Dr. Natalia Trofimova gave an interview to Virtuaalkliinik on the topics of healthy nutrition and diet on April 26, 2024. You can read a summary of the interview in English below:

Diet Choice Depends on Health Issue

“Even an overweight person can be happy if everything is fine and they are satisfied with their health and weight. Inevitably, excess weight starts affecting health at some point, and then one should think more about how to change their dietary habits. Is it to reduce weight or lower cholesterol levels? Is it to get blood pressure to normal or alleviate joint pain, find a solution for skin problems, or allergies?” says Dr. Trofimova.

Accordingly, the doctor can decide which analyses need to be done and which dietary plan may help address health issues. If a person doesn’t know whom to turn to, they should always start with their family doctor.

Dr Natalia Trofimova on 40aastase kogemusega kliiniline arst, üldarst-terapeut, toitumisnõustaja ning loodusravikeskuse Loodus BioSpa ja Biokliiniku peaarst. Ta on populaarse raamatu “Paastuga terveks” autor.

Natalia Trofimova is a clinical physician with 40 years of experience, a general practitioner, a nutrition consultant, and the chief physician of the nature health spa Loodus BioSpa and the Bioclinic. She is the author of the popular book “Healing with Fasting.” Photo: private collection

Dr. Trofimova says that often patients come to her with previously conducted analyses that don’t provide her, as a doctor, with the necessary information about the specific patient’s complaints and illnesses. Therefore, first and foremost, one should set a goal with the doctor and discuss what the problem is. Based on the diagnosis, the next steps can be chosen – deciding which dietary plan or dietary restrictions to choose and what additional analyses need to be done.

Doctor Gives the Diagnosis, Nutritionist Develops the Menu

So, first, one should consult a doctor who will examine the patient’s health condition, and only then turn to a nutritionist. “I only refer the patient to a nutritionist after I have determined the reasons for the patient’s complaints – what exactly is the goal of this person’s dietary plan, and what do we expect from nutrition therapy. The nutritionist helps to create a balanced menu and combine recipes,” she says.

“For example, in the case of the Dr. Simeons diet (a strict 40-day diet named after its creator, aimed at weight loss, known worldwide since 1977), the person must accurately record what and how much they eat. The consultant reviews the dieter’s diary online to see if the person has eaten enough or incorrectly or if any problem has arisen. Definitely, stricter diets require supplements. We have conducted studies to determine metabolic syndrome – for example, the person must have normal blood indicators to start dieting,” Dr. Trofimova points out why it is important to check a person’s health before starting a diet.

“Even with the Atkins diet (one of the world’s most famous low-carb, high-protein diets, created in 1972 by Dr. Robert Coleman Atkins), which is an example of a ketogenic diet, it is important to check kidney function so that the person doesn’t harm themselves,” she emphasizes.

If one wants to eat more balanced and healthier, they can find dietary advice on the website of the Estonian Health Development Institute, where there is a free NutriData nutrition program that provides useful advice for healthy eating

Theory of Metabolic Flexibility

The book “Met Flex Diet: Use Better Fuel, Burn More Fat” is based on the theory of metabolic flexibility, starting from the premise that we can change the speed of our metabolism ourselves. Dr. Trofimova comments that the principle of every diet or dietary plan is to reduce insulin resistance (the condition in which the body does not properly respond to insulin and cannot use glucose from the blood for energy).

“The Met Flex Diet” also incorporates principles of intermittent fasting. “Intermittent fasting trains metabolism – and that’s good!” Dr. Trofimova acknowledges that the theory of metabolic flexibility is explained sufficiently clearly in the book. “However, concerning these recipes, for each recipe, if we want the food to train metabolism, it is necessary to have separate information about carbohydrates, proteins, fats, and calories,” she notes. Since people vary in height and weight, metabolic training must also consider a person’s basal metabolism.

She points out that, more specifically, in addition to fast-acting and slow-acting carbohydrates, the metabolism of fats and proteins is also important in dieting. Dr. Trofimova emphasizes that when starting a diet, one should definitely know the person’s health background – whether they have food intolerances, lactose, or gluten intolerance – all of these nuances can only be considered by a doctor.

Why Fasting Was and Is a Popular Diet?

Dr. Natalia Trofimova recalls that in the past, 15 different diets were used according to the disease – for example, for gout, intestinal, stomach, or joint problems. Nowadays, many food intolerance tests are used to show how a person’s body reacts to a specific food. Based on the number of immunoglobulins, one can see how well a person tolerates a particular food. “It’s all very personal, and before any recommendations, you need to know the person’s health condition – for example, to have various blood tests done, to examine cholesterol levels, what preparations the person takes,” notes Dr. Natalia Trofimova, that only a doctor can interpret food intolerance tests.

Dr. Trofimova says that even today, the most popular diet is fasting, which has been extensively studied. “In 2016, Japanese cell biologist Yoshinori Ohsumi received the Nobel Prize for the discovery of yeast cell autofagia (autophagy is a catabolic process in which a starving cell reorganizes nutrients from unnecessary processes to more important processes). Therefore, autophagy helps burn sick inflammatory cells at the right time in the body, but this cannot be done with a pill; the body must be put in a situation where it restarts and activates its reserves and resources.

Diet – Lifestyle, Long Life

The word “diet” was first used in English in the 13th century. Its original meaning was the same as today, namely “ordinary food and drink.” However, in the Middle Ages and the early modern period, the word “diet” was also used in another sense: namely, the original meaning of the Greek word δίαιτα is derived from a verb meaning “to lead life.” “Diet therefore also means a long life – that one must choose a suitable lifestyle,” makes Dr. Natalia Trofimova a small digression into (linguistic) history.

Food Pyramids Have Changed Over Time

Speaking of food pyramids, Dr. Trofimova says that every country has its own pyramids, and they have changed over time. “But the principle is that there are essential nutrient groups that must be present in our diet – carbohydrates, fats, proteins, micronutrients, and vitamins. But within each group, we must also choose, for example, which protein or carbohydrate is better for a particular person. Some people do not tolerate certain grains and they need to include in their diet those carbohydrates that suit them better,” she explains. One cannot solve their health problems with a 7-day diet, because in the case of illness, and especially if one wants to keep it under control, it is necessary to change their diet.

“For example, for people with asthmatic diseases or autoimmune diseases, dairy product consumption needs to be reduced,” she explains that in certain cases, dietary restrictions are necessary.

Weight loss Medications and Bariatric Surgery

Dr. Trofimova notes that metabolic training is indeed very important. Weight loss medications are indicated when other weight loss options (diet, lifestyle, physical activity) have not helped the patient, and the same applies to the treatment of diabetes where appropriate medications are indicated. “I believe that everything has its indications. If we want to lose weight faster, then medication can be helpful at the beginning, but one must think about what to do next. Certain medications reduce appetite, and as a result, calorie intake decreases,” she explains. The need for medications is decided by the doctor based on the specific individual.

But who and when needs bariatric surgery? “First of all, the person must understand before the surgery that they will lose a certain part of their stomach permanently, and the absorption of nutrients and vitamins is disrupted, and they will need to start taking supplements constantly. So, the indication for bariatric surgery is still when a person otherwise cannot control their excessive weight or has many accompanying diseases – such as diabetes, heart problems,” explains Dr. Trofimova. It must be understood that after the surgery, it is necessary to change one’s lifestyle and diet.

When Assistance Is Needed, One Must Seek a Specialist

“Supporting individuals often requires the expertise of a specialist who guides and explains. Experience confirms that when a person’s goals and action plans are clearly articulated, their success becomes more noticeable,” she emphasizes the importance of specialists. Drawing from her experience at Loodus BioSpa, she highlights how the environment and program there help individuals find support from both specialists and others through courses and group activities, in addition to offering exercises, massages, and breathing exercises.

“Our program is like a puzzle, where a suitable solution is found for everyone – whether it’s fasting or a specific diet. People quickly adapt to the new routine, especially when it is supported by a different environment and program. Breaking out of the routine inspires, and experience builds confidence, which in turn makes independent continuation easier,” she explains how new environments and experiences can breathe new life into one’s existence.

Source: Dr Natalia Trofimova: dieeti alustades on oluline paika panna eesmärk (virtuaalkliinik.ee)