Revista Colombiana de Cirugía (Sep 2011)
Obesidad y enfermedades no transmisibles relacionadas con la nutrición Nutrition, obesity and non-communicable diseases
Abstract
La situación de sobrepeso y de obesidad en la población se considera un problema grave de salud pública. Actualmente, en el mundo existen cerca de 1.600 millones de adultos con sobrepeso, de los cuales, 400 millones son clínicamente obesos. En el caso de Colombia, según la Encuesta Nacional de la Situación Nutricional, realizada en 2005 por el Instituto Colombiano de Bienestar Familiar, existe sobrepeso y obesidad en 46% de la población adulta, lo que afecta en forma más importante a las mujeres. La globalización se encuentra ligada a los rápidos cambios socioeconómicos, demográficos y tecnológicos; esto forma parte de la evolución y genera el proceso de la transición nutricional. Los seres humanos han sufrido cambios importantes en su actividad física y su estado nutricional, lo cual ha influido en el desarrollo de las enfermedades no transmisibles relacionadas con la nutrición: la urbanización, el crecimiento económico, los cambios tecnológicos en el trabajo, el procesamiento de alimentos, la cultura y el crecimiento de la información masiva. Los efectos de la modificación de los patrones implican un incremento en el consumo de alimentos, en su contenido calórico, en la disminución del gasto energético, o en todas las anteriores. Diversos estudios han correlacionado la presencia de ciertos tipos de cáncer con obesidad y la dieta es un factor muy importante para prevenirlo. Finalmente, debe considerarse la obesidad como un problema económico derivado de factores tales como políticas gubernamentales, influencia de importantes compañías de alimentos y de la inseguridad alimentaria presente en las clases socioeconómicas menos favorecidas. Es absolutamente necesario implementar programas educativos a diferentes niveles y, sobre todo, a multiplicadores de información, sobre lo que significa una dieta balanceada y la importancia de una alimentación sana en la salud y el bienestar del individuo.Nowaday's, obesity and overweight are considered an important area in public health. Worldwide, it is estimated that nearly 1.6 billion adults are considered overweight, among which 400 million are clinically obese.The infant population is not exempt from this problem, considering that 20 million children under five are overweight. The World Health Organization (WHO) has estimated that by the year 2015 approximately 2.3 billion adults will be considered overweight and 700 million will become obese. In Colombia, according to the “Encuesta Nacional de la Situación Nutricional” conducted by the Instituto Colombiano de Bienestar Familiar (ICBF) in 2005, 46 % of the adult population appeared overweight or obese. Women, in particular, are the largest group suffering from the consequences of overweight and obesity. Globalization is linked to rapid socio-economic, demographic and technological changes, and when coupled with our natural human evolution, it generates a process of nutritional transition. Humans have had major changes in physical activity and nutritional status, which have influenced the development of non-communicable diseases related to nutrition, urbanization, economic growth, technological changes at work, food processing, culture, and the mass media messages. The changes generated in view of this inevitable interaction imply an increase in the consumption of foods leading to an increase in caloric consumption coupled with a decrease in energy expenditure. The major underlying processes that affect the world are related to the products of globalization, the information provided by the media and the influence of large multinational corporations. Soft and/or sugary drinks are important sources of caloric consumption, which stimulate factors related to obesity and increased cardiovascular risk. Barker has introduced the “fetal origin hypothesis”, which suggests that the disturbance by the plasticity of development due to malnutrition during fetal life, infancy and early childhood, permanently change the structure and function of the body by a phenomenon called “programming”. Furthermore, this becomes a determining factor in the development of a group of diseases, including type 2 diabetes, coronary heart disease, myocardial infarction, and hypertension. Because several studies have correlated certain types of cancer with obesity, diet becomes an important factor to prevent it. Finally, obesity should be regarded as an economic problem resulting from factors such as government policies, the influence of major food companies and food uncertainty, which is present in the lower socioeconomic classes. It is necessary to implement educational programs targeted at the different socioeconomic classes and, above all, to transmit the message to “information multipliers” concerning the importance of a balanced diet and incorporating healthy foods for our personal wellbeing.
