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'Obesity can't be blamed on genetics'

The number of people with obesity in Spain is on the rise, despite efforts by central and regional governments and nutrition experts to halt the epidemic. Wiki Spanish Food sat down with Professor Ángel Gil, President of the Spanish Society for Nutrition and the Iberoamerican Nutrition Foundation, who explained that genetics is not the reason that certain people are overweight or obese. In his opinion, these illnesses are directly related to lack of exercise, bad eating habits and poor nutrition.

Wiki Spanish Food.- How did it feel to win the NAOS award (for Nutrition, Physical Activity and the Prevention of Obesity) in recognition of your professional track-record?

Winning the NAOS award was, for me, more than just public recognition. It was a great honour and motivates me to continue working to promote healthy eating habits for children. For many years, my work has been focused on the study of lipid metabolism in children and the effects of the structure of certain compounds in breast milk, in particular on children's immune systems.

However, in recent years my research group has been looking at genetic determinants of child obesity and early metabolic syndrome, a condition which notably increases the chances of developing certain cardiovascular diseases. I view the award as recognition for the work my research group has been doing for many years, and it will inspire us to work even harder in the future.

W.S.F.- Why is the number of people with obesity on the rise despite the information available on nutrition?

This is due to several reasons. Obesity is not strictly attributable to nutritional aspects, although they are very important (change in diet, the increase in portion sizes, etc.). Beyond that, there is a very serious problem in terms of sedentary lifestyles and the lack of physical activity. Of course, other environmental aspects also have an impact on the obesity epidemic.

As the first law of thermodynamics says, energy can be neither created nor destroyed, but it can change forms. When we consume more calories than we burn, those excess calories accumulate and are stored as fat. Therefore, we must hammer home the importance of exercising more and changing sedentary habits. It's important to play sports regularly and, in the case of children, they need to engage in moderate to intense activity to ward off this disease.

Children experience a change in lifestyles very early on. In fact, when they're being weaned from breastfeeding, they're given foods which are high in proteins and low in fruits and vegetables. Beyond breast milk, they must start eating a healthy diet from the very beginning so as not to suffer from obesity later in life.

W.S.F.- To what degree does genetics influence the onset of this illness?

A person has genetic information that would give him a 70% risk of acquiring obesity. This situation has developed over thousands of years. Man has always had to search for food, and having fat allowed him to survive periods of famine. However, that is no longer the case: we don't need an abundance of food, especially in developed countries.  

Genetic susceptibility exists, but 95% of obesity cases are due to multiple genes and various causes. So we can't blame obesity on genetics, even when we have genetic determinants which make us more likely to be overweight.

And even when our genes make us more susceptible, if a person consumes less calories than he burns, he doesn't gain weight. Nevertheless, it's true that we have genetic variants which make some people more likely to be obese or overweight.

And with a nutritional diet and physical activity, that is to say, with a healthy lifestyle, the genetic determinant can be reversed.

W.S.F.- Are certain foods "prohibited" for overweight people or is it that a sedentary lifestyle is increasingly common?

No foods are absolutely off limits; if they were they wouldn't be food. It's a good idea to eat a bit of everything, it just has to be in the right quantities. We should eat between 5 and 7 servings of fruits and vegetables per day, whereas high-energy-dense foods should be eaten only occasionally. But there are no foods that can't be eaten.

It all depends on quantity. For example, virgin olive oil is an extraordinary product when we consume the right amount. Eating too much means eating too many calories.

Each product must be consumed in the right context. To that end, the Iberoamerican Nutrition Foundation (FINUT), of which I am president, recently created a pyramid of healthy habits which addresses the three aspects I mentioned earlier: nutrition, physical activity and environmental characteristics. They are an integral part and, accordingly, it's necessary to stress that, in terms nutrition, there are no "bad foods", there are only foods that should be consumed in larger or smaller quantities.

W.S.F.- How do you view the increase in bread consumption in recent months?    

This is excellent news, since data in the last few decades showed a decline, from 250 grams per person per day, to 52 grams. This contrasts with childhood obesity, which has increased from 4.8% in 1984 to 18% currently. Unfortunately, consumption of bread, a Mediterranean food, and of fruit and vegetables has declined, while the consumption of industrial baked goods has risen.  

At any rate, I'm pleased that bread consumption has expanded in recent months, which will result in a reduction in the consumption of other foods. Bread is also an important part of the Mediterranean diet. Data from this year aside, the numbers show that bread consumption in Spain has fallen by 500% in the last two decades. This is very bad news because bread has been replaced by other foods made with white flour, saturated fats, etc.

W.S.F.- Do you believe the government should take specific measures to combat obesity? If so, what would you suggest?

The government can get involved—and it is. The Ministry of Health is setting out guidelines, within the NAOS program, to encourage healthy lifestyles. For the last two years, the Spanish Agency for Food Safety and Nutrition (AESAN) has been working tirelessly on the NAOS program. There's also a PAOS program (on food and beverage advertising aimed at children), which many food industries are joining with a view to promoting a healthy lifestyle.

There's still a lot to be done; however, national and regional governments have an obligation to promote healthy habits which, at the end of the day, means investing in disease prevention. Enough resources need to be invested for this to happen.

Additionally, the government's messages are only partially reaching citizens, and in some cases they are considerably distorted. In this day and age, the media is very influential, and not just traditional mediums like TV, radio and the paper, but especially the internet, where there is inevitably a lot of misinformation and false data. In this regard, we are all responsible. As healthcare professionals, we must provide people with clear, simple, science-based information. There's still a very long road ahead, but I believe that, at least in Spain, the governments are aware that obesity is a very serious problem, especially for children.

W.S.F.- Why are the Canary Islands and Andalusia the regions with the highest obesity rates?

Most likely this is due to eating habits which revolve around high-calorie foods. It's also very closely linked to the decline in exercise.

However, there's no reason to think we have different genetic determinants; Spain has a very mixed population. It's also worth noting, though, that less than 1% of human obesity is attributable to genetic variation. 

The regional differences are due to less healthy lifestyles compared with other regions, such as Navarre and the Basque Country, for example.

W.S.F.- Do you believe the food industry is doing enough to stop obesity, or could it do more?

It's not doing enough, but many segments are on the right track. Some have joined the PAOS program, where companies commit to not cater advertising to children under 12 and to provide correct information on labels, etc. Nevertheless, it's not enough, and we must continue put pressure on them. Hopefully, in the near future, 100% of the food industry will be involved in these types of initiatives, where a fundamental aspect is promoting healthy habits.

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25/07/2017