The dynamic is the same as in other years: it is to see summer looming on the horizon and decide to go on a diet to eliminate excess weight accumulated over many months. The problem happens – and happens all too often – when you try to lose too many kilos suddenly, resorting to rigorous regimes and the recommendations of pseudo-experts in social networks. "We carry out highly restrictive diets that can not only lead to nutritional deficiencies, but also pose a risk for developing eating disorders. After a period of restriction it is common to find another binge, either because "I deserve it", after achieving my goal, or because by not reaching it "at least I will eat what I like", explains Daniel Ursúa, dietitian-nutritionist and disseminator. Reduction of muscle mass, kidney or liver failure, cardiovascular damage, psychological consequences... Weight loss, in addition to temporary, can be very expensive.
The true specialists are clear: it is advisable to flee from miracle diets, magic pills and great restrictions, and resort to nutrition professionals with proven training and experience. More than losing weight by subjecting ourselves to unsustainable diets over time, it is about assuming definitive changes in habits that improve our health and in which weight loss is a side effect. That is to say: no periods with beginning and end "in which we make an effort to make a series of changes, and then return to our previous routine," warns Ursúa. And, above all, distrust the internet of the guidelines set by influencers without the necessary training and "of all those people who collaborate with dietary supplements or slimming products. It is always necessary to check the information with other sources such as disseminators with a certain trajectory or official guides, "he adds.
In a 2014 TED talk, neuroscientist Sandra Aamodt recalled that, five years after dieting, most people have regained it, and 40% even gained additional weight. On the contrary, "incorporating healthy habits into our lives is relatively easier. We must always prioritize adherence to changes: if it does not cost you too much to incorporate them into your daily routine, that will make them last over time, "adds Beatriz Nespereira, doctor in Biochemistry and editorial coordinator of the European Center for Masters and Postgraduate Studies (CEMP).
Obesity and overweight, a silent pandemic
The incidence of obesity leaves little room for doubt: in the world there are already more than 800 million people who suffer from a condition that favors the appearance of cardiovascular problems and other chronic diseases, in addition to contributing to a worse quality of life and early mortality. In Spain, according to the Global Obesity Observatory, 37.8% of adults weigh more than recommended and 16% are obese, while the data on the child population are not far behind, with 21.6% overweight children and 11.8% obese, according to the Pasosstudy of the Gasol Foundation.
Some figures to which we should add that of those who, without reaching these thresholds, fall victim to what the Spanish Federation of Nutrition itself calls "obsession with the cult of the body" and the invasion of perfect bodies in social networks that push others to question their own. A perfect breeding ground for the industry related to rapid weight loss: "There are multiple companies that sell products to lose weight, since it is a very tempting business that moves 100,000 million euros per year in Europe. According to the Eating Disorder Foundation, it is the only profitable business in the world with a 98% failure rate," says Nespereira.
Which experts to trust?
Juan Revenga already says it in his blog El nutricionista de la general: to build a house, we resort to an architect; to fix the car, to a mechanic; for toothache, to a dentist... But, for a nutritional treatment, reaching the dietitian nutritionist implies overcoming a whole tangle made up of family, friends, internet, media and companies in the food industry, among many other elements. "Intrusion is a serious problem because, beyond the damage it can do to the profession, which it does, many patients are put at risk. There are many people who chain one diet after another and end up developing serious health problems," says Ursúa.
Therefore, it is convenient to be clear about who are the most suitable professionals for nutritional advice: there are, in the first place, graduates in Human Nutrition and Dietetics, a degree that includes not only specialized training in nutrition, dietetics and public health, but basic knowledge about Food Science and Technology (among other aspects, knowing how to analyze its composition, properties and nutritional value) and related disciplines such as Physiology, Biochemistry, Anatomy and hygiene and food safety. Another relevant university degree would be that of graduates in Medicine who have specialized in Endocrinology.
The senior technicians in Dietetics, for their part, have completed two years of the corresponding higher degree of Vocational Training, which has enabled them, according to the description of their competences by the Ministry of Education, to "develop diets adapted to individuals and / or groups and control the quality of human food, analyzing their eating behaviors and nutritional needs; program and implement educational activities that improve the eating habits of the population, under the corresponding supervision".
With regard to exercise, an integral part of healthy lifestyle habits, it should be remembered that "in Spain, only people who have a FP in the sports field (such as senior technicians in Animation of Physical and Sports Activities, in Physical Conditioning or in Teaching and Socio-Sports Animation), or the degree in Physical Activity and Sports Sciences can practice as personal trainers; while, for certain activities, people with certificates of professionalism can also practice," recalls Nespereira.
As for postgraduate training, there are also a series of master's degrees that serve for graduates of related disciplines such as Pharmacy, Physiotherapy or Sports Sciences to acquire knowledge of nutrition and dietetics, although that does not train them at the same level as the specialists already mentioned; and even in Sports Nutrition or Personal Training.
Obtaining adequate and lasting results passes, in short, by resorting to professional nutritionists and personal training whose work, according to the CEMP, must go beyond proposing diets or exercise routines:
- It is necessary to investigate the patient's personal history, analyze his health history and his previous experience with training and nutrition.
- Generate a personalized and efficient plan that takes into account the tastes of each person.
- Get motivation, discover the real reason for change, have the support of people close to you and try new things that are fun.
- Promote perseverance and adherence, slowly introducing new habits to adapt to them without problems. It is also advisable to set realistic goals without great demands, in order to avoid feelings of frustration.
Although the figure of the dietitian-nutritionist is usually associated with nutritional counseling consultations or the hospital environment, where they prescribe special diets depending on the different pathologies, the truth is that these specialists have numerous options for professional development such as teaching; research in laboratories, integrated into multidisciplinary teams; the food industry (as an advisor in companies in the sector, in central kitchens, planning diets, or ensuring quality processes); disclosure; community action (focused on prevention and health promotion); personalized nutrition or sports.
For Beatriz Robles, dietitian-nutritionist and professor at the Isabel I University, the biggest challenge for the future has to do with the public health system, as she told this newspaper in March 2022: "The main challenge is to enter public health. Currently we are not, although the data clearly reflect that having dietitians-nutritionists in public health is economically profitable by, for example, reducing the problems of hospital malnutrition (which increase hospital stays)". The lack of these professionals, he continued, "opens a social gap, because it is a mostly private service that cannot be accessed by the population that has fewer resources and that, on the other hand, is the one that presents the greatest health problems related to food."
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