Medical nutrition therapy of obesity and its metabolic complications.

Diet therapy of obesity and its metabolic complications is focused on the reversal of chronic positive energy balance, systemic inflammation and adipose tissue dysfunction. The priority in the treatment is caloric restriction together with increased nutritional quality, prevention of nutritional deficits, care of intestinal microbioma, reduction of the organism's exposure to contaminants and increase of the protective components in the diet. The recommended daily energy dose ranges from very low-calorie diets (1.5 to 3 MJ) to low-calorie diets (5 to 7 MJ). According to common EASD and ADA guidelines, the following energy-restricted types of diets are recommended in the management and prevention of metabolic complications of obesity in the form of type 2 diabetes mellitus: Mediterranean, DASH, low-carbohydrate, and vegetarian style of diet. Particular attention is required for the diet following metabolic-bariatric surgery, which is focused on the prevention and treatment of potential nutritional deficits.