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WGO Handbook on Diet and the Gut_2016_Final

World Digestive Health Day WDHD – May 29, 2016 GREAT SIGNIFICANCE OF LATEST PAN AMERICAN HEALTH ORGANIZATION NUTRIENT PROFILE MODEL TO PREVENT GROWING OBESITY INCIDENCE NATALIE NABON DANSILIO, MD Gastroenterologist Assistant in Gastroenterology Department National Medical School at Hospital de Clínicas, Director Prof. Henry Cohen Montevideo, Uruguay Obesity prevalence is an alarming health problem worldwide, but even more so for the Americas, where it reaches the highest rates. Over the last few decades, global strategies aimed to stop or slow down this pandemic phenomenon have clearly failed. Obesity and overweight related diseases have turned out to be the first causes of morbidity and mortality throughout American countries, surpassing disabilities and deaths due to malignancies, infection, and malnutrition. Fiftyfive percent of all deaths are currently caused by associated obesity and overweight diseases. Obesity and being overweight affect 62% of adults in the Americas, with Mexico, Chile, and the USA being at the top of the list. Seven out of ten adults in these countries are obese or overweight. Concern grows further when checking prevalence rates in childhood and adolescence; obesity and being overweight have also been constantly increasing in this group, reaching prevalence rates of 25%. Several robust investigations have already found a cause/ effect relationship between diet and obesity. Unanimously, studies show that energy excessive input is a hallmark of the modern diet. This energy excess poses a threat to physiological mechanisms of weight homeostasis. After many years of hard scientific search, investigations managed to disclose the main issue behind the excess of energy in diet. It is not only the energy excess itself, but also its quality, that really makes the difference for human health. Belief in the caloric hypothesis has finally weakened since components in alimentary products are now considered potent hormone and neurotransmitter triggers for nutrition science. Most of the ingredients used in the process of food production add a powered effect in terms of metabolic responses, when compared to “in natura” food effects, which have less impact on energy body regulation. Subsequently, repetition in the consumption of processed food leads to well-known underlying hyperinsulinemia, the very early stage in the development of overweight and obesity disorders. In order to facilitate the recognition of healthy or unhealthy food, four categories have been proposed: 1. “In natura” food is directly obtained from plants or animals (such as leaves, fruits, eggs, and milk) and is ready to consume without any kind of modification after leaving nature. This type of food couples physiologically with human metabolic pathways and helps to preserve weight homeostasis. 2. “Minimally processed” food is the result of “in natura” food after a minimum modification process, such as drying, polishing or grounding of grains, meat freezing, or milk pasteurization. In this group, components like oils, fats, sugar, and salt (critical nutrients) are moderately used in culinary preparation to add flavor and diversity to dishes without affecting nutritional balance. This kind of food is still harmonious with human metabolism. 3. “Processed” food is mainly produced by the addition of critical nutrients to “in natura” food or “minimally processed” food. Some examples include: canned vegetables, syrup fruits, canned meats, cheese, and packaged bread. This kind of food is created to last longer than “in natura” or “minimally processed” foods, but it loses original nutritional qualities detrimental to health balance. 4. “Ultra-processed” food is characterized by several manufactured steps. Most of it is represented by industrial exclusive components, such as refined vegetable oils, high fructose syrup, synthetic proteins, modified starch, petroleum and coal derived synthetics, colorants, flavoring, and additives. Some examples include: soft drinks, stuffed biscuits, ice cream, sweets, sweetened cereals, cakes mixtures, cereal bars, soups, pasta and sauces ready to heat, sweetened milks and yogurts, energy drinks, and frozen meal products ready to heat. These are all high energy dense and their components impact directly on metabolic pathways, impairing hormonal and sensorial balance, and accelerating weight gain. When compared to “in natura” or “minimally processed” foods, “processed” and “ultra-processed” foods have much more sugar, unhealthy fat, and sodium. Furthermore, “processed” and “ultra-processed” foods lack diet fiber, minerals, and vitamins, while carrying higher energy density. Even with all of these harmful characteristics, “processed” and “ultraprocessed” foods are still conveniently practical, ubiquitous, strongly publicized, extremely palatable, and habit stimulat 54 WGO Handbook on DIET AND THE GUT World Digestive Health Day WDHD May 29, 2016


WGO Handbook on Diet and the Gut_2016_Final
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