New Report States the World is in “Nutrition Crisis:” How We Can Help Address the Double Disease Burden Caused by Poor-Quality Diets

| October 1, 2016

Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania.


Dear Colleagues,
In a previous editorial, I discussed the different types of diets prescribed for weight loss and referenced clinical trials that discovered the following: caloric restriction by approximately 500 calories per day and sustained adherence are the key predictors of successful weight loss and maintenance.[1-3)] While quantity via caloric restriction is important, there is another factor to consider—diet quality.

Last month, a report released by The Global Panel on Agriculture and Food Systems for Nutrition titled “Food systems and diets: Facing the challenges of the 21st century,” brought to light the devastating link between poor quality diets and the world’s disease burden, stating that we are facing a “nutrition crisis.” One of their key findings:
Three billion people from 193 countries now have low quality diets and nearly half of all countries are experiencing the simultaneous problem of serious levels of undernutrition, overweight, and obesity. Yet our global understanding about the quality of our diets is limited

In our field, we are aware of the statistics on obesity and related disease. This report addresses malnutrition as a whole contributing to a “double burden” of both undernutrition and overweight. The authors of the report warn that this situation is set to worsen dramatically over the next 20 years as powerful drivers of change, such as population growth, climate change, and urbanization, converge on food systems. They list clear priorities for action at national and international levels, as well as detailed advice and guidance for decision makers in all countries.

I believe that we can learn from this advice and play our part in helping to reverse this crisis by emphasizing the message of high-quality diet in conversations with patients.

The report (available at http://glopan.org/foresight) recommends “stressing the importance of eating a diverse diet made up of safe foods, drawing on as many food groups as possible, with plenty of fruits and vegetables, wholegrains, fiber and nuts and seeds, while limiting free sugars, sugary snacks and beverages, processed meats and salt, and replacing saturated and industrial trans fats with unsaturated fats.”
I think we are already echoing this this message through diets prescribed, including the Mediterranean, low-fat, and low-carbohydrate diets. These diets also address the issue of quality, incorporating more foods that are of higher nutritional value, such as the monounsaturated fats (MUFAs), vegetables, nuts, and legumes, and protein. But there is another part of the diet equation of which we are all aware: obstacles that come with the reality of everyday life.

We are healthcare professionals in the field of obesity management but we are also human. We understand the challenges that stand in the way of eating healthy: cost, convenience, time, and accessibility—the elephants in the room. I believe that we can attempt to address all of these points by encouraging an approach I’ve touted before: small but significant changes. For example, you can encourage patients to start meal planning, which might help control cost and accessibility, thus leading to better choices and better adherence.

We should also strive for consistency in the message of good diet quality. Patients can benefit from working with dietitians, nutritionists, and other experts. I recommend utilizing these services in the multidisciplinary approach if available or referring patients out.

The bottom line is that good nutrition achieved through high-quality diet is a priority in treating obesity for both weight loss and overall health. We can do our part in helping patients keep it top of mind.

Should you have feedback on this message or any recommendations for encouraging high-quality diets, please submit a Letter to the Editor. We would love to hear your thoughts.

Sincerely,

Christopher Still, DO, FACN, FACP

References
1.    Foster GD, Wyatt HR, Hill JO, et al. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med. 2010;153(3):147–157.
2.    Bazzano LA, Hu T. Effects of low-carbohydrate and low-fat diets. Ann Intern Med. 2015;162(5):393.
3.    Dansinger ML, Gleason JA, Griffith JL. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293(1):43–53.
4.    Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK.

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