Nutrition and Dietetics

The Diet is one of the cornerstones in the treatment of overweight and obesity, a serious public health problem that is reaching epidemic aspects and represents one of the greatest medical challenges in developed societies.

The prevalence of obesity in Europe is between 10% and 25%. It is the second leading cause of preventable death in the developed world, following illnesses resulting from the consumption of tobacco. It is an additional risk factor when certain pathologies exist: heart diseases, respiratory problems, etc. It is also in the origin or aggravation of many pathologies: sedentary osteoarthritis, diabetes, varicose disease, hernias, etc.

In the fight against obesity it is essential to have a long-term multifactorial approach: less sedentary, an eminently hypo caloric and balanced diet, and support of pharmacotherapy with an extended control and monitoring.
Obesity is the result of an imbalance, usually chronic, between energy intake and output, resulting in a positive energy balance (= energy reserve). The Dietotherapy should allow control of the energy intake. There are countless diets. For the establishment of either one of them a preliminary step is essential, as in performing preliminary analytical determinations (blood chemistry, blood count, thyroid function, etc.), in addition to a medical history with a detailed anamnesis and study of habits.

A weight loss program should be essentially hypo caloric. Restrictions are based on quantity and/or quality.

Referring to the duration of treatment, it is essential to understand and accept the nature of the chronic obesity. It is based on genetic and constitutional changes, in eating behaviors, in a worrying tendency of inactivity. Research is carried out in relation to those with the aim to redirect them. However, for now, all authors agree on the need to establish long-term therapeutic guidelines, controls and prolonged monitoring, even after achieving the desired weight reduction. THE PRIME OBJECTIVE IS TO ACHIEVE A DIETARY REEDUCATION IN ORDER TO ACCOMPLISH STABILITY OF THE RESULTS.

As a final remark we must note that being overweight and obesity, given its effect on the overall health of people, surpass the realm of the purely aesthetic, and in many cases is related to errors in habits. It is always necessary to have preventive hygienic -dietary advice. When they appear, diet therapy should be considered, choosing the most appropriate diet for each patient, such as liposuction, and even intermediate alternatives such as the placement of a intragastric balloon or more radical surgery, such as gastroplasty.



Sensitivity studies and food intolerance:

When we eat food it interacts with our organism through chemical processes, which do not always involve beneficial consequences. In these cases we must distinguish two distinct phenomena, with different clinical consequences:


Food allergy: A process mediated by an antibody, immunoglobulin E, developed by our defense system against the protein of the ingested food. This process manifests itself by a rapid and more or less intensive cause-effect reaction (itching, swelling, rashes, etc.), which can result in the patient having to consult an emergency medical service.

Food intolerance: A process which is less easy to detect and whose manifestations are often less clear, more insidious and often difficult to intuit. Food intolerance happens due to the formation of antibodies to certain foods, but not the Ig-E type (which trigger an allergic process), if not in a first stage the immunoglobulin A type and, after multiple stimuli or successive contact, sometimes for long time, the formation of immunoglobulin G.

Thus, certain foods can trigger more obvious digestive disorders, but others may cause insidious symptoms, difficult to relate to it, precisely because they are moderate pathologies and of the chronic type. Clinical manifestations that have been linked to food intolerance include:

Dermatological processes (16%): Acne, eczema, psoriasis, rashes, urticaria.

Gastrointestinal disorders (50%): abdominal pain, constipation, diarrhea, bloating, irritable bowel syndrome.

Neurological complaints (10%): Headache, migraine, dizziness, vertigo.

Respiratory discomfort (10%): Asthma, rhinitis, respiratory distress. In these cases it may overlap with an allergic process.

Psychological disorders (11%): Anxiety, lethargy, depression, fatigue, nausea, hyperactivity (especially in children).



FOOD INTOLERANCE TEST

In obese people who do not respond to standard treatments for thinning, weight loss was experienced by eliminating foods from the diet which presented a high sensitivity. For this reason, a food intolerance test can be very suitable as evidence to be included in regular clinical examinations, prior to the establishment of a diet to treat obesity.

It consists in conducting an analysis of the specific sensitivity of our immune system, by using a minimal blood extraction, compared with 90 different foods, which will tell us in a few days what we can eat without fear, what we should avoid and what should we completely remove from the diet as it causes harm to our health. From this point a list of recommendations is elaborated, if necessary, a customized diet to eliminate the harmful effects that these foods are causing us.

Improvements have been found between half and two thirds of the cases, which have met the diet established by your doctor, removing aliments which have been indicated as not recommended through analysis. Generally, improvement is seen between 20 and 60 days of having established the appropriate diet. It is therefore an important option to consider within the group of diseases described, and which can be improved simply by removing the cause or aliment that originates them.