Dorit Adler, B.Sc , MPH, PhD student, Director of the Nutrition and Dietetic Department, Hadassah Medical Center, Ein Kerem
We live at a time when the epidemics of obesity, diabetes, and certain types of cancer are spreading at a worrying pace. These days, most of the population suffers from overweight, meaning the “norm” has changed. At this rate, in a few years time, only a small fraction of the population will not suffer from obesity. Once people’s homes are full of cakes, biscuits, unhealthy snacks, sugary sweetened beverages (SSBs), “burekas,” and other high energy foods, it is almost impossible not to put on weight.
The main reasons for today’s spread of the obesity epidemic are mainly environmental–the obesogenic environment we have created.
Most foods eaten today are processed, and most processed foods are dense with calories and low in essential nutrients. One hundred grams (100g) of processed foods may provide hundreds of calories, almost 10 times more than 100g fruit or yogurt, which provides around 50 calories. Most of the foods around us, at home, work, restaurants, events, are calorie-dense foods, which generally come in large packages.Food portions have grown over the years, and are now about three times larger than they were 30 years ago. For example, a bagel 30 years ago may have contained 80 calories and today contains about 300 calories. As the portion sizes grow, we eat more. The SSBs we drink provide us with empty calories that do not have any effect on our satiety, contributes to weight gain and even to a new epidemic–fatty liver disease. These products are increasingly available in increasingly wide ranges of flavors and packaging. The wider the variety, the more we eat. Advertising campaigns have become more aggressive, and we as consumers are consistently meeting the consumption targets set for us by the food industry. Food packaging has become a marketing tool, beaming messages and captions, many of which are misleading.
These are all central factors in accelerating the spread of obesity.
New “tools” are required to enable people to lead a healthy, balanced lifestyle whilst faced with a powerful environment promoting obesity. Trustworthy information and tools to promote healthy food changes, healthy and tasty cooking, control over portion sizes and the ability to stand up to surrounding temptations, are all essential.
Western society has built an environment that is not suited to the physiology of the human body. Man was meant to move around a lot, and eat smaller amounts. Meanwhile, our environment is designed so that we have no reason to move at all, and we are, in effect, “drowning in food.” We are surrounded by food wherever we go–meetings, funerals, wedding or other happy events. Even if we go hiking in a remote valley, at the end of it, we will be greeted by a mobile kiosk. Vending machines selling fast foods and snacks are all easily accessible to the whole population, from adults to children, even in the education system. Today, one portion of certain foods can provide our whole day’s energy requirements, and it is therefore no surprise that being overweight is now normal.
However, despite the environmental factors working against us, we can change and adopt healthy food habits–and enjoy them. In the last decade, several key studies have been published, which prove one can change one’s eating habits and keep them for years. These studies have proved time and again that a comprehensive nutritional approach dramatically reduces the risk of developing Type 2 diabetes, repeated heart attacks and hypertension. The effect of integrating a number of nutritional changes, together with physical activity, on prevention of these diseases, was highly significant.
However, despite all these studies proving one can take on a variety of changes over time, as the obesity epidemic spreads like wildfire, so too does the “epidemic of diets.” New diets appear daily, each time with new messages. They use different approaches, mostly based on limiting certain food types, but no one has proven to be advantageous over the others. Most diets are based on self control with food. However, since the environment has a central role in the development of obesity, these factors also have a major role in prevention and treatment of obesity. In such an environment, one needs a variety of tools to enable one to lead a healthy lifestyle. And regulation has an important role to protect the population, as happened with cigarettes.
We at Hadassah have developed a comprehensive new model, “The Hadassah Way to Healthy Nutrition and Weight,” based, first and foremost, on the principles of healthy nutrition. These principles have been proven in key studies in the last decade to have a dramatic influence on prevention of diabetes, hypertension, and cardiovascular diseases.
Yes, one can prevent diabetes, recurrence of heart attacks and hypertension, by making a few changes in our eating habits, combined with physical activity. The changes required are small but significant.
The emphasis in our new model is on principles and not calories, on healthy nutrition and healthy weight that were proven to prevent development or recurrence of NCD (non-communicable diseases), and not just on weight. The model is based on principles and not prohibitions. These principles are the core of healthy nutrition. Our philosophy is comprehensive, and emphasizes what it is important to eat, as well as what it is advisable to leave out of home. Since much of today’s consumed goods are processed, it is important to equip our clients with a wider range of tools, including critical knowledge, in order to decipher what is real and what is a marketing ploy. We equip them with knowledge and insight on food portions that are proving beyond human proportions, control over increasing calorie density, tools to choose and buy healthy foods in a market of misleading information and advertising. The principles of fast and healthy cooking, the identification of personal “danger areas,” when it comes to eating habits. These are all accompanied by increasing client motivation. Yes! It is possible to change eating habits and physical activity, and make them an integral part of our lifestyles.
Moreover, one can enjoy them! This is not a magical new formula; it is a real pathway which equips one with knowledge, understanding and the tools required to manage one’s diet and weight in a sustainable way. This new model uses a variety of aids aimed at making it easy for clients to adopt this model and equips them with the tools required to change their nutritional environment, to one which discourages eating unhealthy foods in an uncontrolled manner, leading to obesity and ill health.
Major components of the model:
- A Holistic Attitude–Healthy Nutrition–Not Only Calories.
- Emphasis on Habits: Breakfast, Family Meals…
- Emphasis on what is important to eat: Vegetables, Fruits, Nuts, Etc.
- Empowering Motivation
- Emphasis on the Food Surroundings: Food Portions, Caloric Density
- Acquisition of a tool box to help organize and control one¡¦s nutrition: food diary
- Physical activity: pedometer
- Emphasis on demonstration and experiences in both the individual and group programs
- Our staff has attended preparation courses in Motivational interviewing, Nerative, CBT and group leadership–and we are always open to new projects.
Adopting a healthy lifestyle results in a better feeling overall, at all levels, and this can be possible in the long term, through personal consultations on nutrition, through group treatments for healthy weight and diet. In addition we run courses to develop healthy nutrition skills, based on this new, applicable approach. The consultations are accompanied by experience, distribution of material and aids to help absorb and apply the data and turn it part of the daily life.
The approach encompasses small changes in nutritional makeup of food, quantity, purchasing of food, cooking and food choices at parties and events, which can lead you to far greater and more significant results than you could ever imagine.