Food has become in recent years one of the most developed sciences of our time. 50 years ago the way of feeding was condemned by the work that was developed, the place where it was lived and the time of year. Thus, for example, the same was not eaten in a province of southern Spain in spring as in northern Germany in summer. And this is not a coincidence, the advancement of globalization has caused that we can currently eating products that are not of season in our city or country because they import them from other countries in such a way that in the supermarket, we have everything, every day.
However, a few years ago this was not the case. We have come a long way in a very short time and the food industry has been able to take advantage of this. The economy and industrialization have meant that if before 500 biscuits were produced in a bakery every day, today more than 5000 can be produced and distributed to all the large companies. And where before, you could only eat once a week today you can eat 5 times in a single day.
The food of today
This is the background of our diet and we must be aware that the changes in habits of our society are imposed by an advance in industrialization and an increase in the availability of products of low food quality but very addictive. As we mentioned, the advancement of technology and the power of the food industry has caused our diets to be rich in food habits that the movement has been reduced in quantity (1, 2). Because of these two factors the numbers of people with obesity have increased worldwide.
This increase is mainly due to the existence of a balance within the kcal consumed and the kcal spent, the so-called energy balance. His theory is simple, if you eat more than you spend the value of the scale will increase and if you eat less than you spend the value of the scale will decrease. However, this approach is a bit of a list since there are other factors that we do not take into account. Hills, A. and collaborators already exposed in 2014 you can not reduce everything to what you eat and what you spend but there are also other factors that are summarized really well in this table.
The summary in this table shows that the total energy expenditure depends on factors that have to do with movement such as energy expenditure per exercise (training) and energy expenditure for physical activity (movement that is not training) and factors related to one’s own existence such as energy expenditure at rest and energy expenditure due to the effect of food. This must ALWAYS be taken into account if we want to make a much more accurate “approach” to food. On the other hand, and although it does not appear in the table, we would have the value of the kcal ingested and we would make a “balance” between the kcal that enters the organism and those that leave.
Once we take this seriously and knowing that a hypercaloric diet maintained over time causes serious health problems in the body, we will emphasize the numbers of benefits that food has in the body and for the treatment of different diseases. To do this, we are going to analyze 3 studies in which the influence of diet on diseases such as type II diabetes mellitus and obstructive sleep apnea is observed.
Diabetes Mellitus Type II
The study we are going to analyze was carried out in 2018 by Vitale, M. and collaborators (3) whose main objective was to evaluate the relationship between the Mediterranean diet and the risks of cardiovascular disease in people with type II diabetes. They got no more and no less than 2568 participants with diabetes. To evaluate the habits of food intake, there is a questionnaire widely used and validated in this type of study called EPIC (European Prospective Investigation into Cancer and Nutrition). This questionnaire has some limitations by its own length (248 items) that may bore the participant, but offers very good information. In addition, the important thing about this study is the adherence to the Mediterranean diet and its effect on health measured through the Rmed (Relative Mediterranean diet score) (4).
One of the most interesting reasons of this study is that women tend to follow the Mediterranean diet better than men, it also seems that older people are more faithful to this type of diet, as well as people from the south of the country (in this case Spain). However, it doesn’t seem to depend on education or socioeconomic factor. Next, the consumption of different foods is detailed depending on whether you have a high adherence or a low adhesion.
As can be seen, 705 people had a high “Score” and it can be seen that they consume fruits, vegetables, legumes, cereals, fish, olive oil and alcohol to a greater extent. On the other hand, when we compare people with a high score vs a low one, we see that there are significant differences in many of the cardiovascular risk factors.
In view of these results, we can conclude, as do the authors, that an approach to the Mediterranean diet, understood as a healthy diet, is associated with a healthier cardio metabolic profile and better glucose control and that, therefore, it should be included in clinical practice.
Obstructive Sleep Apnea
Obstructive sleep apnea is a disease that affects the airways and causes a reduction in airflow to the lungs when we are sleeping. The main cause of this disease is overweight and obesity. Therefore, reducing adipose tissue and controlling weight is one of the most important strategies for this disease. In addition, the common treatment for people with sleep apnea is a device called CPAP that infuses air through a mask when the person sleeps. As you can imagine, it is a very invasive treatment that makes it very difficult to sleep.
Once we take this into account, we will analyze a study called INTERAPNEA (5) in which through nutritional education and physical exercise people with this disease improved not only their weight but also their quality of life. In this case, the nutritional approach was given by a professional nutritionist who developed 8 sessions of nutritional education, that is, he did not impose any diet, he simply advised and reported the benefits and harms of such habits. Below, we have the organizational chart of the sessions:
Thanks to this intervention, people with obstructive sleep apnea managed through an interdisciplinary approach and based on greater information about eating patterns, always combined with physical exercise, to improve their quality of life and have fewer problems derived from obstructive sleep apnea.
Results and conclusions
In view of the results presented and spinning with the beginning of this blog post we can conclude that nutrition is a key tool in the management of different diseases. If we stop for a second to reflect on the times a day we eat a food, we will realize the importance it has. In addition, using a very well-known simile in society, our body is like a car and we must select very well the fuel we give to our body.
Finally, I can only recommend to all readers of the Vitruve blog that, if they have any questions, do not hesitate to contact us and above all I recommend that we are aware that what we ingest today may help us to have a better life tomorrow and to be able to develop a full life, happy and disease-free.
- Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of Ad Libitum food intake. Cell Metabolism. 2020;32(4):690.
- Tobias DK, Hall KD. Eliminate or reformulate ultra-processed foods? Biological mechanisms matter. Cell Metabolism. 2021.
- Vitale M, Masulli M, Calabrese I, Rivellese AA, Bonora E, Signorini S, et al. Impact of a Mediterranean dietary pattern and its components on cardiovascular risk factors, glucose control, and body weight in people with type 2 diabetes: a real-life study. Nutrients. 2018;10(8):1067.
- Buckland G, González CA, Agudo A, Vilardell M, Berenguer A, Amiano P, et al. Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study. American journal of epidemiology. 2009;170(12):1518-29.
- Carneiro-Barrera A, Amaro-Gahete FJ, Díaz-Román A, Guillén-Riquelme A, Jurado-Fasoli L, Sáez-Roca G, et al. Interdisciplinary weight loss and lifestyle intervention for obstructive sleep apnoea in adults: Rationale, design and methodology of the INTERAPNEA study. Nutrients. 2019;11(9):2227.