– The content of the Standard Plan

1. Miosotis Healthy Living Programme – Printed and online edition
     – Duration: 18 weeks, divided into 5 phases.
     – Format: A high-quality book that will be sent by post.
     – Purpose: To facilitate in-person consultation and the manual recording of notes, weight, waist circumference and vital signs, allowing the subscriber to track their progress in a tangible way. The online version is intended to make consultation easier, at any time and in any place.
     – Monitoring: The data must be recorded weekly in the online section so that the clinical team can assess progress and adjust the menu for the next phase.

2. Daily standard menu
     – Structure: Standard menu provided daily, in 1500, 1800 and 2000 kcal formats per day.
     – Adaptation: Users should adjust the menu in line with their biometric progress, dietary restrictions and the clinical team’s recommendations.
     – Online support: Weekly access to the standard recommendations and to the adjustments suggested by the clinical team at the end of each week in order to improve the eating plan for the following week.

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3. Nutrigenetic assessment
     – In almost all people with obesity, the obesity is polygenic in nature, that is to say, it is due to multiple genetic variants.
     – Nutrigenetics allows us to obtain information on:
          1) The predisposition to respond better to low-carb or low-fat diets.
          2) The regulation of satiety, according to how leptin and ghrelin signalling is affected.
          3) The response to exercise and the most advisable type of exercise.
          4) The individual response to anti-obesity medicines, optimising the effectiveness of treatment and reducing the risk of side effects or of therapeutic failure.
     – It should be borne in mind that genes represent only a predisposition, not an inescapable destiny. Epigenetic factors, such as lifestyle, sleep, stress and the gut microbiome, play a crucial role in modulating the expression of genes. The genetic interpretation will be carried out by the Programme’s clinical team, within the patient’s overall clinical context.

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4. Daily personalised menu
     – Exclusivity: In addition to the standard menu, subscribers receive a personalised plan at the start of each week, covering every day of the week. Three alternatives are presented, adapted to the subscriber’s place of residence and to the time of year.
     – Personalisation: Based on the subscribers’ genetic information, their objectives, changes in parameters and personal preferences.
     – Coverage: Includes all daily meals (breakfast, lunch, dinner and snacks), presented in the form of 3 alternatives.

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5. Physical activity advice
     – Frequency: A minimum recommendation of 30 minutes a day.
     – Method: The focus is on integrating physical exercise into the daily routine (making use of everyday routines to be physically active, and exercises at home such as press-ups, sit-ups and squats), rather than being limited to running or walking.
     – Benefits: Reduced cardiovascular risk, weight loss, improved sleep, reduced stress and the prevention of chronic diseases.
     – Flexibility: Teaching “physical activity equivalents” so that exercise can be adapted to each individual’s lifestyle.

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6. Physical activity programme
     – Structured Approach: Unlike the basic plan, this is a programme designed and coordinated by exercise physiologists.
     – Content: It includes daily activities and aerobic exercises introduced in phases 0 and 1.
     – Monitoring: Physiologists monitor how it is carried out and introduce specific adaptations for each participant, with a view to cardiovascular, metabolic and mental benefits.

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7. Motivational advice
     – Mindful Eating: Turning the act of eating into a mindful ritual, eliminating the automatic consumption of food and excessive alcohol intake.
     – Emotional Control: Learning to distinguish physical hunger from emotional hunger (“cravings”) in order to eliminate compulsive behaviours .
     – Techniques: Eating slowly, recognising the signs of satiety, using the five senses and dealing with guilt or food-related anxiety.

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8. Motivational programme
     – Focus on mindful eating: It turns eating into a mindful act in order to eliminate compulsive behaviours and food “cravings”.
     – Specialist support: A structured weekly programme, led by psychologists.
     – Methodology: Teaching techniques in phases 0 and 1, followed by weekly follow-up and corrections based on individual progress after phase 1.

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9. Advice on super-nutritious and functional foods and on cooking techniques 
     – Superfoods: Rich in antioxidants and vitamins (e.g. açaí, chia, quinoa).
     – Functional foods: They contain active compounds that prevent chronic diseases (e.g. olive oil, green tea, broccoli).
     – Foods that activate the sirtuins: Foods that activate the sirtuins (proteins that repair DNA and burn fat), such as dark chocolate, walnuts and turmeric.
     – Application: These foods are incorporated into the menus in optimised quantities so as to maximise metabolism and longevity. Weekly delivery of content on healthy cooking techniques, the properties of foods and current topics in the field of nutrition.

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10. Healthy Eating Literacy Programme.
     – Purpose: Understanding and applying nutritional information so as to make informed, balanced dietary decisions. It is not merely a matter of having theoretical knowledge, but of turning that knowledge into practical everyday action.
     – Knowing how to choose: Understanding and interpreting the nutritional labels and traffic-light labelling on supermarket products.
     – Knowing how to plan: Managing the budget, selecting foods and structuring varied meals.
     – Knowing how to prepare: Preparing food safely and healthily.
     – Critical thinking: Distinguishing recommendations based on scientific evidence from nutritional misinformation.
     – Disease prevention: It acts as a public health tool to prevent obesity, diabetes and cardiovascular problems.

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11. Weekly monitoring of weight and waist circumference
     – Key indicators: Weight and waist circumference are the fundamental metrics for measuring the effectiveness of the programme and the reduction in cardiovascular risk.
     – Dynamic adjustment: Monitoring takes place at the end of each phase so as to allow the precise adjustment of the menus (standard and personalised) for the next phase.

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12. Personalised teleconsultation on healthy eating
     – Ongoing support: Permanent support from the clinical management team to answer questions about the nutrition, physical activity and motivational programme.
     – Access: Questions are submitted by means of an online form or chatbot.
     – Rapid response: Clarifications provided in real time or within a maximum of 24 hours.

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13. Personalised assessment of cardiovascular and of OBSCORE risk
     – Periodic calculation: carried out at the end of each phase on the basis of the data provided by the subscriber.
     – Differentiated Objectives:
          1) High Risk and moderate risk: Focusing on a significant reduction by the end of the 18 weeks.
          2) Low Risk : A focus on maintaining and stabilising the values.
     – In the long term: The promotion of habits that ensure the reduction or the maintenance of cardiovascular health over the years.
     – OBSCORE: this is a model that estimates the risk of 18 complications of obesity over 10 years in individuals with a BMI ≥ 27 kg/m².
          1) It is based  on just 20 routine clinical variables, which were selected from more than 2000 potential indicators.
          2) It allows personalised risk profiles to be generated, which is especially useful for prioritising modern and expensive therapies.
          3) It also makes it possible to: identify the subscribers who will benefit most from early intervention; select the optimal therapeutic modality; and monitor progress and the response to treatment.
          4) It represents an advance on BMI, since it replaces a single metric with a multidimensional profile based on real-world data. With just 20 variables, it is able to predict the risk of developing 18 obesity-related complications over 10 years.

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14. Personalised report every week
     – Detailed feedback: Delivery of a detailed weekly report, drawn up by the clinical team.
     – Content: It analyses adherence to the programme and progress in weight, waist circumference and cardiovascular risk.
     – Adjustments: It includes specific recommendations to correct or optimise eating and physical activity habits for the following week.