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  今年春季以来,“体重管理”持续成为公众关心的热点。体重是评估人体营养与健康状况的核心指标,每个人都是自己健康的第一责任人。如何管理体重才更有效?“管住嘴”“迈开腿”就够了吗?中日友好医院的多学科医生,针对体重管理的常见问题进行了解答。

  “练哪儿瘦哪儿”是一个伪命题

  网络上流行很多瘦腿、瘦腰的运动减肥方法,然而很多人练习之后发现效果并不明显,这是什么原因呢?

  中日友好医院康复医学科主任江山表示,“练哪儿瘦哪儿”其实是一个伪命题。“身体里的脂肪就像是装在桶里的水,不是从桶的哪个部位舀出,哪个部位的水就减少。脂肪减少也是全身性的,而不会发生在某个特定部位。”

  江山进一步解释说,很多人会通过卷腹锻炼来瘦腰,但实际上,卷腹可以增强腹直肌的力量,却并不会直接起到瘦腰的效果。因为腹部脂肪的减少是随着整个身体脂肪含量的减少而发生的。在减肥的时候,脂肪多的部位瘦得较快,脂肪少的部位瘦得较慢,这种现象会让人们误以为局部减肥有效,但其实这只是全身脂肪分布的自然规律。因此,如果想要瘦腰,不能只依赖于腰部的锻炼,而是要通过合理饮食和运动,减少整体脂肪含量,进而达到瘦腰的目的。

  “喝凉水都胖”怎么办

  很多正在减肥的人会抱怨,自己明明吃得不多,却还会长肉,甚至“喝凉水都胖”,这是怎么回事呢?

  中日友好医院营养科主治医师于永超认为,在排除疾病和药物影响因素后,如果“觉得吃得不多”却依然会变胖,很可能是因为“吃得不多”未必是真实情况。有些人可能只是饭吃得少,但客观上,一天中吃的所有东西的总量却并不少。

  不过,现实中确实存在吃得很少,却很难瘦下来的情况。于永超说,这是因为这些人曾经有过节食减肥的历史。如果经过多次反复节食,身体的基础代谢率会降低,变成“易胖体质”,从而使身体合成脂肪的效率增高,导致吃一点东西就会变胖。

  此外,很多上班族还存在“过劳肥”的现象,这是因为,在睡眠不足、压力比较大的情况下,皮质醇会升高,从而导致体内脂肪向躯干部位聚集,也就是所说的“向心性肥胖”。

  于永超说,评价一个人的胖瘦,不能简单地看身高和体重,更要关注代谢参数,进行身体成分分析。比如一个“肌肉型”的人,就像大草原上奔跑的骏马,虽然吃得不少,但运动量很大,也就不会存在“吃什么都胖”的情况;而一个“脂肪型”的人,即使吃得不多,也会把脂肪储存在腹部,就像沙漠里的骆驼,将脂肪都储存在驼峰一样。

  于永超说,体重管理最关键的是要“稳”,不能过度节食。要通过规律饮食,将基础代谢“养”上去,再通过运动,锻炼肌肉,把自己的状态从“骆驼”变成“骏马”,从而解决“喝凉水都胖”的问题。

  生酮饮食法减肥有弊端

  《中国超重/肥胖医学营养治疗指南(2021)》里推荐了低碳水化合物饮食的减重方法,通过适当降低碳水化合物的摄取量,达到减重的效果。

  于永超提醒,低碳水化合物饮食过程中不能走极端,例如正常饮食中的碳水比例通常是50%-65%,想要减重的人群可以将其降低到40%左右。但是如果完全戒掉碳水化合物,例如采取网上流行的生酮饮食法,则会给健康带来很大风险。生酮饮食法能够将脂肪快速分解,并通过尿液排出,但同时需要付出心情烦躁、抑郁、失眠、脱发、便秘,以及女性生理期不规律的代价,尿酸高的人还很有可能痛风发作,血脂高的人会加重动脉粥样硬化的进程。

  如何判断自己是否需要减重

  需要注意的是,体重管理并不意味着以瘦为美。在关注体重管理的同时,先要判断自己是否属于超重和肥胖人群。那么,如何评估自己的体重是否正常?什么时候需要减重呢?

  中日友好医院体检中心主任马骁介绍,临床常用的体重评估方法有三种,第一种是体重指数,也叫体质指数,即BMI。对于中国人群来说,18.5≤BMI≤23.9,属于正常范围;24≤BMI≤27.9属于超重;BMI≥28属于肥胖。不过,BMI的评估方法具有一定局限性,不能明确区分脂肪和肌肉的重量,可能会将肌肉发达的运动员型人群误判为超重和肥胖。

  第二种是腰围和腰臀围比,中国成年男性腰围≥90厘米,女性腰围≥85厘米,即可判定为腹型肥胖,也叫中心型肥胖。腹型肥胖比BMI定义的肥胖对体内代谢健康影响更大,因此,大腹便便的“苹果型”身材的人群,需要进行积极的体重干预。

  第三种方法是体成分分析,即通过生物电阻抗分析法,根据脂肪、水、肌肉导电强弱的不同,来综合评估肌肉、脂肪的分布是否合理。这种方法可以检测出“隐形的胖子”,也就是BMI和腰围测量在正常范围,但体脂率(体脂率是人体脂肪重量占总体重的百分比,中国成人男性的体脂率大于25%、女性大于30%就属于肥胖的状态——记者注)其实已经超标的人群。

  上班族管理体重的三个要点

  肥胖与不良生活方式密切相关,然而,加班、熬夜、饮食不规律是很多上班族的生活常态,这部分人群应如何有效管理体重?

  马骁表示,体重管理没有捷径。要想有效控制体重,必须从调整生活方式做起。

  马骁介绍,管理体重有三个要点:首先要重视,要意识到超重和肥胖状态会对健康产生严重影响,甚至可能危害生命。其次要掌握吃、动、睡眠和心理调整的科学办法。

  在饮食方面,可以按照中国居民平衡膳食宝塔(2022)推荐的种类和数量进食,同时采用一些辅助性的小技巧,例如用小型餐具来减少主食的摄入,控制吃饭速度(太快进食也会增加肥胖和超重的风险),调整进食顺序——先吃蔬菜,再吃蛋白质类,最后吃碳水化合物、谷物类,科学的进食顺序对避免血糖升高和体重增加也会起到一定效果。

  在运动方面,对于紧张忙碌的上班族来说,可以利用碎片化的时间进行运动。比如把上下班的交通方式改为骑车或者跑步,在开会时通过局部运动来锻炼肌肉力量,尤其是四肢肌肉力量。

  在睡眠方面,需要养成良好的睡眠习惯。高质量睡眠有助于调节体内激素平衡,控制食欲。而在睡眠不足时,身体会分泌更多的饥饿素,使人更容易感到饥饿,从而增加食物摄入。

  在心理方面,要调整心理状态,缓解压力,避免因压力导致过度饮食。

  最后,要在身边营造关注健康体重的氛围,比如跟家庭成员一起运动,控制饮食;同事之间互相提醒,一起做工间操。互相督促的环境更有助于养成体重管理的习惯。

  中青报·中青网记者夏瑾来源:中国青年报

  2025年04月19日03版

  4月19日电据中央气象台网站消息,预计未来三天,江南等地多降雨和强对流天气,关注可能引发的次生灾害及对交通安全、简易搭建物、农业生产等的影响;黄海、东海等地关注大雾对船舶航行的影响;西北地区多沙尘天气,关注对交通、人体健康等影响。

  江南等地有大到暴雨和强对流天气

  未来一周南方地区多降雨和强对流天气。19日,湖南东南部、江西中南部、浙江南部、福建北部、广西北部、广东西北部等地部分地区有大到暴雨,其中,湖南东南部、江西南部局地有大暴雨;西南地区东南部、江南西南部和中东部等地的部分地区将有8级以上雷暴大风或冰雹天气,其中,江西中南部、福建西北部等地的部分地区将有10级以上雷暴大风,最大风力可达11级,中央气象台4月19日06时继续发布暴雨蓝色预警、强对流天气蓝色预警。

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