Nutrición: Realidad de Hoy, Necesidad del Futuro

Autores/as

  • Patricia Savino Lloreda Pontificia Universidad Javeriana, Bogotá

Palabras clave:

obesidad, sobrepeso, paradoja de la nutrición, enfermedades no trans misibles relacionadas con la desnutrición, jarabe de maíz con alto contenido de fructosa, obesity, overweight, nutrition paradox, nutrition-related non-communicable diseases, corn syrup

Resumen

RESUMEN
Anteriormente el sobrepeso y la obesidad se consideraban un símbolo de riqueza, mientras que la delgadez reflejaba pobreza y enfermedad. Actualmente, en el mundo existen cerca de 1.600 millones de adultos con sobrepeso, de los cuales, 400 millones son clínicamente obesos. Además es posible que se presente en una misma familia la paradoja de la nutrición al observarse simultáneamente unos sujetos con obesidad y otros con desnutrición.

Se considera que el sobrepeso y la obesidad son de causalidad múltiple y que el proceso de globalización es un factor fundamental que ha alterado el equilibrio energético del ser humano, al favorecer la producción y la disponibilidad de alimentos, y disminuir el gasto calórico mediante el desarrollo tecnológico.

Otros factores que predisponen a la obesidad son el bajo peso en los recién nacidos y la alimentación inadecuada de la mujer embarazada y del niño durante sus dos primeros años de vida. A esto se le pueden sumar las diferencias genotípicas ancestrales relacionadas con los factores de supervivencia en medios ambientes difíciles que generan una respuesta metabólica diferente.

Las enfermedades no transmisibles relacionadas con la nutrición, que se dan como consecuencia del sobrepeso y de la obesidad, han crecido en incidencia en forma alarmante, lo cual ha llevado a considerar la cirugía bariátrica como una buena alternativa médica y económica para su tratamiento.

La industria de los alimentos y las políticas agropecuarias y gubernamentales deben considerar la nutrición como un factor determinante en la formulación de políticas orientadas a disminuir este grave y creciente problema de salud pública.

Palabras clave: obesidad, sobrepeso, paradoja de la nutrición, enfermedades no trans misibles relacionadas con la desnutrición, jarabe de maíz con alto contenido de fructosa,

ABSTRACT

Nutrition: a Fact Today, an Imperative Tomorrow

In past times, overweight and obesity were considered symbols of wealth, while skinny figures mirrored poverty and sickness. Nowadays, around 1.6 billion adults are overweight, of which 400 million are clinically obese. A nutrition paradox is currently found in a regular family, where the presence of both obesity and malnutrition can coexist.

Obesity and overweight are considered problems with multiple factors, mainly highlighting globalization as a primary cause, due to both the strong alteration to the energy balance of human food production, as well as the availability of food products that reduce the caloric consumption through technological advancements. Another causal factor for the increasing incidence of obesity is underweight of newborns and the inadequate nutrition that both the pregnant mother and the child receive during the first two years of the child’s life. This is then coupled with strong survival oriented ancestral genotypes and other survival factors in harsh environments, which provoke a different metabolic response.

Non-communicable diseases related to nutrition, generated by overweight and obesity, have increased to alarming levels, making bariatric surgery a feasible medical and economical modality of treatment. The food and agricultural industry as well as governmental legislation, must now consider both health and nutrition as a prime factor in the definition of policies aimed at controlling this increasingly serious public health problem.

Key words: obesity, overweight, nutrition paradox, nutrition-related non-communicable diseases, corn syrup high fructose.

Biografía del autor/a

Patricia Savino Lloreda, Pontificia Universidad Javeriana, Bogotá

Licenciada en Nutrición y Dietética, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia. Master of Business Administration in Health Care, Colorado Technical University, Colorado Springs, CO, USA. 

Referencias bibliográficas

Chopra M, Galbraith S, Darnton-Hill I. A global response to a global problem: the epidemic of overnutrition. Bull World Health Organ.2002;80:952-8.

Caballero B. A nutrition paradox – underweight and obesity in developing countries. N Engl J Med. 2005;352:1514-6.

Corbo S. Apolipoprotein E(APOE) allele distribution in the world. Is APOE4 a “thrifty” allele? Ann Hum Genet. 1999;63:301-10.

Kaput R. Nutritional genomics.New Jersey: John Wiley&Sons;2006.

Kumar D. Genomics and clinical medicine. Oxford:Oxford University Press; 2008.

World Health Organization. Obesity and overweight.Geneva: WHO;2006. Fecha de consulta: 30 de abril 2009. Disponible en: htpp://www.who.int/mediacentre/factsheets/fs311/en/print.html.

OECD.Health at a Glance 2009:OECD Indicators. Oct 19, 2009. Fecha de consulta: 10 de enero de 2010.Disponible en: htpp://www.dx.doi.org/10.1787health glance-2009-22-en.

Centers for Disease Control and Prevention. NCHSHealth E Stats. Prevalence of overweight, obesity and extreme obesity among adults: United States trends 1960-62 through 2005-2006. Nov 19, 2009. Fecha de consulta: 8 de enero de 2010.Disponible en: htpp://www.cdc.gov/nchs/data/hestat/overweight_adult.htm.

Olshanky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352:1138-45.

Centers for Disease Control and Prevention.Obesity and overweight for professionals:childhood:trends:NHANES,Nov 17, 2009. Fecha de consulta: 8 de enero de 2010, Disponible en: htpp://www.cdc.gov/obesity/childhood/prevalence.html.

Olaiz-Fernández G, Rivera J, Shamah T, Rojas R, Villalpando S, Hernández M, et al. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública;2006.

ICBF. Encuesta Nacional de la Situación Nutricional en Colombia 2005. Bogotá: Panamericana Formas e Impresos, S.A.; 2006.

Ono T, Guthold R, Strong K. WHO Global Comparable Estimates. Fecha de consulta: 10 de enero de 2010. Disponible en: htpp://www.who.Int/infobase.

Caballero B, Popkin B. Introduction. En: Caballero B,Popkin B. editores. The nutrition transition diet and disease in the developing world. San Diego,California: Elsevier Science; 2002.p.1-6.

Omran A.The epidemilologic transition: A theory of the epidemiology of population change. Milbank Q.2005;83:509-38.

Popkin B. An overview on the nutrition transition and its health implications: The Bellagio meeting. Public Health Nutr.2002;5:93-103.

Popkin B. Global nutrition dynamics:The world is shifting rapidly toward a diet linked with noncomunicable diseases. Am J Clin Nutr. 2006;84:289-98.

Popkin B. What is the nutrition transition.UNC Carolina Population Center.Fecha de consulta: 18 de mayo de 2009. Disponible en: htpp://www.cpc.unc. edu/projects/nutrans/whatis.

Reardon T, Berdegue J. The rapid rise of supermarkets in Latin America: Challenges and opportunities of development. Development Policy Review. 2002;20:371-8.

Delgado C. Rising consumption of meat and milk in developing countries has created a new food revolution. J Nutr.2003;133:3907S-10S. 21. Delgado C, Rosengrand M, Steinfield H, Ehui S,Courbois C. Livestock to 2020: The next food revolution. Washington, D.C.: International Food Policy Research Institute; 1999.

Popkin B. Reducing meat consumption has multiple benefits for the world’s health. Arch Intern

Med.2009;169:543-5.

Lichtenstein A, Appel L, Brands M, Carnethon M,Daniels S, Franch H, et al. Diet and lifestyle

recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee. Circulation.2006;114:82-96.

Gidding S, Lichtenstein A, Faith M, Karpyn A, Mennella J, Popkin B, et al. Implementing American Heart Association Pediatric and Adult Nutrition Guidelines. Circulation.2009;119:1161-75.

Wolff E, Dansinger M.Soft drinks and weight gain: How strong is the link?Medscape J Med. 2008. Fecha de consulta: 5 de mayo de 2009. Disponible en: htpp://www.medscape.com/viewarticle/578319_print.

Mattes R. Dietary compensantion by humans for supplemented energy provided as ethanol or carbohidrates in fluid. Physiol Behav.2006;59:179-87.

Bray G. Fructose – How worried should we be?Medscape J Med. 2008. Fecha de consulta: 8 de abril de 2009. Disponible en: htpp://medscape. com/viewartcle/575891_print.

Elliot S, Keimm N, Stern J, Teff K, Havel P. Fructose,weight gain, and the insulin resistance

syndrome. AmJ ClinNutr.2002;76:911-22.

Fulgoni III V. High-fructose corn syrup: everything you wanted to know, but were afraid to ask. AmJ ClinNutr. 2008;88:1715S.

White J. Straight talk about high fructose corn syrup: What it is and what it ain’t. Am JClin

Nutr.2008;88:1716S-21S.

Melanson K, Angelopoulos T, Nguyen V, Zukley L, Lowndes J, Rippe J. High fructose corn syrup,

energy intake, and apetite regulation. AmJ ClinNutr. 2008:88:1738S-44S.

Schorin M. High fructose corn syrups, part 1: Composition, consumption, and metabolism. utrToday. 2005;40:248-52.

Duffey K, Popkin B. High- fructose corn syrup: Is this what’s for dinner? AmJ ClinNutr.2008;88:1722S-3S.

Stanhope K, Havel P. Endocrine and metabolic effects of consuming beverages sweetened with fructose, glucose, sucrose, or high-fructose corn syrup. AmJ ClinNutr.2008;88:1733S-7S.

Schaefer E, Gleason J, Dansinger M. Dietary fructose and glucose differentially affect lipid and glucose homeostasis. J Nutr.2009;139:1257S-62S.

Malik V, Popkin B, Bray G, Després JP, Hu F. Sugarsweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk.Circulation.2010;121:1356-64.

Brownell K, Frieden T. Ounces of prevention- The public policy casefor taxes and sugared beverages.N Engl J Med. 2009;360:1805-8.

Jacobson M. Liquid candy: How soft drinks are harming Americans’ health. Washington, D.C.: Center for Science in the Public Interest; 2005. Fecha de consulta: 25 de febrero de 2010. Disponible en: Center for Science in the Public Interest: htpp://www.cspinet.org/liquidcandy.

Ritchie L, Woodward-Lopez, Gerstein D, Smith D,Johns M, Craford P. Preventing obesity: What should we eat? California Agriculture. 2007;61:112-8.

Gerrior S, Putnam J, Bente L. Milk and milk products. Their importance in the American diet. Food Rev. 1998;14:29-37.

Duffey K, Popkin B. Shifts in patterns and consumption of beverages between 1965 and 2002. Obesity. 2007;15:2739-47.

Nielsen S, Popkin B. Changes in beverage intake between 1977 and 2001. Am J Prev Med. 2004;27:205-10.

Brownell K, Farley T, Willet W, Popkin B, Chaloupka F, Thompson J, et al. The public health and economic benefit of taxing sugar-sweetened beverages. N Engl J Med. 2009;361:1599-605.

Barquera S, Hernández-Barrera L, Tolentino ML, Espinosa J, Wen Ng S, Rivera J, et al. Energy intake from beverages is increasing among mexican adolescents and adults. J Nutr.2008;138:2454-61.

Popkin B.The world is fat. London, England: Penguin Books Ltd.; 2009.

Popkin B, Barclay D, Nielsen S. Water and food consumption patterns of US adults from 1999 to

Obes Res.2005:13:2146-52.

McDonald C, Baylin A, Arsenault J, Mora-Plazas M, Villamor E. Overweight is more prevalent than stunting and is associated with socioeconomic status, maternal obesity, and a snacking dietary pattern in school children from Bogotá, Colombia. J Nutr.2009;139:370-6.

American Heart Association. Sugar:Frequently asked questions (consumers).Fecha de consulta: 7 de mayo de 2010. Disponible en: http://www.americanheart. org/presenter.jhtml?identifier=3068663.

Caballero B. Introduction. J Nutr. 2001;131:866S-70S. 50. Caballero B. The global epidemic of obesity: An overview. Epidemiol Rev. 2007;29:1-5.Fecha de consulta: 19 de mayo de 2009. Disponible en: htpp://www.epirev.oxfordjournals.org/cgi/content/full/mxm012v1.

Doak C, Adair L, Bentley M, Montero C, Popkin B. The dual burden household and the nutrition transition paradox. Int JObes.2005;29:129-36.

Popkin B, Mendez M.The rapid shifts in stages of the nutrition transition: The global obesity epidemic. En:Kawachi I, Wamala S, editores. Globalization and health. New York: Oxford University Press; 2007. p. 68-80.

Monteiro C, Conde W, Popkin B. The burden of disease from undernutrition and overnutrition in

countries undergoing rapid nutrition transition: A view from Brazil. AmJ Public Health.2004;94:433-4.

Barker D, Martyn C.The maternal and fetal origins of cardiovascular disease.J Epidemiol Community Health.1992 ;46 :8-11. Fecha de consulta: 28 de febrero de 2010. Disponible en: httpp://www.ncbi.nih.gov/pmc/art.

Barker D, Fall C. Fetal infant origins of cardiovascular disease. Arch Dis Child.1993;68:797-9.

Barker D, Clive O, Forsén T, Kajantie E, Eriksson J.Trajectories of growth among children who have coronary events as adults. N Engl J Med. 2005;17:1802-9.

Barker D.The origins of the developmental origins theory. J Intern Med.2007;261:412-7.

Kajantie E, Baker D, Osmond C, Forsén T, Ericksson J. Growth before 2 years of age and serum lipids 60 years later: the Helsinki Birth Cohort Study. Int J Epidemio.2008;31:280-9

Barker D, Osmond C, Kajantie E, Eriksson J. Growth and chronic disease: findings in the Helsinki Birth Cohort. Ann Hum Bio.2009;36:445-8.

Osmond C, Barker D. Fetal infant, and childhood growth are predictors of coronary heart disease,diabetes, and hypertension in adult men, and women.Environ Health Perspect.2000;108:545-53.

Phillips D. Insulin resistance as a programmed response to fetal undernutrition. Diabetología.1996;39:1119-22.

Baker D, Forsen T, Vitela A, Osmond C, Ericsson J. Size at birth and resilience to the effects of poor living conditions in adult life: Longitudinal study. BMJ.2001;323:1-5.

Yajnik C. Commentary: Fetal origins of cardiovascular risk-nutritional and non-nutritional. Int J Epidemiol. 2001;30:57-9.

Langley S, Jackson A. A increased systolic blood pressure in adult rats induced by fetal exposure to maternal low protein diets. Clin Sci.1994;86:217-22.

Mellanby E. Nutrition and child-bearing. Lancet.1933;2:1131-7.

Mussey R. Nutrition and human reproduction: An historical review. Am J Obstet Gynecol. 1949;57:1037-48.

Hossain P, Kawar B, El Nahas M.Obesity and diabetes in thedeveloping world. A growing challenge. N Engl J Med.2007;356:213-5.

Wild S, Roglic C, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.

Programa Nacional de Salud 2007-2012. México,D.F.: Secretaría de Salud; 2007.

Pan American Health Organization. Diabetes in the Americas. Epidemiological Bull. 2001;22:2:1-16.

Pan American Health Organization. Diabetes Initiative for the Americas (DIA): Action Plan for Latin America and the Caribbean 2001-2006.Washington, D.C.:PAHO; 2001. Fecha de consulta: 21 de marzo de 2010. ,Disponible en: htpp://www.paho.org/English/AD/DPC/NC/dia-action-plan-2001-2006.pdf.

Organización Panamericana de la Salud. Salud en las Américas 2007. Volumen II. Países.Fecha de consulta: 21 de marzo de 2010.Disponible en: htpp://www.crid.or.cr/digitalización/pdf/spa/doc16712/doc16712.htm.

Oh M, Winn J, Poordad F. Diagnosis and treatment of non-alcoholic fatty liver disease. Medscape J Med. 2008. Fecha de consulta: 10 de octubre de 2008. Disponible en: htpp:www/.medscape.com/viewarticle/580930_print.

Grundy S. Does a diagnosis of metabolic syndrome have value in clinical practice? Am J Clin

Nutr.2006;83:1248-51.

Bruce K, Hanson M. The developmental origins, mechanisms, and implications of metabolic syndrome.J Nutr.2010;140:648-52.

Giugliano D, Ceriello A, Esposito K. Are there specific treatments forthe metabolic syndrome? Am J Clin Nutr. 2008;87:8-11.

Zhao Y, Encinosa W. Bariatric surgery utilization and outcomes in 1998 and 2004. Rockville, MD:Healthcare Cost and Utilization Project;2007. p. 1-7.

Encinosa W, Bernard D, Steiner C, Chen C.Use and costs of bariatric surgery and prescription weightloss medication. Medscape J Med. 2005. Fecha de consulta: 30 de abril, 2009. Disponible en: htpp:www.medscape.com/viewarticle/508412_print.

Buchwald H, Avidor Y, Braunwald E, Jensen M, Pories W, Fahrbach K, et al. Bariatricsurgery: A systematic review and meta-analysis. JAMA. 2004;292:1724-37.

Christou N, Sampalis J, Liberman N, Look D, Auger S, McLean J. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. AnnSurg.2004;240:416-24.

Kohn G, Galanko J, Overby W, Farrel T. Recent trends in bariatric surgery case volume in the United States. Surgery.2009;146:375-80.

Nguyen N, Silver M, Robinson M, Needleman B,Hartley G, Cooney R, et al. Result of a national audit of bariatric surgery performed at academic centers.Arch Surg.2006;141:445-50.

Samuel I, Mason E, Renquist K, Huang Y, Zimmerman B, Jamal M. Bariatric surgery trends: an 18-year report from the international bariatric surgery registry. AmJ Surg.2006;192:657-62.

HealthGrades.The Second Annual HealthGrades Bariatric Surgery Trends in American Hospitals Study. Golden, CO: Health Grades Inc.; 2007.

Tillotson J. America´s obesity: Conflicting public policies, industrial economic development,and unintended human consequences. Annu Rev Nutr.2004;24:617-43.

Philipson T.The world-wide growth in obesity: An economic research agenda. Health Econ.2001;10:1-7.

Drenowski A. Fat and sugar: An economic analysis.J Nutr. 2003;133: 838S-40S.

Edelstein SGB. Food and nutrition at risk in America: Food insecurity, biotechnology, food safety, and bioterrorism. Boston: Jones and Bartlett Publishers; 2009.

Crawford P, Lamp C, Nicholson Y, Krathwohl S, Townsend M. Food insecurity may be linked to chidhood obesity in low-income Mexican-American families.Cal Ag. 2007;61:106-11.

Mello M, Studdert D, Brennan T. Obesity- The new frontier of public health law. N Engl J Med.

:354:2601-10.

Seidell J. Epidemiology and health economic of obesity. Medicine.2006;34:506-9.

Nestle M. Food Politics. Berkeley and Los Angeles, California: University of California Press; 2007.

República de Colombia. Diario Oficial, Ley 1355 de 2009; octubre 14, 2009.

Kussmann M, Fay L. Medscape. Nutrigenomics and personalized nutrition: science and concept.

Personalized Medicine. 2008;5:447-55.

German J, Roberts M, Watkins S. Personal metabolomics as a next generation nutritional assessment.J Nutr. 2003;133: 4260-6.

DeBusk R. Nutrigenomics:The foundation for individualized nutrition. In:Grooper S, Smith J, Groff J.Advanced nutrition and human metabolism. Belmont, CA: Thomson Wadsworth; 2005.p. 168-71.

Cómo citar

[1]
Savino Lloreda, P. 2011. Nutrición: Realidad de Hoy, Necesidad del Futuro. Medicina. 33, 4 (oct. 2011), 260–283.

Descargas

Los datos de descargas todavía no están disponibles.

Descargas

Publicado

2011-10-15

Número

Sección

Artículos de Revisión