danger we expose, but also how our body suffers if we take dietary supplements without asking for a doctor's advice..

“Weekend Adevărul“: Before, to get rid of the extra kilos, there was only one solution: to eat less, but now on the market there have been much more handy solutions, synthetic or homeopathic products. What does medicine say about these products?

Dr. Sorina Ispas: In recent years, the weight loss supplements have exploded. Supplements are so common that they print the idea that they do wonders without the help of a healthy lifestyle. The advertisements are very attractive, but science shows that the real effects on the weight are minimal. If before the solution was clear – less food and more movement – now there are synthetic products, food supplements or homeopathic solutions that promise quick results.

How effective are these dietary supplements?

Small to moderate efficacy, frequently below the relevant clinical threshold. Even when an initial decrease occurs, it is often water and low mass, not fat. In conclusion, their efficiency is reduced and in the short term, with the risk of the yo-yo phenomenon and the weight gain will be quick. The appearance of metabolic memory is essential in any balanced weight loss process.

What are the health risks in the case of their consumption? Many products are sold online, not subject to any sanitary control, without the product information in Romanian …

Certain neglected health conditions (diabetes, hypertension, arrhythmia, hyperthyroidism, liver/kidney disease) may be aggravated if a correct therapeutic behavior is not established. We had documented situations in which “natural” supplements for weight loss led to emergency hospitalizations for acute hepatitis.

Supplement vs treatment

Are dietary supplements that can affect the liver or other organs?

Not all supplements are harmless. Indeed, some may affect the liver, kidneys or even cardiovascular system. There are documented cases of toxic hepatitis induced by weight loss supplements. Also, certain treatments may aggravate pre -existing diseases (hypertension, arrhythmia, diabetes). Let's not forget about the teas in which there were traces of amphetamine. We do not have to confusion between supplements, which by definition did not go through the clinical trials, and the approved treatment that has proven its benefits through clear scientific research and documentation. Obesity treatment is safe and has the solid research basis in order to be approved and put on the market.

What advice do you give to those who, although they do not have a prescription, get injections for diabetics and call on this path to lose weight? The use of ozempic has become an international fashion.

Dr. Sorina Ispas Personal Archive

Oral semaglutide and cauldlutide (injectable) are strictly approved for type 2. diabetes management. In contrast, injection semaglutide, lyraglutide or thyrzepid are approved for the treatment of obesity for weight loss, according to specific criteria (BMI). Injectable forms (injection semaglutide, thyrzepid) are clearly superior in weight loss. Semaglutide, in oral form, not being approved for obesity, has more modest effects on weight. In our common struggle against obesity we are lucky, because we have treatments approved in Romania, which have proven their efficiency and multiple benefits are documented through clinical studies.

Weakening must be monitored

Can you lose a few pounds in a week?

Yes, but be careful what is lost … unwanted water and muscle mass. The correct monitoring is by regular evaluation to the doctor, to verify if it has lost visceral, subcutaneous or muscle mass. Therefore, evaluation of body composition (BIA, DEXA) is essential to differentiate fat loss from muscle mass.

What effect does the loss of kilograms have on the body in a very short time? In the case of many women, they prevail the physical appearance, but there are also associated diseases.

Through protective mechanisms, the body wants to restore what has lost and this leads to quick recovery of kilograms. The negative effects are: loss of muscle mass – not just fat, which slows metabolism; nutritional deficiencies – through extreme diets or severe restrictions (vitamins, minerals, proteins); Hormonal imbalances – affects the thyroid, cortisol, estrogen/testosterone; Cardiovascular impact – oscillating blood pressure, rhythm disorders; risk of gallstones – especially at fast losses, over 1.5 kg/week; Yo-yo effect-lost kilograms often come back, sometimes with surplus; Hair loss, nail fragility and skin left due to the sudden decrease in nutrient and collagen reserves. Ideally, we would have a slow and constant decrease (0.5-1 kg/week).

Also, a weight loss cure should be associated with physical activity, which protects muscle mass, and a balanced diet and correct hydration. In patients with chronic diseases, such as diabetes or hypertension, medical and nutritional monitoring is recommended.

In other civilized countries, what is the situation?

Many “weight loss supplements” have been banned or withdrawn from the market due to liver or cardiovascular toxicity. Countries with firm action are US, Canada, UK, Australia. In these countries, Ephedra (Cârcei) or Aristolochia (the wolf's apple) have been declared illegal, in others they are forbidden, and the imports, sanctioned.

The key to success: high quality, small quantity

FOOD FOOD FOOD SUPPERS

Hungry is a solution? There are people who eat one day yes, one no, and others say they didn't eat six to seven days.

Hungry is not a solution and can cause severe deficiencies, hormonal disorders and yo-yo effect. The consequences are serious in the long term by decreasing the basal metabolic rate. The person will try to lose weight later and will not be able to reduce the basal metabolic rate by starvation. Our body knows how to calculate intelligently to protect itself. We confuse it when we do not understand that there is a mathematics in the correct calculation of several parameters.

To lose weight is it more effective to eat less at the same meal or healthy foods?

The key to success? The quality and structure of the tables and not to neglect the quantity of the portions. It is much more effective to choose healthy foods, reduce processed sugars and fats, than simply eat less, blind calories.

“Healthy food can be tasty”

What would be a daily menu of those who want to get out of pounds? Do the oatmeal in the morning represent a solution?

Example of daily menu: at breakfast you can eat oatmeal with natural yogurt and berries (attention, oats increase blood sugar, but also has fibers that slow down; the portion matters). At noon it is good to eat grilled chicken breast, high salad with raw vegetables and olive oil, and for dinner, oven with steam vegetables. If we want snacks, these can be raw nuts, Greek yogurt, fruits with low glycemic index, ie not bananas and grapes. And healthy food can be tasty, but tastes are also educated.

When is it best to consume fruit?

Fruits, abundant in vitamins, should be consumed in the first part of the day, for their effective absorption. The breakfast cannot be replaced by any other meal of the day. If you jump over the first meal of the day you tend to eat more at lunch, usually many calories, processed products, fast food. I draw attention to a fact: consuming tasty, but unhealthy products, leads to deficiencies of vitamins and minerals, and children will especially suffer from iron deficiencies, zinc, calcium.

Is black bread healthier than white flour? What should we look at the label when we buy it?

Whole grain bread (made of flour with bran) is healthier than white, because it has more fiber and a lower glycemic index. However, the labels can be misleading: a colored bread with malt or caramel is not necessarily integral. When purchasing, it must be checked: the first ingredient should be “whole flour”, to have a minimum of 6-7 g fiber/100 g product, not to contain unnecessary additions of sugar or hydrogenated fats. I like homemade bread. I knead and bake bread at home and I am sure that they are not extra -unwanted ingredients.

“Healthy Plafuria” for the little ones

In the case of overweight children, does the situation change? In their case is it completely forbidden to ingest food, synthetic or homeopathic supplements? Or from case to case?

Their treatment consists in changing the lifestyle, family involvement, correction of diet and encouraging daily movement. In some cases, psychological counseling is recommended. Visceral fat also occurs in children and adults and leads to multiple short or long -term complications. Blood fats affect the whole body, from head to soles.

As a specialist, how do you treat a small overweight patient? Are there different treatments?

Gently, trying to understand the cause of the weight surplus. There are children who have accumulated several pounds during the vacation, but it's not a problem. I do not recommend weight loss diets. Instead, I recommend making physical effort. It is ideal to practice a sport, in an organized framework, with a coach.

How do we determine the little ones to eat vegetables?

Children eat “with their eyes”. On the plate, the vegetables should be cut into playful shapes, and if the plate is colored, there are greater chances that the baby wants to try vegetables and replace the sweets. As a rule, the little ones do not do what they are told, but inherit the rules and customs in the family. Where the parents eat vegetables, drink water and not juice, are physically active and do not sleep in front of the TV, sleep enough, then their children will follow the example and will not start the meal with a chocolate. According to estimates, by 2035, one in four people will live with obesity and two of five children will be overweight or obese, worldwide.

You had a campaign that spoke to the students from the National College “Constantin Brătescu” in Constanța about the concept of “Healthy Plafurie”.

Yes, everything is about education, but over time it is learned-and fast recipes for busy parents and not to forget to involve children in training. Students are eager to learn, which made me think I came to their soul. It was a dialogue, not a monologue. They listened and asked relevant questions.

What does the “healthy plate” look like?

Half of the plate must have fresh vegetables and fruits, as varied coloristically, on a quarter to have lean meat, fish, eggs, legumes, another quarter to be whole bread, brown rice, whole pasta, and the rest is complemented by water, olive oil, avocado, nuts.