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Video: A Reasonable Person Can Always Make Up A Healthy Menu For Himself, If There Is A Desire
A reasonable person can always make up a healthy menu for himself, if there is a desire
Healthy eating is an effective tool for reducing morbidity and mortality. About how this tool is used by our medicine, and what is necessary for the Russians themselves to start eating properly, Mednovosti talks with Academician of the Russian Academy of Sciences Viktor Tutelian, scientific director of the Federal Research Center for Nutrition, Biotechnology and Food Safety.
Victor Tutelyan. Photo: Press Service of the Federal Research Center for Nutrition, Biotechnology and Food Safety /
Healthy eating is an effective tool for reducing morbidity and mortality, no one argues with this anymore. About how fully this tool is used by our medicine, and what is necessary for the Russians themselves to start eating right, Mednovosti talks with the scientific director of the Federal Research Center for Nutrition, Biotechnology and Food Safety, an expert of the League of Nation's Health, academician of the Russian Academy of Sciences Victor Tutelyan.
Viktor Aleksandrovich, how do you assess the level of competence of our doctors in nutritionology and how much the factor of healthy nutrition is taken into account in practical medicine?
- Let's start from the beginning, with the fact that nutrition issues in our medical universities are covered unacceptably poorly, and future doctors do not receive a systemic education in this regard. And the system is needed, the science of nutrition - nutritional science - is based on the laws of nature, which no one can violate. Moreover, every doctor must know them.
15-20% of human health depends on health care, and about 50% - on healthy, nutritious nutrition, another third is physical activity and rejection of bad habits.
Of course, no one relieves the responsibility for this from the person himself, but the doctor must equip him with special knowledge. So, serious disturbances in the nutrition of the expectant mother can cause fatal harm to the fetus. For example, the absence of just one simple organic compound, for example, folic acid in the early days of pregnancy, when the fetal neural tube is laid, leads to its defect, and these are congenital deformities and even death. Therefore, a woman of childbearing age must be prepared for an accidental pregnancy and provide herself with adequate nutrition in order to guarantee the health of her unborn child.
Basic knowledge of fundamental nutritional science should be laid down already in the first years of medical universities, together with physiology, biochemistry, and biophysics. And in the senior years it is already necessary to move on to its applied part - dietology. Optimal nutrition, depending on the specific pathology, is the number 1 factor in the patient's rehabilitation. And a doctor of any specialization must know his specifics, be able to apply diet therapy methods in his complex treatment, be it surgical or medication.
But even if doctors have such knowledge, things are not very good with their application in an average Russian hospital. It seems to me that the only thing that can be healed a little on a modest hospital meal is obesity
- On the contrary, it is often possible to acquire obesity in a hospital bed, because the calorie intake in the hospital exceeds the energy consumption of a patient, especially a lying person. And the first law of the science of nutrition concerns precisely the correspondence of the energy value of the diet to energy expenditure. Another thing is that hospital food may be unbalanced, excessive in calorie content and poor in vitamins and microelements. Therefore, until now, the patient's relatives are given advice to go to the market, buy a chicken and bring broth - just as it was 100 years ago. And this despite the fact that today there are recommendations for therapeutic nutrition for each disease and a whole range of specialized products for preventive and therapeutic nutrition have been created.… By the way, there will be a nutritional section in the clinical guidelines, which are now acquiring the status of a law. This requirement was put forward by the Minister of Health, and we are now actively developing such sections.
But for all this to work, every clinic must have a specialist nutritionist, and large hospitals must have an entire nutritional sector. It is these specialists who must properly prepare the patient, for example, for surgical treatment, and then carry out his rehabilitation: provide first with enteral, then specialized nutrition and, finally, restore his usual diet. This is a big, serious science that should work for every patient.
For example, a person has had liver or stomach surgery. And at the same time, it is necessary to ensure the main goal of nutrition - to convey to each cell of the body the required amount of energy, plastic material and minor biologically active substances. To every cell, regardless of the difficulties, when the disease creates obstacles. And the task of dietary nutrition is to facilitate such access. This is such an alimentary food shunting - bypassing a broken link, be it the heart, kidneys, or any other organ.
And if we talk about a conditionally healthy person who wants to stay the same as long as possible. How to "force" people to massively switch to a healthy diet?
- Only through education. According to the monitoring of actual nutrition for 2017 , the average Russian consumes about 40% below the norm of fish, dairy products, vegetable oil, eggs, vegetables and fruits, even potatoes. Their place is filled with unhealthy confectionery, sugar, meat and bread products. The culture of food must be taught, from an early age to a ripe old age, people must receive in an accessible form, including through the media, reliable information about healthy eating, scientifically based recommendations. But so far things are bad with this.
So far, TV screens only advertise sausages and recommendations to help a stomach full of steaks with enzymes and probiotics
- I am not opposed to a person having fun eating a thin piece of sausage. But when they show how her huge chunks are devoured by children, as in the advertisement for "Daddy Can" - it's just wildness. Unfortunately, advertising is a lot of money that no one will refuse. And here I see a way out in the allocation of special channels, special time on the air line of the main TV companies for a direct conversation with a doctor. And this conversation should be not only reliable, but also convincing and targeted. After all, everyone knows that they need to eat less sweet, fatty and salty. But at the same time, from childhood, we have formed our own eating behavior, which runs counter to this. After all, what, for example, does a loving grandmother do for a grandson?
- Pies are not a problem. But let's say the mother of a six-month-old baby refused to breastfeed and went to work. They bought the baby milk substitutes and complementary foods in the store. Today these are, as a rule, competently produced high-tech specialized products, but the grandmother tries - it doesn't taste good. And adds sugar here. And if the next time she doesn't put sugar in her grandson's porridge, he will spit it out, because his eating behavior is already perverted.And then the child just gets a piece of candy - at any time and as much as he wants. But in some European countries, especially northern ones, candy is a delicacy once a week on Sundays, and the child habitually does not require more. But our children are already initially hooked on sweets. Of course, there are people in our country who are interested in a healthy lifestyle and try to eat right. But in general, this must be dealt with very seriously and comprehensively at the state level.
So what is the role of the state here, which ultimately saves money on such prevention? And if healthy eating is beneficial, why isn't it widely promoted?
- It cannot be said that the state does nothing in this regard. For example, Rospotrebnadzor, together with the Ministry of Health, will introduce a new important information tool called "Traffic Light". Its essence lies in the fact that when buying food in a store, a person could not look for microscopic inscriptions about the content of certain nutrients in them, but immediately saw by the color of the "traffic light" how much their composition approaches the recommendations for proper nutrition. Or, on the contrary, it contains an excessive amount of components that are not beneficial to health.
First of all, we are talking about added salt, the daily amount of which should not exceed 5 grams. A large amount of salt provokes hypertension, from which more and more Russians today suffer, and other serious diseases. Fast-digesting carbohydrates and added sugar do not add to health. It is clear that no confection can be prepared without sugar, but the amount of this sugar is important. And, of course, animal fat, which contains saturated fatty acids. We all love sausages, small sausages - tasty, convenient. But they all contain at least 20-30% of such fat, sometimes in an explicit form, sometimes in a latent form. And that means, having eaten 100 grams of sausage, a person gets 30 grams of fat, which is 270 kilocalories. To spend them, you need to spend an hour on a stationary bike.
While the use of "traffic lights" is advisory in nature. But, in the end, it will be beneficial for the producers themselves, who will increase consumer confidence. And already today several large companies have begun to actively paint their products.
Today we have entered a confrontation with nature. The energy expenditures of our women, who do not work continuously in the garden, but lead a sedentary lifestyle, are about 1800 kilocalories, and the men sitting in armchairs - 2000 kilocalories. But the average Russian eats 3000-3500 kilocalories. Where are those extra calories going? - Fat in known parts of the body, provoking all cardiovascular diseases, diabetes.
Therefore, we must motivate our food industry to reduce the content of these three critical substances in products: sugar, salt and saturated fat. But how to put pressure on the industry if the consumer himself is not ready for this? Three years ago, Moscow kindergartens tried to slightly reduce the content of butter, salt and sugar. So parental riots in defense of "deprived" children began, and they had to return to the old standards. And here I again come back to the idea that people need to be educated.
But, probably, it's not only about education, but also about financial opportunities, because healthy food is more expensive. It is known that poor people are more likely to suffer from obesity in recent years. What is your advice to Russians, residents of a country with a lower income: how to maintain a normal diet, eat fewer empty calories and get everything you need?
- I do not agree with this statement of the question, healthy food is not necessarily expensive. See how many wealthy overweight young people are around. And this is not because of poverty, but from a low level of food culture, lack of knowledge, willpower. As for people with modest incomes, healthy omega-3 fatty acids can be obtained with salmon, or with herring. Even with plain linseed oil, which is much more abundant than olive oil. You can buy imported avocados, or you can buy local apples and cabbage, which contain no less vitamins.
The purpose of nutrition is to deliver the required amount of chemicals to each cell. There are about 170 of them in total, and if now there is practically no protein deficiency among Russians, then 40-50% of the population has a deficiency of micronutrients (12 vitamins, as well as various mineral substances and trace elements). This means that metabolism is disrupted, immunity decreases, resistance to adverse environmental conditions. There is no need to chase after expensive advertised products, but people with any income must be taught to build their diet in such a way that it fully meets their needs for nutrients and energy. A sensible person can always make a healthy menu for himself, if only there is a desire.
Is it really possible today to talk about healthy eating when there is only one “chemistry” in stores, especially chain stores? The Internet is full of videos showing how "rice" made of plastic burns
- And I don't agree with that either. Everything that goes to store shelves is controlled by the state in terms of safety for us and future generations. And I, for example, will never look at the content of E150 or E230. I know that more than necessary, this preservative will not be added, it is expensive. And the amount that is required fulfills a certain function, because today we cannot do without preservatives that guarantee the safety of products. Otherwise, food that has not been eaten for several hours, even in the refrigerator, undergoes microbiological spoilage, which is much more dangerous than preservatives. For the most part, modern man has no way to go back to nature and eat the plant or meat he just got.
There are no modern products without food additives, these are all marketing gimmicks. We want the food to be tasty and at the same time guaranteed to be safe. But what you need to look at is the expiration date. In many foreign countries, if 10% of the shelf life remains, such a product is exhibited separately, significantly reducing the price. And our trade, taking advantage of the fact that buyers take without looking, keep such products on the shelf to the last. But I would not recommend paying attention to all kinds of "scarecrows" - the fruits of unfair competition.