There is an increasing problem,
which is not overly recognised. We found that overweight and obesity
was very very high. So the problem of obesity is terrible. My favourite food is lasagna. My favourite food are hamburgers. Er, Chinese food. My favourite food is tomato and lettuce salad. My favourite food is pizza. The World Health Organisation says that
obesity is a body mass index over 30, and overweight is between 25 and 29.99 If the patient is overweight, or is obese,
maybe it’s because it has some more Some more intake of calories or energy,
and doesn’t expend a lot. There are many diseases that are linked to obesity. There are cardiovascular diseases, diabetes mellitus, stroke, acute myocardial infarction, hypertension, metabolic syndrome. You can have also sleep apnea,
musculoskeletical damage, especially in joints. You have a propensity to infections and also the obesity
causes an inflammation status of the patient. And also the patients that have obesity
are exposed to thromembolic problems. If you have hypertension and also diabetes mellitus,
those are predisposing factors to myocardial infarctions. Obesity has an impact in life expectancy of our patients,
the people expected life is less than the average. And also in the quality of life. It can be physical and it can be psychological. Physical because you can’t do all your activities, usual activities. You can you can’t move, you can’t be active for a long time, you have to rest, you can’t do sport. And also the psychological impact of obesity. Because you are not well received in our society if you are overweighted or obese. I think there are some links between obesity and depression, and also that affects your quality of life. I can tell you that in our country the main mortality cause now is cardiovascular disease. And I am sure that it became like this because we have For years we have changed our alimentary,
our meals and our foud has changed a lot. Because we use fast food all the time. For lunch, I always eat soup, it can be any soup,
and rice with chicken, that’s it. In the afternoon I eat the same as for lunch. Lunch is sometimes rice with fried chicken and a vegetable soup. For lunch I ate meat, meat with rice and salad. For breakfast I had bread, eggs and fruit juice. We became much more urban than in 1986 And people eat much more times outside the home, including the weekends. There was a definitive change in cooking patterns. There is an increasing problem, which is not overly recognised. So we decided that we need to know what is going on with the population in Ecuador And we decided to do a national survey and combine Not only the problems of deficit, but also the problem of access along with the identification of some parameters of chronic diseases. We found when we measure by some basic indicators of what is the the situation in chronic disease We found for example that hypertension affected half of the population. We found that the only weight and obesity was very very high. Overweight depending on the group of age is over 30%, over 35% But the increment of overweight and obesity in school children is very high, nearby 30% percent. In adolescents exactly the same, and in adults, it jumped to 40 to 60 percent, including the elderly people. So we, after this data, we find out that we are facing with an epidemiologic transition in a very very fast mode. In Ecuador in a couple of studies right now in Galapagos, the beautiful islands the best in the world, nevertheless present the highest rates of overweight and obesity in the country. It’s unbelievable. The other thing that we see, is that among the so called poor population, mostly the indian population. They are shorter because they were malnourished when they were kids. They are also presenting higher rates of overweight and obesity. That means the velocity of increment of overweight was much faster than the velocity of decrease in stunting. And that is when we talk about the double burden of disease, that is one of the concerns. But in terms of urban areas the coastal area are higher in obesity and overweight than the sierra, the mountain area. For one thing they are exposed to more sugary drinks because of the temperature. The consumption of drinks, processed drinks that have suger, is unbelievable. And it’s going high. I don’t remember the figure, but it’s going in this direction But also juice that they put with a lot of sugar. If you tell me what is the group of population which is more affected, I could say you cannot make an exception. Taking in consideration specific characteristics, all the population are affected. So the problem of obesity is terrible. But it’s not only the issue of figures, because that is easy to say you know: “This population is less or more.” The whole issue is, what are the determinants of these problems. Because then you have to talk about the transition from rural to urban, and what it means in terms of lifestyle. You have to talk about the transportation system. More and more people use means to move from one place to another. Means less physical activity. You also have to talk about the exposition of ultraprocessed food and processed food that is in general with a high increment in sugar, salt and fat. And that means you really have to recognise that the industry is playing a very negative role in the presence of overweight and obesity. But how you compete with the industry, that they can provide to you an item that you can buy and you can eat. You don’t need to cook, you don’t need a dish, you don’t need a fork, you don’t need a knife. You just open the container and eat it, and you are eating an excess of sugar, excess of salt, excess of fat. In addition there is another problem, and that is an external influence from the US culture: the oversizing. We not only are exposed to ultraprocessed food, but also with the local food that is served in big amounts. So it’s very difficult to make people aware because when you start taking issues that are related to personal interests then you go beyond science. You have to deal with politics and with policies and with commitment and that is very difficult. Especially now that the problem of nutrition is not the problem of a country. It’s a problem that is being moved by international organisations, by international NGOs, and by donors. Now in the world everybody’s busy and everybody was running. There is no priority for life, you know, for healthy lives. And how we undertake the importance of being healthy until we get old. Because we are going to get old anyway,
but we want to get old healthy. Education alone means nothing.
Education has to go with two things. One is that you have to respect, you have to know the environment and what are the positive and the negative factors that can influence in your diet. And the second thing is that you have to have a less obenogenic environment. That is, you provide food that is healthy anyway. You provide the possibility of access to healthy food
or to eat what you prepare in the house. So that is, this is my definition of education. Okay, along with that you have to educate the children. Them you have to educate, because they are learning,
they go to school for learning. You have to teach them to learn to like the good food,
to enjoy the good food, to sit and eat. So I think the schools can play a very very important role if you develop this kind of strategy. Because if you change for good the habits of the children, that would last forever. Healthy food, for me, is food that gives energy and vitamins and things like that. Vegetables and fruits. Like apples and vegetables. Okay, for me, healthy food are fruits, salads, food that is not very heavy. Healthy food, are the food that make our body good,
and make us healthy people.

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